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Thursday, December 05, 2019

What is gestational diabetes? A doctor explains

Among the commonly associated side-effects of untreated gestational diabetes is preeclampsia. This is a grievous condition if not treated on time and can lead to preterm labour and may cause miscarriages in certain cases.

Updated: November 18, 2019 4:12:34 pm
gestational diabetes, pregnancy Gestational diabetes usually resolves after delivery but there are certain risks that are prevalent during pregnancy.

By Dr Mamta Pattnayak

Gestational diabetes occurs in pregnancy, when due to placental hormones, the sugar levels in the body increase at around 24 to 28 weeks. It may be due to sudden gain in sugar levels or sudden decrease in insulin level in pregnancy.

High risk of developing gestational diabetes

· One in seven women is at high risk of developing diabetes in pregnancy.

· High BMI or women who were already overweight and starting their pregnancy are at more risk.

· Family history of diabetes, especially siblings and mother is also a factor.

· Rapid weight gain during pregnancy.

· Women aged over 30 to 35 are more prone to gestational diabetes.

· Other medical conditions like PCOS, high cholesterol, etc, are also triggers.

How to diagnose

In routine practice, we do blood sugar checks after loading a dose of 75 gm glucose on the first visit, then in the 24th week and again in the 28th week of pregnancy.

· The blood sugar range after 75 gm loading dose should be in the range: Fasting <92, 1hr <180, 2hrs <153.

· If sugar levels are more than these values, then there’s a need to monitor with ultrasound of pregnancy and Hba1c.

· If a pregnant lady screens positive, then we normally advise first diet and exercise, like regular walks, an endocrine review and regular blood sugar charting.

· If sugar levels are not in control, then sometimes medicines are given and, in some patients, insulin as well.

How does gestational diabetes affect pregnancy?

As the name says, gestational diabetes usually resolves after delivery. However, there are certain risks that are prevalent during pregnancy.

Preeclampsia: Among the commonly associated side-effects of untreated gestational diabetes is preeclampsia. This is a grievous condition if not treated on time and can lead to preterm labour and may cause miscarriages in certain cases.

Stillborn: The risk increases if the mother is not controlling her sugar level properly.

Type 2 diabetes after delivery: It may happen if the mother is not maintaining proper diet, weight management or lifestyle modification.

How does gestational diabetes affect the baby?

Gestational diabetes does not affect the mother much, but can affect the baby.

Macrosomia: Here, the baby grows more than the expected weight. As the mother has a higher sugar level, it travels to the baby, who secretes more insulin and grows more.

Hypoglycaemia: After delivery, the baby’s pancreas secretes more insulin so it can become hypoglycaemic.

Breathing problem: Some babies may develop breathing problems after delivery.

Risk of jaundice: These babies have a higher risk of jaundice after delivery.

Type 2 diabetes: The babies may be at a higher risk of developing type 2 diabetes.

In pregnancy, higher sugar levels can cause harm to the foetus, so it should not be ignored. Gestational diabetes mostly goes away post-delivery, if controlled through lifestyle changes like exercise, diet and a stress-free life.

Diabetes and pregnancy: ‘Even one or two shots of alcohol can raise risk for baby’

(The writer is Consultant, minimal access Gynae surgery, Fortis Memorial Research Institute, Gurugram.)

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