A medical condition affecting about a hundred thousand women yearly, gestational diabetes (GDM) is a condition that does not receive the attention it deserves. In this article, we would walk through what gestational diabetes is, risk factors for GDM, symptoms, how it is diagnosed, complications and how to prevent it.
What is GDM?
First, a quick background. Insulin is a hormone produces by the body in the pancreas that regulates energy levels by helping convert blood sugar into energy. GDM occurs when hormones produced in pregnancy (e.g. progesterone, human placenta lactogen, cortisol) affect the normal functioning of insulin, leading to an increased level of blood sugar (or hyperglycemia) in pregnant women.
GDM is usually only seen during pregnancy and usually clears up after the baby is born. It usually arises between the 24th and 28th week of pregnancy.
What are the risk factors for developing GDM?
All women are at risk of developing GDM. However, some factors may put you at increased risk. These include:
- Being of Black, Asian or Middle eastern background.
- Having a Body Mass Index of >30 [This can be calculated by Weight(kg)/Height2(m2)]
- Having a previous baby with a birth weight greater than 4 kg
- A family relative diagnosed with diabetes
- A previous pregnancy with GDM.
What are the symptoms of GDM?
Most women with GDM would not present with any symptoms. However, some women may have:
- Sugar in urine. A test done by the nurses at the clinic would diagnose this.
- Frequent urination, but in large quantities.
- Increased thirst
- A dry mouth
How is it diagnosed?
During your routine antenatal visits, the doctor would assess your risk of having GDM. He would ask you questions about your medical background, run a couple of tests around 24 weeks to ascertain your blood sugar levels. The oral glucose tolerance test. The routine urine test during your antenatal visit is also a way of screening for GDM.
What are the possible complications?
While most women with GDM have normal pregnancies, some women may have some of the following complications:
- Accumulation of excessive amounts of the fluid (amniotic fluid) around the baby. This is a potential cause of premature labour.
- GDM can lead to heart abnormalities in the baby.
- There is a risk of infertility, pregnancy loss, or stillbirth.
- Premature labour (these are contractions coming in before you are 36-37 weeks)
- Large babies: The Birth Weight of the baby may be greater than 4 kg.
- Large babies run the risk of injuries during birth.
- If not properly managed, GDM can evolve into Type II Diabetes.
- It can also reoccur in future pregnancies.
Is there any way to treat it?
The fundamental ways include monitoring and control of your blood sugar level and eating a special diet as prescribed by a dietician. You also need to loose weight if you are obese. Medication may be offerred if these fail to control your blood sugar.
Can GDM be prevented?
If you are planning on getting pregnant and you have any of the risk factors above, it is also very important to watch your weight and plan your pregnancies with your doctor.
American Diabetes Association; 24/06/2020; https://www.diabetes.org/diabetes/gestational-diabetes
Thomas R. Moore; 24/06/2020; https://emedicine.medscape.com/article/127547-overview