What exactly is gestational diabetes? Is it the same as a patient with diabetes becoming pregnant?
Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes.
To understand gestational diabetes we need to understand what diabetes is. In simple terms diabetes is a condition where the glucose level in blood is higher than normal because the body cannot use it properly. All of us have an organ called pancreas in our abdomen which makes a hormone called insulin. Insulin is the key that unlocks the door to the body’s cells. Once the door is unlocked glucose can enter the cells where it is used as fuel. Diabetes develops when we either make too little insulin or the insulin we are making is not working properly.
Gestational diabetes is a type of diabetes that arises during pregnancy usually around 24 to 30 weeks. Gestational diabetes occurs when the body cannot produce enough insulin to meet the extra needs of pregnancy.
How common is gestational diabetes?
Although in USA it happens in about 4 % of all pregnancies, in India about 15% of all pregnancies may develop this condition.
What exactly causes gestational diabetes?
We do not for sure as what causes gestational diabetes but there are a few theories. The placenta supports the baby inside the uterus as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This leads to the glucose level to rise in the mother`s blood.
Which groups of women are more likely to develop gestational diabetes?
The risk factors for developing gestational diabetes include
• Obesity
• Family history of diabetes
• Large baby in the previous pregnancy (> 4.5 kg)
• Gestational diabetes in previous pregnancies.
• Unexplained stillbirth in the previous pregnancy.
How do we diagnose gestational diabetes?
This is done by two blood tests: one fasting and the second two hours after ingestion of 75 grams glucose by talking blood from a vein. A fasting glucose value of > 126 and/or a two hour post 75 grams glucose value of 140 imply that there is gestational diabetes.
How can gestational diabetes affect the baby?
The high blood glucose levels in the mother`s blood reaches the baby and as a result the baby gets more energy than it needs to grow and develop and this extra energy is stored as fat. This can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. The newborn may also have very low blood glucose levels at birth.
How do we treat gestational diabetes?
Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don’t have gestational diabetes. It may also include daily blood glucose testing. Often blood glucose levels can be controlled by diet .If blood glucose levels cannot be controlled by diet alone then insulin may be needed.
Does it go away after the baby is born?
It does go away in most cases. The diabetes treatment is stopped after delivery. However, to be sure the mother should have blood tests (fasting glucose and glucose level two hours after 75 grams glucose) about two months after delivery.
Women with gestational diabetes have a 30% risk of developing diabetes during their lifetime. Healthy diet and maintaining appropriate weight for height may prevent progression to diabetes later in life.
While gestational diabetes is a cause for concern, the good news is that you and your diabetologist, gynaecologist and dietitian can work together to lower your high blood glucose levels. And with this help, you can turn your concern into a healthy pregnancy for you, and a healthy start for your baby.















Posted in Endocrinology |