What is Gestational Diabetes?
Morning sickness, nausea, increased appetite, changes in the pigment of the skin, pain and inflammation of ligaments, unexplainable mood swings… These are some of the “mild” effects of the hormonal changes in the body of a pregnant woman. Among the “not so mild” pregnancy “symptoms”, gestational diabetes is on the top.
Gestational diabetes is a condition characterized by high blood glucose levels during pregnancy (especially during the third trimester) in women without previously diagnosed diabetes. This condition is a result of the increased levels of certain hormones made in the placenta, which interfere with the ability of insulin to manage glucose, and the final outcome is the insulin resistance. Even if the pancreas of a pregnant woman usually produces three times the normal amount of insulin, in some cases, the pancreas cannot produce enough insulin to overcome the effect of the increased levels of hormones made by the placenta, so the gestational diabetes interferes. Usually, this phenomenon interferes in the late stages of pregnancy, usually between the 20-th and 24- th week of pregnancy.
Depending on the population studied, this condition can affect an important percent of the mothers-to-be (up to 14 percents).
National Diabetes Data Group (NDDG): gestational diabetes= carbohydrate intolerance of variable severity with onset or first recognition during pregnancy
Unlike type 1 and type 2 diabetes, gestational diabetes usually disappears, within 6 weeks after the baby is delivered.
Which category of mothers is more exposed to the risk of gestational diabetes?
- mothers over the age of 30 years of age;
- overweight mothers;
- mothers with a family history of type 2 diabetes;
- South Asian, Vietnamese, Chinese, Middle Eastern, Polynesian/Melanesian, Native American, African mothers;
- Mothers who have given birth to large babies or who have had obstetric complications;
- Mothers who have had gestational diabetes in previous pregnancies.
Which are the symptoms of the gestational diabetes?
Because of the multiple changes which take place in the body of a future mother, the symptoms of the gestational are hard to observe. Rarely, an increase in thirst or increased urination may be noticed, but they can be put on the pregnancy condition.
How is the gestational diabetes diagnosed?
During pregnancy, the mothers-to-be should take regular blood tests to check their blood sugar level, especially done between 24 and 28 weeks of pregnancy. The most common test is a 50 gram glucose challenge test (GCT). The GCT involves ingesting a drink containing 50 grams of glucose and having the blood sugar level tested one hour later. If the results indicate values are above the normal range (>7.8 mmol/L), the glucose tolerance test (GTT) should be taken. For GTT, patients should be fasting for ten hours prior to and during the test (except for water). Blood is drawn prior to taking a 75 gm gram sugar drink and then again at one and two hours. The normal blood sugar level is under 105 mg per dL.
Does the gestational diabetes involve any risks for the mother or for the baby?
If it is kept under control, gestational diabetes is not an impediment for any mother to deliver healthy babies. However, gestational diabetes that it is not properly managed can cause problems for both the mother and the baby.
- “Gestational Diabetes”- Ronald Coustan, MD