Gestational diabetes often causes no complaints at all, yet without treatment and monitoring it can lead to serious complications for mother and baby. A simple test is enough to detect it in time.
What is gestational diabetes?
Gestational diabetes is high blood sugar that appears for the first time during pregnancy. It usually develops after the 20th week, as the placenta releases more anti-insulin hormones: these hormones weaken the action of insulin and blood sugar rises.
Unlike diabetes that existed before pregnancy, gestational diabetes goes away after childbirth in most cases.
Who is at risk?
Gestational diabetes can develop in any pregnant woman, but the risk is higher in the following cases:
- pregnancy after the age of 30;
- starting pregnancy overweight (body mass index above 30 kg/m²);
- gaining excess weight during the first 18–24 weeks of pregnancy;
- diabetes in the family;
- sugar found in the urine (glucosuria);
- having previously given birth to a baby heavier than 4 kg;
- impaired glucose tolerance, insulin resistance or polycystic ovary syndrome before pregnancy;
- gestational diabetes in a previous pregnancy;
- multiple pregnancy.
How is the glucose tolerance test (OGTT) done?
Blood sugar is checked at the first prenatal visit. If fasting blood sugar is high, a glucose tolerance test – the oral glucose tolerance test (OGTT) – should be done. It is the main method for diagnosing prediabetes, diabetes and gestational diabetes.
Even without risk factors, this test is recommended for all women at weeks 24–28 of pregnancy.
- the test is done in the morning after at least 8 hours of fasting;
- fasting blood sugar is measured first, then you drink 75 g of glucose dissolved in water, and blood sugar is checked again after a set time;
- alcohol, coffee and smoking are not allowed the day before the test;
- during the test you must not eat, smoke or do physical work – otherwise the result is considered invalid.
What are the risks for mother and baby?
Poorly controlled blood sugar affects both the mother’s health and the baby. The risk of the following complications increases:
- premature birth and miscarriage;
- high blood pressure and pre-eclampsia;
- excess amniotic fluid and infections;
- a large baby (macrosomia) and, as a result, a difficult delivery;
- shoulder injuries, breathing difficulties and jaundice in the baby at birth;
- low blood sugar (hypoglycaemia) in the mother.
It is important to know these risks, but there is no reason to panic: women who follow their doctor’s advice and receive proper treatment can have a normal pregnancy and a safe delivery.
What should you do after the diagnosis?
Once gestational diabetes is found, blood sugar should be measured at least 4 times a day – on an empty stomach and 1 or 2 hours after each meal. These readings show in time whether medication is needed.
The basis of treatment is proper nutrition and physical activity approved by your doctor. When these are not enough, the endocrinologist prescribes treatment that is safe in pregnancy, mainly insulin.
Overcoming insulin resistance before pregnancy reduces the risk of “pregnancy sugar” to a minimum.
Dr. Samir Shukurov
What happens after childbirth?
In most women who had gestational diabetes, blood sugar returns to normal after delivery. But this does not mean the problem is completely over: the risk of gestational diabetes returning in later pregnancies is high, and prediabetes and diabetes can develop a few years later.
That is why blood sugar should be rechecked a few weeks after childbirth and then monitored regularly. Women who have had gestational diabetes belong to the risk group for diabetes.
This article is for general information only and does not replace a medical examination.