Diabetes can affect people of all ages. Diabetes can also occur during pregnancy, or existing diabetes can complicate the pregnancy. The condition is called gestational diabetes.
Pregnancy is a time where a lot of physiological changes occur within a female. For example, females can their immune system changes to accept the foreign fetus growing inside of her, the mood can fluctuate, and so does her blood sugar levels.
Yes, in pregnancy, a previously healthy female can develop resistance to insulin due to hormonal changes in her body, such as cortisol, estrogen, and human placental lactogen.
Gestational diabetes is common, 5% of all pregnancies in the UK are found to have gestational diabetes mellitus, and if not managed properly, it can lead to a lot of unwanted complications.
Risk factors for gestational diabetes
There are several risk factors for gestational diabetes,
- Obesity and over weight – Just like type 2 diabetes, being overweight and obese carry a high risk of developing gestational diabetes.
- Polycystic ovary syndrome (PCOS) – This is a hormonal disorder that occurs in females in their reproductive age. Having PCOS before pregnancy will increase your risk of developing gestational diabetes.
- Lack of physical activity
- Ethnicity – People who are Asian, black, or hispanic decent carries a higher risk of developing gestational diabetes, than white people.
- Family history of diabetes – Females who have relatives with diabetes will carry a higher risk of developing diabetes during pregnancy.
- Previous pregnancy with gestational diabetes – If you had a previous pregnancy with gestational diabetes, then your next pregnancy will have a higher risk of developing gestational diabetes.
How to diagnose gestational diabetes?
According to the latest NICE guidelines, gestational diabetes can be diagnosed in the following ways,
- a fasting plasma glucose level of 5.6 mmol/liter (100 mg/dl) or above or
- a 2-hour plasma glucose level of 7.8 mmol/liter (140 mg/dl) or above.
Women who are already diagnosed with diabetes should keep their,
- fasting blood sugar level less than 5.3 mmol/litre or 95 mg/dl
- a 1-hour PPBS of less than 7.8 mmol/liter or 140 mg/dl
- a 2-hour PPBS of less than 6.4 mmol/liter or 115 mg/dl
What are the complications of diabetes during pregnancy?
Uncontrolled diabetes during pregnancy can have a lot of complications for both mother and child, some of these complications include,
- early induction on labor
- a large baby, this can cause difficulty in labor, it can also lead to a cesarian section
- a large baby has a higher risk of developing episodes of low blood sugar (known as hypoglycemia)
- structural abnormalities including congenital heart problems
- during the third trimester of pregnancy, there is also a risk of stillbirths
Special tests done for mothers with diabetes during pregnancy
- All pregnant women will be offered screening for gestational diabetes by an oral glucose tolerance test.
- A retinal assessment (a test to determine whether your eyes are affected due to diabetes), for women with pre-existing diabetes, unless the woman has been assessed in the last 3 months.
- A renal assessment (a test to determine your kidney functions) for women with pre-existing diabetes if this has not been performed in the last 3 months.
- Measure HbA1c levels for women with pre-existing diabetes to determine the level of risk for the pregnancy.
- A retinal assessment at 16–20 weeks to women with pre-existing diabetes if diabetic retinopathy was present at their first antenatal clinic visit.
- At 20 weeks, an ultrasound scan for detecting fetal structural abnormalities, including examination of the fetal heart,
- At 28 weeks, an ultrasound scan of fetal growth and amniotic fluid volume. A retinal assessment for all women with pre-existing diabetes.
- At 32 weeks, an ultrasound monitoring of fetal growth and amniotic fluid volume,
- Another ultrasound scan at 36 weeks for fetal growth and amniotic fluid volume.
By 37 weeks, your doctors will decide on the mode of the delivery for the baby, they can offer of induction of labor, or a cesarian section, depending on the condition of both mother and child.
Things females with diabetes should know before and during pregnancy
- You should eat a healthy diet, this includes, replacing your high glycemic index food with low glycemic index food.
- A regular exercising, this includes exercising at least 30 minutes a day to maintain a low blood sugar level.
- Take your medications on time to control your blood sugar levels, such as insulin or metformin.
- Keep an eye on episodes of hypoglycemia, especially if you are taking insulin to control your blood sugar levels.
- If you have diabetes or develop diabetes during pregnancy, meet a dietician who will help you to develop a good diet plan.
- Females who develop gestational diabetes, have a higher risk of developing diabetes later in life.
- Children born to mothers with gestational diabetes, also have a higher chance of developing diabetes as adults.
Is gestational diabetes curable?
Gestational diabetes can go to a remission after delivery of the babu, however the condition can persist. And mothers who has had gestational diabetes during pregnancy, has a higher chance of developing diabetes later in life.
In this lengthy article we covered some basics about gestational diabetes, make sure to ask any questions about gestational diabetes with your family physician.
