Gestational Diabetes In Pregnancy

Gestational diabetes is a type of diabetes specific to pregnancy and is caused by too much glucose (sugar) in your blood.

Diabetes in Pregnancy

Normally glucose levels are controlled by insulin, however during the second and third trimester of pregnancy some women have higher levels of glucose detected in their blood. It is estimated that gestational diabetes effects up to 14% of pregnant women.

What causes gestational diabetes?

  • A hormone called insulin, which is produced by the pancreas, controls the amount of glucose in your blood.
  • Hormonal changes during pregnancy make your body insulin resistant. Simply put, your cells respond less well to insulin and the level of glucose in your blood stream remains high.
  • Some women have higher levels of glucose in their blood and their bodies cannot produce enough insulin to transport the glucose into your cells, which is known as gestational diabetes.

Risk Factors

You may be at increased risk of developing gestational diabetes if:

  • Your body mass index (BMI) is more than 30
  • You have had a big baby over 4.5kgs in the past
  • You have had gestational diabetes in a previous pregnancy
  • You have a family history of diabetes
  • Your nationality is South Asian, Caribbean, or Middle Eastern

Screening

Every pregnant woman should be offered screening for gestational diabetes during pregnancy to identify those more at risk. The type of test and when it is performed may vary in different regions, but should be available to all women. Some women may be offered screening in the first trimester, but the general regime seems to be a blood test for a random blood sugar at 28 weeks with further tests such as a glucose tolerance test if the glucose results are raised.

Treatment

If you develop gestational diabetes, you will be advised about monitoring and controlling your blood sugar levels. For the majority of women simply changing your diet and increasing the amount of exercise you perform is enough to manage your condition. Occasionally, medication will be required to control your diabetes. Your obstetric team will monitor your health and your baby’s closely.

Complications

If gestational diabetes is not detected or managed effectively, it may cause complications for you and your baby. These include:

  • Pre-eclampsia a condition that causes high blood pressure and swelling in pregnancy
  • Placental abruption (which is when the placenta separates) is more common most likely due to the effects of pre-eclampsia
  • Premature labour with complications of prematurity for baby
  • Large baby (macrosomia) which leads to more labour and birth complications such as shoulder dystocia (shoulders get stuck)
  • Babies may suffer from hypoglycaemia (low blood sugar) and jaundice

Conclusion

Gestational diabetes is a growing concern as the average weight of our population increases. Screening programs are very good at detecting gestational diabetes and effective management may help to reduce the risk of complications for both mother and baby. Women that have had gestational diabetes are much more likely to develop it in a subsequent pregnancy and are also more prone to type 2 diabetes later on.

Photography: DQmountaingirl @Flickr

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