Gestational diabetes – a pregnancy problem

Gestational diabetes, like type 1 diabetes and type 2 diabetes, it increases the level of glucose (sugar) in the blood. When you eat, the digestive system converts food into glucose, a substance necessary to live.

Glucose enters the blood and cells use it as “fuel”. With the help of insulin, a hormone produced by the pancreas, muscles, fat, and other cells in the body absorb glucose. If, however, the pancreas does not produce enough insulin, then the excess glucose remains in the blood, is not converted into energy and diabetes occurs. During pregnancy, the body becomes resistant to insulin, so that more glucose feeds the fetus. Most pregnant women do not have a problem, as the pancreas secretes more insulin when it has to process excess glucose. In some cases, however, if the pancreas does not meet the need for insulin, blood sugar (glucose) levels rise too much and gestational diabetes occurs. This condition must be diagnosed and treated as soon as possible, so as not to affect the health of the mother and fetus. Unlike other types of diabetes, gestational diabetes is not a permanent disease, but disappears on its own with the birth of the child.

However, this condition that appeared during the 9 months of pregnancy predisposes the woman to long-term diabetes.

Gestational diabetes risk factors

Gestational diabetes can occur in any pregnant woman, but there is an increased risk in the following situations:

• Obesity

• The previously born baby weighed more than 4.5 kilograms at birth

• One of the mother’s parents or siblings suffers from diabetes

• The pregnant woman suffered from gestational diabetes during another pregnancy.

Gestational diabetes symptoms

Often, gestational diabetes is not manifested by symptoms, but the following signs should sound the alarm:

• Increased thirst

• Continuous need to urinate

• Dry mouth

• Fatigue.

How Gestational Diabetes Affects Pregnancy

If the mother suffers from gestational diabetes, the following situations may occur:

• The baby may exceed the normal weight, which means that difficulties may occur at birth.

• Polyhydramnios – too much amniotic fluid, which in turn can cause premature birth.

• Preeclampsia – hypertension during pregnancy, which in turn can cause other complications.

• Blood pressure in the fetus at birth, which requires treatment.

• Fetal loss – in very rare cases.

Gestational diabetes treatment

First of all, it is essential to constantly monitor the level of glucose in the blood. This means that you need to check your blood sugar 4-5 times a day: in the morning, when you wake up, after every meal and in the evening, at bedtime. Then, you must adopt a healthy diet. Portions of food should be decent and food should be healthy.

The number of kilograms must be kept under control if the diagnosis of gestational diabetes has been made. Fruits, vegetables and whole grains should be staple foods during pregnancy. Consult a nutritionist to make a specialized diet plan. Sport should also be part of your life, especially during pregnancy.

Physical activity lowers blood glucose levels and stimulates the body to convert glucose into energy.

If your doctor thinks that changing your lifestyle is not enough, he will prescribe insulin injections to lower your blood sugar. About 10 to 20% of women diagnosed with gestational diabetes need insulin injections.

The importance of screening tests

Somewhere between week 24 and week 28 of pregnancy, your doctor will most likely send you to a lab for screening tests to detect gestational diabetes. If you have a higher risk of developing gestational diabetes, your doctor may send you to the lab for tests just before the 16th week of pregnancy. It is important to detect such a problem during pregnancy, especially since the tests are valuable, and so your doctor will know what treatment to recommend.

If you fall into the high risk category, you will receive a free specialist consultation, which may include blood tests to determine the current stage of diabetes!

Gestational diabetes is a temporary condition – which only occurs during pregnancy – in which your body does not produce an adequate amount of insulin, so your blood glucose level is high. During pregnancy, hormones secreted by the placenta block the action of insulin secreted by the mother in her body. This problem is called insulin resistance and makes it very difficult for the mother’s body to use insulin. Insulin requirements may increase in these conditions up to three times the normal value.

For many pregnant women it will not be a problem because their pancreas will compensate and secrete even more insulin. In some cases, however, this does not happen. Without insulin, glucose cannot leave the blood to be converted into cells into energy and accumulates in the blood to high levels, a situation called hyperglycemia, and the result will be gestational diabetes.

How do I know if I have gestational diabetes?

You are more likely to get diabetes if you:

You are obese – your body mass index is over 30

You have previously given birth to a baby weighing> 4.5 kg

You had a gestational diabetes at a previous pregnancy

You have a history of polycystic ovary syndrome

You have 1st degree relatives with diabetes

Although gestational diabetes is not common, you may experience the following symptoms:

  • You feel tired
  • Your mouth is dry
  • You are thirsty
  • You urinate frequently
  • You get recurrent infections, such as oral candidiasis
  • You have blurred vision

Many of these symptoms are somewhat normal during pregnancy and the woman does not give them importance until the diagnosis of gestational diabetes. Hence the absolute need for testing for gestational diabetes in 24-28 weeks of pregnancy.

What tests are done to diagnose gestational diabetes?

The test for gestational diabetes is called the oral glucose tolerance test and is performed in the 24-28 weeks of pregnancy. You will need to go to the doctor’s office to perform the test. The night before and in the morning of the test you will not have to eat anything or drink water. A nurse will take a blood sample to get a basic level of your fasting blood sugar. Then you will drink a sugar drink (75 grams of glucose) and after an hour and two hours, respectively, the nurse will collect blood again to see how the body responded to the load with glucose.

Thus, the oral glucose tolerance test with 75 g of glucose involves performing three blood glucose tests: On an empty stomach (normal <92 mg / dl) At one hour (normal <180 mg / dl) Two hours after ingestion of 75 g glucose (normal <153 mg / dl). According to the American Diabetes Association (ADA), it is considered gestational diabetes if at least one of the three blood glucose levels is greater than or equal to the established threshold.

How is gestational diabetes treated?

The most important aspect of treatment is the control of blood glucose levels. All women diagnosed with gestational diabetes should monitor their fasting blood sugar and blood sugar two hours after meals, preferably using a finger blood glucose tester. It is recommended to obtain blood glucose In addition, your diabetes specialist will advise you on how to combine a healthy diet with an exercise program. If you were overweight before becoming pregnant, your doctor will recommend reducing your calorie count and doing at least 30 minutes of moderate physical activity a day.

If diet and exercise are not enough to control your blood sugar, you will need special treatment or insulin injections. In addition, your doctor may recommend that you have additional ultrasounds – every 4 weeks between 28-36 weeks of pregnancy – to check how your baby is developing and how much amniotic fluid there is. He will also advise you to be careful and check your child’s movements regularly. If you notice any changes in this regard, tell your doctor immediately.

How will diabetes affect a child’s development?

Many women with gestational diabetes will give birth to healthy children because this condition can be identified in time and treated appropriately. However, if not diagnosed and treated with the utmost care, gestational diabetes will lead to fetal damage and complications during pregnancy, birth and immediately thereafter, but also long-term, evident in childhood or young adulthood.

The increased level of glucose that the fetus receives through the placenta will stimulate insulin secretion to get rid of this excess sugar. Receiving a greater amount of energy than necessary for growth, the fetus will deposit the excess in the form of fat and gain weight, becoming larger and heavier at birth than normal (macrosomia). Also, uncontrolled diabetes can cause an increase in the amount of amniotic fluid, a condition called polyhydramnios.

How will diabetes affect the birth of a child?

Pregnancy diabetes increases the risk of having birth complications, such as premature birth. During pregnancy, the doctor will check the blood sugar level, and the baby will be monitored regularly to detect signs of fetal distress. Depending on how the pregnancy will go, you may be advised to induce labor or cesarean section between 38-40 weeks of pregnancy. Another option after the 38th week of pregnancy is to wait for the birth to start naturally, while the pregnancy is frequently monitored by ultrasound. In addition, your doctor may advise you not to give birth in water, as both you and your baby should be closely monitored during birth.

How will diabetes affect the baby after it is born?

Because insulin secretion is high during pregnancy and low glucose intake after birth, a below normal drop in glucose (hypoglycemia) may occur in the baby’s blood. Blood glucose levels will need to be monitored for some time in the neonatal intensive care unit. In addition, babies born before week 37 of pregnancy will need special care. It has also been shown that babies whose mothers had gestational diabetes have an increased risk of becoming obese and developing type 2 diabetes in adulthood. Breastfeeding and a healthy diet later in life, as well as a regular exercise program will protect them from these diseases.

Will I have diabetes even after I give birth?

The diagnosis of gestational diabetes is maintained only during pregnancy. After birth, if diabetes persists, it will be classified as type 1 diabetes, type 2 (most common) and rarely secondary, depending on the situation. If the blood sugar returns to normal after birth, it should be noted that the mother has a very high risk of developing gestational diabetes in a subsequent pregnancy or even diabetes outside the pregnancy. As a result, all women diagnosed with gestational diabetes should perform an oral glucose tolerance test with 75 g of glucose at 6-12 weeks after birth to determine the degree of impaired carbohydrate metabolism after birth. In addition, the discovery of gestational diabetes that later disappears after birth is associated with an increased risk of developing type 2 diabetes throughout life. For this reason, it is recommended that women who have had gestational diabetes be tested for diabetes at least once every 3 years.

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