What is gestational diabetes?
Pregnancy diabetes is a type of diabetes that occurs during pregnancy and normally disappears just after delivery. The disease is most common among women who are overweight or have family members with diabetes.
A healthy lifestyle considerably reduces the risk of developing Type 2 diabetes.
What is the cause of pregnancy diabetes?
The hormone insulin is produced in the pancreas and acts to decrease blood sugar. During pregnancy women require more insulin, and diabetes occurs if the body is not able to produce the increased amounts. After delivery, the need for insulin decreases back to normal levels and the diabetes will disappear.
A mother who has had pregnancy diabetes will have an increased risk of developing Type 2 diabetes later on in life as the production of insulin decreases with increasing age. This risk can be considerably reduced if a healthy lifestyle is adopted. This should involve following a healthy diet, exercising regularly and maintaining a healthy body weight.
What are the symptoms of pregnancy diabetes?
In most cases, pregnancy diabetes has no external symptoms and is only detectable through screening. Only rarely do symptoms appear. (See the general factsheet on diabetes.)
Screening can be done in the following ways.
A pregnant woman may have her fasting blood sugar measured. (See the general factsheet on diabetes.) This is done if the mother-to-be has one or more of the following characteristics:
- a family history of Type 1 or Type 2 diabetes
- she has previously given birth to very large children (over 4kg)
- she was overweight prior to pregnancy
- she is above 35 years of age
- glucose is present in the urine.
If the fasting person’s blood glucose value is in a ‘grey zone’, another test is often carried out, which is called the ‘sugar-loading’ test. This test is able to detect the existence of pregnancy diabetes. If the blood glucose value is normal, then another reading of the blood glucose level is taken in the 32nd to 33rd week of pregnancy.
How is pregnancy diabetes diagnosed?
By screening and measuring the blood glucose values through a sugar-loading test.
It is also important to consult a diabetologist.
Gestational diabetes treatment
How is pregnancy diabetes treated?
Pregnancy diabetes is always treated with a diabetes diet.
Sometimes it is also necessary to include insulin in the treatment. Quick-acting insulin will be given at mealtimes and slow-acting insulin at bedtime.
Which types of medication can be used?
- Quick-acting insulin as injection.
- Slow-acting insulin as injection.
- Mixed-insulin as injection.
Note: antidiabetic tablets should be avoided because diabetes can be controlled more tightly during pregnancy with insulin and this reduces the chances of complications.
What can be done by the patient?
Maintain a healthy ‘diabetes’ diet that is low in fat and rich in complex carbohydrates such as potatoes, rice and pasta. The diet should also include daily portions of fresh vegetables and fiber.
The patient must measure their blood sugar very regularly in order to decide if the prescribed treatment is helping.
The patient should also consult a diabetologist who has a joint clinic with a specialist obstetrician to monitor the diabetes and the baby’s progress carefully during pregnancy.
After the pregnancy, it is important to get examined once a year in order to find out if the diabetes has developed again.
The likelihood of developing diabetes later in life can be reduced by:
- avoiding becoming overweight
- eating a healthy diet
- exercising regularly
- not smoking (this will benefit both the fetus and mother).
Pregnancy diabetes treatment: Future possibilities
A patient who has not followed proper treatment for pregnancy diabetes will risk their baby being born with a low blood sugar count, being born too large, or other complications. Proper treatment will also lower the risk of deformities and other serious illnesses.
As mentioned, pregnancy diabetes carries a greater risk of developing Type 2 diabetes later in life. It also means that there is an increased risk of toxemia (blood poisoning) and high blood pressure during the pregnancy itself.