Gestational Diabetes: Understanding the Basics

By Dr. Ankita Singh in Obstetrics And Gynaecology

Nov 28 , 2020 | 2 min read

Gestational Diabetes- Is high blood glucose levels first diagnosed when the woman is pregnant. It may be pre-existing but is diagnosed during pregnancy or may have started during pregnancy. Dr. Ankita says, it may occur at any stage of pregnancy but is more common during the last three months.

This disease can cause complications for you and your baby during pregnancy, labour and even after childbirth also. The risks may be reduced if it is detected and managed in time.

Are you at risk of Gestational Diabetes?

Although any woman can have gestational diabetes, you are at increased risk if:

You are overweight or obese
History of previous baby with macrosomia
You had gestational diabetes in your previous pregnancy
One of your parents or first degree relatives has diabetes
Family origin is South Asian, African-Caribbeans or Hispanics.
Your age>35 years
Bad outcome in previous pregnancy

How can gestational diabetes affect your pregnancy?

Most women with gestational diabetes can manage to have an uncomplicated pregnancy and delivery outcome. Though the common complications women may witness are:

If your baby is growing larger than period of pregnancy- This may lead to difficulty in delivery, thereby increasing chances of instrumental delivery and caesarean section
Polyhydramnios-Too much fluid around the baby in womb
Premature delivery-before 37 weeks of pregnancy
Pre-eclampsia-condition associated with high blood pressure in pregnancy
Rarely loss of baby(stillbirth)

How to diagnose this condition?

Gestational diabetes is diagnosed by screening tests as it usually does not cause any symptoms.

During the initial assessment, your doctor will ask you certain questions and determine your risk for diabetes in current pregnancy.

About 40-60% females with GDM do not have any risk factors. Usually, stepwise approach is used where a suspicious result on a screening test is followed by a confirmatory test with a glucose challenge (intake of high levels of glucose).

If you fall into a high-risk category, screening tests may be offered directly at the first antenatal visit otherwise screening test is usually done at 24 to 28 weeks of pregnancy.

Management of GDM

Most women can control their sugar levels with diet modification and exercise. Self-monitoring of blood glucose levels can guide you regarding further management of the disease.
You may need anti-diabetic drugs, mostly insulin if diet and exercise are not sufficient.
You will also be closely monitored for the well being of your baby during pregnancy. Earlier delivery may be recommended if blood sugars are not controlled or any other complication arises.

Long-term effects of gestational diabetes

Blood sugar levels usually fall after delivery of baby but women with gestational diabetes are more likely to develop:

Gestational diabetes in future pregnancy
Type II Diabetes Mellitus in future-that requires lifelong monitoring

You should get your sugar levels checked 6 weeks after delivery and thereafter as per your doctor’s advice.

Planning future pregnancies

If you are known diabetic or had gestational diabetes during your last pregnancy and you are planning your next pregnancy, you should see your obstetrician ensure that your sugars are well controlled before you get pregnant. High blood sugar levels can be harmful to your baby in the initial weeks, even before you know you are pregnant.