Gestational or pregnancy diabetes
In this article, we will answer some of the most common questions regarding gestational diabetes: its causes, symptoms, and treatment.
what is gestational diabetes?
Like common diabetes or diabetes mellitus (DM), gestational diabetes (GDM) is caused by elevated blood sugar or glucose levels . However, unlike DM, it occurs in women who did not have diabetes before becoming pregnant.
Gestational diabetes mellitus (GDM) arises due to insulin resistance. Insulin is a hormone secreted by the pancreas that allows glucose to be transported to cells to be converted into energy. When insulin does not function properly, sugar accumulates in the blood, and the pancreas increases insulin production to counteract this imbalance. When the pancreas is unable to produce enough insulin , it is called diabetes. If this occurs during pregnancy, it is called gestational diabetes.
This specific type of birth usually reverses after delivery , whether natural or by cesarean section.
What causes gestational diabetes?
Research into the specific reason why only some women develop gestational diabetes during pregnancy is still inconclusive. However, it is known that the increased likelihood of developing it is due to the placenta producing large amounts of hormones that interfere with insulin's action.
However, there are also some risk factors , such as age –women 35 and over–, family or personal medical history –prediabetes or having suffered from it in previous pregnancies, etc.–, being overweight, and even ethnic group –women of African American, Hispanic, Native American or Asian origin–, which increase the chances of suffering from it.
When does gestational diabetes develop?
Because hormone production increases as pregnancy progresses and the fetus grows, gestational diabetes usually develops as early as week 20, that is, in the second half of pregnancy.
How is gestational diabetes diagnosed?
O'Sullivan test
In patients with risk factors for gestational diabetes, the O'Sullivan test should be performed during the first trimester. In pregnant women without risk factors, this test is performed between 24 and 48 weeks of pregnancy. This test is based on the determination of venous plasma glucose 60 minutes after ingesting 50 g of glucose.
In the case of a positive O'Sullivan test (≥140), diagnostic confirmation is necessary by performing the O'Sullivan II test or oral overload test.
Oral Overload Test (SOG)
For the three days prior to the OGTT, pregnant women are advised to follow a carbohydrate-free diet, or at least one with a daily carbohydrate intake of more than 3 g.
On the day of the test, blood will be drawn to determine the baseline value, and then 100 g of glucose in 300 ml of liquid will be administered orally over the course of 5 minutes.
The woman will then be required to remain seated and venous blood samples will be taken after 1, 2 and 3 hours.
What is the normal glucose level during pregnancy?
It is common for blood sugar levels to rise after each meal during pregnancy, but to rule out gestational diabetes, the result of the glucose test -O'Sullivan- must be less than 140 mg/dl or, if it is greater or equal, no more than one altered value should be found in the oral load test.
What are the symptoms of gestational diabetes?
One of the major problems with gestational diabetes is that it does not present symptoms in most women , and for this reason, it is necessary to perform the O'Sullivan test on all pregnant women between 24-48 weeks of pregnancy, regardless of whether or not they belong to the risk group.
What can I do to prevent gestational diabetes?
Women who are part of this risk group will require thorough monitoring involving several health professionals, which is why the Women's Unit has a multidisciplinary team that ensures the well-being of women, and their future babies, in the face of this or any other diagnosis during and after pregnancy.
Likewise, follow a healthy diet , avoiding excessively fatty or high-calorie foods and opting for those with a high fiber content. Also, reduce portion sizes at each meal.
On the other hand, to prevent gestational diabetes, it is recommended that women be active before pregnancy. During pregnancy, they should engage in moderate, low-impact exercise , such as walking or swimming.
Ideally, you should start adopting these healthy lifestyle habits as soon as possible, even before becoming pregnant. The main goal is to begin pregnancy with a body mass index (BMI) between 20 and 25.
What are the consequences of a pregnancy with diabetes?
Following the habits described above is important; however, it won't always guarantee a negative diagnosis. Nevertheless, there's no need to worry: most women with gestational diabetes who follow medical advice give birth to perfectly healthy babies.
In cases where blood sugar levels are uncontrolled, the baby may be overweight at birth and be born prematurely. Furthermore, these babies may experience respiratory distress syndrome and hypoglycemia at birth. In the most extreme cases, fetal death may even occur in utero or after birth.
Gestational diabetes can also cause health problems in women, increasing their chances of developing high blood pressure during pregnancy or developing type 2 diabetes after age 40.
How to control gestational diabetes?
Maintaining a healthy diet and staying active will help manage gestational diabetes. In addition, the medical team will prescribe the appropriate treatment. This may include a special diet, daily blood glucose monitoring, or insulin injections, always taking into account the severity of the condition and each patient's individual circumstances.
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If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling 917303673, schedule an in-person appointment , or book an online consultation if you prefer; always with top specialists.