Gestational Diabetes During Pregnancy
Let’s discuss how diagnosis occurs, doctors diagnose gestational diabetes between the 5th and 6th months of pregnancy through:
1- Fasting Blood Glucose Levels
- Prediabetes: levels are between 100-125mg/dl.
- Gestational Diabetes: levels are higher than 125mg/dl.
2- Initial Glucose Tolerance Test
This test has another name which is the glucose screening test. It doesn’t require fasting for the previous hours. In this test, you will drink a sugar-containing liquid or syrup. Then, after 1 hour, the doctor will take a blood sample to examine. If the blood glucose level is 140 mg/dl or more, a further test is needed.
3- Oral Glucose Tolerance Test
For this test, you should fast for at least 8 hours. You will take oral glucose or drink glucose dissolved in water. Then, the doctor will take several blood samples: at time zero, after 1 hour, after 2 hours, after 3 hours, etc….If your blood glucose levels are high in several samples, you will be diagnosed with gestational diabetes mellitus. Doctors may ask for an oral glucose tolerance test if the initial glucose tolerance test is high, but sometimes it is not recommended.
4-Hemoglobin A1C (Hb A1C)
It is a form of hemoglobin. It is composed of hemoglobin and glucose. In Diabetes Research and Clinical Practice Journal on November 2017, A study done on 1195 women found that Hb A1C is not a confirmatory test for gestational diabetes during the first 3 months of pregnancy, but it has two-three advantages which are:
- It is a cheap test.
- Oral glucose tolerance test is sometimes not safe for you, so Hb A1C is preferred.
- It is a follow-up test in the case of gestational diabetes is already diagnosed.
5-Glucose in the Urine
Gestational diabetes symptoms
Now, let’s move to the symptoms that might appear on you if you are a diabetic woman during pregnancy.
Unfortunately, women with gestational diabetes usually show no clear symptom or sign. However, mild symptoms can appear such as:
- Increased frequency of urination. high blood glucose levels draw water to the kidneys, increasing urine volume and the frequency to urinate. However, you shall note that it is normal that pregnancy increases the frequency of urination, so it may not be a confirmatory clue for gestational diabetes.
- Increased thirst. Due to the excessive water loss through the kidney, you will need to drink more
- Blurred vision
- Abnormal weight loss
- Weight gain above the standard. Normally, during pregnancy, there is a gradual weight gain with a certain amount. A study in Diabetes and Clinical Research Practice Journal in July 2018 concluded that, if you gain weight above the normal level, it may be a sign of gestational diabetes.
- Infections of the vagina, bladder or skin.
Complications of Gestational Diabetes
For the good news, If you have controlled gestational diabetes, you will return back to normal blood glucose levels. Your baby will be healthy and will be delivered safely. On the contrary, uncontrolled conditions lead to complications for you and your baby.
The Complications that may Affect you Include:
- Abnormal blood pressure: Gestational diabetes increases the risk of high blood pressure. Pre-eclampsia and eclampsia are states of high blood pressure that occurs during pregnancy. It threatens the life of the mother and the baby. Eclampsia is more severe and very dangerous.
- In the future, diabetes mellitus can develop. Uncontrolled gestational diabetes can turn into diabetes type 2 after pregnancy. It will be a lifelong disease. Also, you will have an increased risk of having future gestational diabetes on the upcoming pregnancy.
- Difficult delivery: this happens, when the baby is overweight.
A study done on pregnant women with gestational diabetes in July 2018 in Diabetes and Clinical Research Practice Journal showed that their weight may decrease or increase, which will affect their normal health and pregnancy tolerance.
- You are at risk to develop heart diseases, kidney disease, nerve damage and retinal damage(you may lose your vision).
Gestational diabetes complications that Can Affect Your Baby :
- Diabetic Hypoglycemia (low blood glucose level): If you have gestational diabetes, Your High blood glucose levels pass through the placenta. This stimulates your baby’s pancreas to produce more and more insulin. As a result, the baby will suffer from low blood glucose levels after the delivery. The excessive decrease in blood glucose level or repeated Low blood glucose level, affect the brain of the baby and causes seizures.
- High birth weight: Due to high blood glucose levels, the pancreas increases insulin secretion, which causes the baby to grow too much. The baby will have an excessive weight of 4.05 kg or more, which will cause difficulties during delivery, baby injury and may require a cesarean delivery.
- Low birth weight: Gestational diabetes may affect the growth of the baby and stop it. Thus, the baby is either has high or low birth weight.
- Early delivery: High blood glucose level of the mother leads to the early birth of the baby before the 9 months are complete. Or, due to the excessive weight of the baby, it is recommended to deliver the baby early.
- Respiratory problems: Due to gestational diabetes and early delivery, the lungs of the baby are still immature. He/she will suffer from difficulty in breathing.
- Metabolic disorders: Risk of diabetes type 2 is present in later life besides obesity. Obesity may develop starting from the first day of the baby’s life when born for a mother having gestational diabetes. Obesity is a risk factor for diabetes type 2.
Gestational diabetes management
It is easy to manage gestational diabetes when it is discovered early. The management will depend mainly on the mother’s lifestyle. There are several ways that you should align and do together to keep you and your baby safe, They include:
- Eat a healthy and balanced diet. You should decrease food rich in fats and calories, increase fruits, vegetables and whole grains. Make a variety in your food and eat controlled amounts. (follow with a dietician or your doctor.)
- Before and during pregnancy exercise or walk for at least 30 minutes daily. (follow your doctor’s instructions.)
- If you make lifestyle changes and management and your blood glucose levels are still high, You will take insulin injections or oral hypoglycemics. insulin is safer during pregnancy.
- Always check your blood glucose levels, The targeted blood glucose levels are: During fasting 95 mg/dl or less. 140 mg/dl or less after the meal by an hour. 120 mg/dl or less after the meal by 2 hours(according to the American Diabetes Association).
- Weight gain control. Weight gain during pregnancy should be within the normal limits.
- Visit your doctor every week.
- Visit the doctor to check the baby’s weight and development by the ultrasound.
- According to the European Journal of Obstetrics, Gynecology and Molecular Biology in November 2018 a study concluded that vaginal progesterone can prevent pre-term delivery.
How to prevent gestational diabetes
- Before you get pregnant, try to lose some weight.
- If you are already pregnant, do not try to lose weight because it is unsafe, but also try to monitor your weight gain during pregnancy.
- Eat healthily and stay active.
- If you have a previous history of gestational diabetes or a baby of high birth weight, monitor your weight and lifestyle closely and it is important to monitor with a doctor.
Eventually, if you are a pregnant woman with Gestational Diabetes, there is no need to worry. It can easily be managed and complete recovery after delivery is guaranteed. All that you need to do is to monitor your Blood Glucose Level in your normal check-ups. As well as, following a healthy lifestyle. And keep in mind that, Exercise and Healthy food can keep you safe from any chronic disease. Do not overthink your health state while you are pregnant. Enough to take good care of your health for yourself in the coming days and for your baby 😉.