Gestational diabetes is high blood sugar levels that may develop while you are pregnant and usually disappears after your childbirth. Approximately, 3 to 5 out of 100 pregnant women develop gestational diabetes (3-5%).

How is gestational diabetes diagnosed?

Your obstetrician will use blood tests to diagnose gestational diabetes. You may be advised glucose screening test, oral glucose tolerance test or both.

Glucose screening test:

You may not need to fast for this test. Your obstetrician will draw your blood one hour after you drink a liquid containing glucose. If your blood glucose levels are too high – 140 mg/dL or more you will be advised to go for a glucose tolerance test.

However, this test is not available in our facility. Please check with the site you choose to birth if a glucose screening test is available or not.

Oral Glucose Tolerance Test (OGTT):

Oral Glucose Tolerance Test (OGTT) is usually done between 24 – 28 weeks of your pregnancy. Your obstetrician will ask you to fast for at least 8 to 10 hours for this test.

Once you arrive, you will have your blood sample drawn and then will be given a drink containing 75 grams glucose in 200 ml of water. Further, your blood sample will be drawn one hour and two hours after the drink.

Normal values are as follows:

• Fasting (before drinking glucose) – 92 mg/dL (5.3 mmol/L) or lower
• 1 hour after drinking glucose- 180 mg/dL (10.0 mmol/L) or lower
• 2 hours after drinking glucose- 153 mg/dL (8.6 mmol/L) or lower

Any abnormal value is defined as gestational diabetes.

Cause of gestational diabetes

Normally our body digests the food we eat and produces sugar (glucose) that enters our bloodstream. In this response, insulin is produced by the pancreas. Insulin is a hormone that helps glucose to move from our bloodstream into our body cells, where it is used as energy.

In gestational diabetes, it is thought that the hormones from the placenta that help your baby to develop and grow, block the effects of insulin in your body and raise your blood sugar levels. But the exact cause of gestational diabetes is not yet known.

Who is at risk of gestational diabetes?

Usually, any woman can develop gestational diabetes but you may be at an increased risk if:

• Your body mass index (BMI) is above 30.
• You previously gave birth to a large baby (greater than 4000 grams)
• If you have had gestational diabetes previously
• Previous unexplained stillbirth
• A family history of diabetes

What are the symptoms of gestational diabetes?

You may not notice any symptoms of gestational diabetes but through your routine pregnancy screening tests, your obstetrician might come to know about it.

If at all your blood sugar levels get out of control you may develop symptoms like:

• Increased thirst
• Frequent urination
• Fatigue
• Dry mouth

How gestational diabetes can affect your pregnancy?

If you do not maintain your blood sugar levels during your pregnancy it can lead to problems which may affect both you and your baby.

High blood pressure (Preeclampsia) –

Gestational diabetes can increase your risk of high blood pressure which can cause harm to you and your unborn baby. It can lead to your baby being born early. Your obstetrician will monitor you closely to reduce the complications.

Low blood sugar (Hypoglycemia) –

Low blood sugar levels can be avoided if you monitor your sugar levels closely. If you don’t control your sugar levels during pregnancy, your baby might develop low sugar levels after his/her birth. Your baby’s blood sugar levels will be monitored continuously after birth.

An extra large baby –

High sugar levels during your pregnancy can cause your baby’s blood sugar to be high. It can lead to “macrosomia” a condition in which your baby grows too large due to excess insulin.

Due to high blood sugar levels, your baby receives too much sugar through the placenta. This extra sugar gets converted to fat, making your baby large. Besides this, it can even cause discomfort to you making a vaginal birth difficult. Your obstetrician might advise you to opt for a caesarean in this case.

Treatment and prevention of gestational diabetes:

Your obstetrician will take steps in order to maintain your blood sugar levels in range and monitor your baby closely. If your blood sugar levels are still high, your obstetrician will probably start metformin tablets for you at first.

If you are unable to control your sugar levels or if particular complications like macrosomia, excessive amniotic fluid is observed your obstetrician may immediately start insulin treatment for you. Your diabetic educator will explain you and guide you on how to take insulin injections with the proper timings.

The good news is that gestational diabetes can be controlled by taking a few precautionary measures while you are pregnant.

Important parameters to prevent gestational diabetes:

• Consume a balanced diet of healthy foods – of low glycemic index (GI) with a split meal pattern of eating that will control your blood sugar levels while you’re pregnant. Your dietician will keep a track and plan a healthy and nutritious diet according to your needs during pregnancy to keep your blood sugar levels on track.
• Check with your obstetrician if you can exercise regularly during and after pregnancy to keep your blood sugar levels under control.
• Monitor your blood sugar levels often as directed by your obstetrician.
• After your childbirth make sure you get tested for diabetes after 6 to 12 weeks and then every 1 to 3 years.

What happens with gestational diabetes after your childbirth?

After your baby arrives your body will start to recover from the hard work of pregnancy and childbirth. There is a very good chance that diabetes will go away immediately after your childbirth.

This is especially true if you control your diabetes with a healthy diet and exercise during your pregnancy. But after your childbirth, you need to check your blood sugar levels for several days to make sure that your diabetes is actually gone.

If you don’t control your diabetes during your pregnancy it can affect your baby’s blood sugar levels too. Your obstetrician will immediately take precautionary measures if this happens to avoid any risks.

You will be encouraged to breastfeed your baby within half an hour after birth and then every two to three hours until his/her blood sugar levels stabilize. Your baby will be monitored closely and his/her blood sugar levels will be tested.

After you are discharged from the hospital with your little one, your focus will be caring for him/her. But make sure you take good care of yourself and stick to habits that will help you to keep your blood sugar levels stable. Eat well, exercise regularly, monitor your body weight and start managing your future well to lead a healthy life.