Gestational Diabetes

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A growing problem

Two of my friends had gestational diabetes, one during her first and only pregnancy, and the other during her second pregnancy. I don't have too many friends, just a few close ones, so that got me wondering how common gestational diabetes is.

It turns out, that gestational diabetes used to be fairly uncommon, affecting about 3% of pregnancies, but is now on the rise affecting almost 6% to 8% of pregnancies though the numbers vary from various sources. Some new criterion being considered for diagnosis of gestational diabetes may significantly increase the number of diagonsed cases.

What exactly is gestational diabetes?

According to Wikipedia, gestational diabetes or gestational diabetes mellitus (GDM) is a condition in which a woman without diabetes develops high blood sugar during pregnancy. During pregnancy the body naturally becomes more resistant to insulin, so that more glucose is available for the baby. Usually this isn't a problem, as the pancreas make more insulin to process the excess glucose when necessary. However if the pancreas are having trouble keeping up with the rising demand for insulin during pregnancy, then the maternal blood sugar levels rise resulting in GDM.

How bad is GDM?

GDM, which typically occurs after 20 weeks of pregnancy, i. e. after the baby's body is developed, but still has to grow, does not usually cause the birth defects that can be caused by diabetes, if it is present before pregnancy.

However, early detection and treatment of gestational diabetes is important to avoid complications during pregnancy, and for the future health of the baby and the mother after childbirth.

Left untreated, GDM can result in the baby growing very large due to the excess sugar it receives, and therefore increasing the chances of a C-section. Since the baby's pancreas increases insulin production to process the excess sugar, the baby may have low blood sugar levels at birth.

GDM can also increases the risk of premature birth, baby jaundice, preeclampsia, and in very rare cases, it can result in still birth.

Research also shows that women with GDM are at greater risk of developing type 2 diabetes later in life. GDM does not put the baby at greater risk for type 1 diabetes, but does increase the risk of the child always being overweight and eventually developing type 2 diabetes. Women with GDM are at a 60% risk of having GDM again during a later pregnancy.

Symptoms and screening

Gestational diabetes may not have any symptoms or very mild symptoms like fatigue, excessive thirst and increased urination. However, as we have seen, left untreated it can cause some serious problems. So it is important to get timely tests done for GDM.

Typically the test for GDM os done between 24 and 28 weeks of pregnancy, but if you are at higher risk for GDM the test may be performed earlier. The test is called and oral glucose tolerance test (OGTT). It involves a fasting blood sugar test. Then you will be given some sweet drink and then a blood sugar test is performed again after sometime. If the result of two tests shows your blood sugar to be too high, you'll be diagnosed with gestational diabetes.

There is some concern, that this test is not sufficiently effective at detecting all cases of gestational diabetes. So a new screening technique has been suggested involving a sweeter drink and multiple blood tests at different times after the drink to monitor how the sugar levels change.

Risk factors

Though the causes of GDM are not exactly known, studies have identified certain risk factors. Common risk factors include family history of diabetes, personal history of gestational diabetes, obesity prior to pregnancy, history of birthing big babies, age etc. Polycystic ovarian syndrome (PCOS) results in elevated glucose levels and thereby may increase the risk of GDM. Isolated correlation studies have also identified snoring and gum disease as risk factors.

Treatment

Treatment for GDM includes healthy diet, exercise and regular monitoring of blood sugar levels. Urine tests may also be required. In some cases, medication or insulin injections may be necessary.

According to NHS UK earlier delivery may be recommended if there are concerns about the baby's health of if the mother's sugar levels have not been properly controlled.

I am thrilled to be participating in the A to Z blogging challenge 2018.

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Tags: health, women, pregnancy, AtoZ Challenge