Gestational Diabetes Mellitus is the high level of sugar in pregnancy. It is a condition where a hormone produced by the placenta hinders the body’s efficient use of insulin, leading to the accumulation of glucose in the bloodstream instead of being absorbed by cells. Typically it resolves after childbirth.

WHAT CAUSES GESTATIONAL DIABETES MELLITUS?

While the exact cause of gestational diabetes mellitus (GDM) remains unknown, several theories attempt to explain its occurrence.

During pregnancy, the placenta serves as a source of nutrients and water for the developing fetus and produces various hormones to sustain the pregnancy. Some of these hormones, including estrogen, cortisol, and human placental lactogen, can impede the action of insulin, a phenomenon known as the contra-insulin effect. This effect typically initiates around 20 to 24 weeks into the pregnancy.

As the placenta continues to grow, it produces increasing amounts of these hormones, raising the risk of insulin resistance. Ordinarily, the pancreas can generate additional insulin to overcome insulin resistance. However, when the pancreas cannot produce sufficient insulin to counteract the effects of placental hormones, gestational diabetes ensues.

WHAT ARE THE SIGNS OF GESTATIONAL DIABETES?

In the case of gestational diabetes, individuals typically do not experience noticeable symptoms or may attribute them to the normal course of pregnancy. The condition is often identified through routine screening. However, some signs that may be observed include:

Increased thirst, heightened hunger with an increase in food intake, dry mouth, fatigue, and a more frequent need to urinate.

WHAT ARE THE RISKS OF HAVING GDM:

Identifying your risk factors for gestational diabetes is more crucial than actively searching for its signs and symptoms. Some women have a higher likelihood of developing this condition, such as those who are:

1. Older than 25 years old
2. Have a family history of type 2 diabetes
3. Have a personal history of prediabetes
4. Experienced gestational diabetes in previous pregnancies
5. Are overweight or obese
6. Belong to a non-white racial background.

HOW GDM IS DIAGNOSED AND WHAT IS THE ORAL GLUCOSE TOLERANCE TEST?

The American Diabetes Association advises screening for undiagnosed type 2 diabetes during the initial prenatal visit for women with risk factors for diabetes. For pregnant women without a known diabetes history, testing for gestational diabetes mellitus (GDM) is recommended between 24 and 28 weeks of gestation.

Furthermore, women diagnosed with GDM should undergo screening for persistent diabetes 6 to 12 weeks after giving birth. It is also suggested that women with a previous history of GDM undergo regular screening for diabetes or prediabetes throughout their lives, with screenings at least every three years.

Your physician will conduct a glucose tolerance test, involving the consumption of a sweet drink containing 50 grams of glucose to elevate your blood sugar. An hour later, a blood glucose test will be administered to assess your body’s response to the sugar intake. If the results indicate elevated blood sugar beyond a specific threshold, a 3-hour oral glucose tolerance test will be required.

For the 3-hour test, you’ll fast for a minimum of 8 hours (the exact fasting duration will be specified by your doctor). Following the fasting period, you’ll consume a beverage containing 100 grams of glucose. Subsequently, blood glucose tests will be conducted every hour for the next 3 hours.

WHAT IS THE TREATMENT OF GESTATIONAL DIABETES MELLITUS?

For the treatment of gestational diabetes, prompt intervention is essential to ensure the well-being of both the mother and the baby throughout the pregnancy and delivery. Your doctor will likely recommend the following measures:

1. Regular Blood Sugar Monitoring: Check your blood sugar levels at least four times a day to keep track of your glucose levels.
2. Ketone Monitoring: Test your urine for the presence of ketones, which are chemicals indicating that your diabetes may not be adequately controlled.
3. Adopting a Healthy Diet: Follow a nutritious and well-balanced diet to manage blood sugar levels effectively. Your doctor or a dietitian may guide meal planning.
4. Incorporating Regular Exercise: Make physical activity a regular part of your routine, as exercise can help regulate blood sugar levels. Consult with your healthcare provider to determine a safe and suitable exercise plan during pregnancy.

WHAT SHOULD BE SUGAR LEVELS IN PREGNANCY?

The American Diabetes Association provides the following blood sugar level targets for pregnant women undergoing blood sugar testing:
Before a meal: 95 mg/dL or lower
One hour after a meal: 140 mg/dL or lower
Two hours after a meal: 120 mg/dL or lower
These recommended targets are designed to help manage gestational diabetes during pregnancy, promoting optimal health for both the mother and the baby. Regular monitoring and adherence to these target levels, in consultation with healthcare professionals, are crucial to achieving effective blood sugar control.

HOW TO PREVENT FROM GESTATIONAL DIABETES MELLITUS?

Indeed, taking proactive steps before pregnancy can help lower the risk of developing gestational diabetes. Key preventive measures include:

1. Maintaining a Healthy Diet: Adopting a nutritious and balanced diet is crucial. Focus on consuming a variety of nutrient-rich foods, including fruits, vegetables, whole grains, and lean proteins, while limiting the intake of processed foods, sugary snacks, and high-fat meals.
2. Regular Physical Activity: Staying active is beneficial for overall health and can contribute to reducing the risk of gestational diabetes. Engage in regular, moderate-intensity exercise, as recommended by your healthcare provider.
3. Achieving a Healthy Weight: If you are overweight, losing excess weight before getting pregnant can be beneficial in lowering the risk of gestational diabetes. Consult with your healthcare provider to establish a safe and realistic weight loss plan.

By incorporating these lifestyle changes before conception, women can promote their overall health and potentially reduce the likelihood of developing gestational diabetes during pregnancy.