During pregnancy, especially around the 24th week, many women tend to develop Diabetes. Termed Gestational Diabetes, it is a disorder of blood sugar levels particular during the period of pregnancy. Why does it arise, and what long-term effects does Gestational Diabetes have? How does it affect the growing fetus?
The reason behind diabetes in pREGNANCY
Gestational Diabetes, like regular Diabetes, occurs when the body is unable to produce enough insulin, the hormone responsible for utilizing blood sugars. During pregnancy, your body produces additional hormones and undergoes changes like weight gain, which can ultimately lead to insulin resistance. All pregnant women have a state of insulin resistance in late pregnancy. Some, however, develop it earlier due to certain contributing factors, including:
- Pre-pregnancy overweight
- Gestational Diabetes in previous pregnancy
- History of giving birth to a ‘big’ baby (4 kgs or more)
- Polycystic Ovarian Syndrome
- Pre-diabetic state prior to conception
Diagnosis of Gestational Diabetes?
In most cases, Diabetes in pregnancy does not present with any particular symptom. Usually between 24 to 28 weeks of gestation, screening takes place, to look for rise in blood sugar levels. The tests include:
- Glucose Challenge Test: A 50g sample of glucose will be given to be taken by mouth, 60 minutes following which a blood sample will be taken. Rise in blood sugar above a certain level would require you undergoing a second test, the Oral Glucose Tolerance Test.
- Oral Glucose Tolerance Test: In this test, 100g of glucose is given, after a high value in the Glucose Challenge Test, followed by hourly evaluation of blood sugar for three hours. Along with the pre-administration level of sugar, if there are two or more abnormal readings, gestational diabetes is confirmed.
How does this affect the mother and the baby?
Diabetes during pregnancy can compromise the baby’s condition in the following ways:
- Macrosomia – the baby can grow too large, leading to various difficulties during normal labour
- Respiratory Distress Syndrome – Breathing problems at birth
- Low Blood Sugar at birth
- High risk of intrauterine and neonatal death
Gestational Diabetes can cause the following problems for the mother:
- Pre-eclampsia, i.e. elevated blood pressure during pregnancy, and its associated problems
- C-section – if the baby’s size becomes too large for normal delivery
- Type 2 Diabetes, if it persists beyond delivery
Treatment of Diabetes during Pregnancy
Controlling mild to moderate increases in blood sugar via a healthy diet and physical activity can be the first step. If it is still not under control, your doctor will prescribe insulin therapy that is suitable for you. In the meantime, regular monitoring of the baby’s growth via ultrasound scan, non-stress tests and other modalities is highly recommended to be on the lookout for any emergencies.