Diabetes Information and Treatment Guide | Gestational Diabetes during Pregnancy

Gestational Diabetes during Pregnancy

06.11.2008 by Dr John Anne in diabetes type

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Gestational diabetes (GD) simply means elevated blood sugar during pregnancy. To understand it, you must first understand the normal changes in pregnancy metabolism (34). When you are pregnant, certain hormones make your insulin less effective at transporting glucose, the body’s fuel, out of your bloodstream into your cells. This increases the amount of circulating glucose, making it available to your baby for growth and development. This “insulin resistance” increases as pregnancy advances. As a result, your blood glucose levels after eating rise linearly throughout pregnancy. By the third trimester, you will tend to have higher blood glucose levels after eating than nonpregnant women (hyperglycemia), despite secreting normal and above normal amounts of insulin. During overnight sleep, the excess insulin has a chance to mop up, which causes morning glucose levels to be lower on average than in nonpregnant women (hypoglycemia).Pregnancy Gestational Diabetes

How is it diagnosed?

Checking urine for glucose is a routine antenatal test, but is unreliable for diagnosing diabetes.

All mums-to-be should have their blood sugar level checked between 26 and 30 weeks of pregnancy. This is done by testing glucose levels in a sample of blood on two occasions. One of two tests will be used to do this: the random glucose test or the fasting glucose test.

If you have a high blood glucose reading on the glucose tolerance test it means that natural hormones secreted by your placenta during pregnancy have increased your body’s resistance to insulin; in other words, your body’s cells are not responding normally to insulin. This means that your body needs much more insulin than usual to carry out insulin’s job of helping the body cells and muscles to take up glucose from the bloodstream after a meal. The result is that the glucose stays around in the bloodstream, hence the high glucose reading of your blood test.

Unlike the diabetes that a woman may have before conception, gestational diabetes does not usually cause birth defects, in part because it sets in after all the baby’s major organs have already been formed. One major complication associated with GD is, as you noted, big babies. Macrosomia, the medical term for this condition, occurs when the unborn baby stores extra glucose as fat and sometimes becomes too large to deliver through the vaginal canal. But GD does not necessarily mean you must give up natural childbirth: nearly 70 percent of women with GD are able to give birth vaginally.

Complications of Maternal Diabetes

Women with diabetes need careful pre-pregnancy planning, intensive management throughout their pregnancy and close follow-up after giving birth. This is because gestational diabetes is associated with an increased risk of spontaneous abortion, and with higher perinatal morbidity (sick newborns) and mortality rates. The major cause of perinatal mortality is congenital malformations, and women with diabetes are two to seven times more likely to have congenitally malformed offspring.

Gestational diabetes during pregnancy, increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus) help shift nutrients from the mother to the developing fetus. Other hormones are produced by the placenta to help prevent the mother from developing low blood sugar. They work by stopping the actions of insulin.

The aim of a good pregnancy gestational diabetes diet is to ensure that you do not have to resort to insulin injections till it becomes absolutely necessary. Many women develop diabetes during pregnancy. They need to cut down on sugar and starchy food in their diet. A pregnancy gestational diabetes diet is different from the best pregnancy diet for women without diabetes. Take care of your calorie levels, and how much you are consuming daily as fats, sugar etc.