Risks, Diagnosis and Treatment
Gestational diabetes can occur in any pregnant woman regardless of whether she had diabetes prior to conceiving or not. The rates in certain populations can be up to 12-13%. The exact cause of gestational diabetes is unknown but it is believed to do with the placental hormones and other factors causing a disruption in the mother’s normal metabolism. This disruption causes her body to not metabolise glucose properly causing glucose levels in the blood to rise. This provides excess fuel to the developing baby and can lead to excessive weight gain for the baby.
Risk factors for developing GDM include – GDM in a previous pregnancy, non-Caucasian ethnicity, obesity, PCOS, strong family history of GDM or type 2DM, previous macrosomic infant.
GDM is tested for by way of a fasting 2-hour Oral Glucose Tolerance Test. Prior to the test, the woman fasts then has a fasting blood sugar level taken. She then consumes a glucose load and her blood sugar levels are checked again at 1 and 2 hours after the load is consumed. There are set levels of blood glucose to determine if GDM is present or not.
It is uncommon for women who did not have diabetes prior to conception for it to persist after their baby is born, but a repeat test is usually done 6 weeks after delivery.
While the management of gestational diabetes can cause some inconvenience if it is properly managed by the expectant mother then the risks are lower for her and her baby.
Risks associated with gestational diabetes, if the condition is poorly managed or untreated include problems for both the mother and her child. It is important to note however that some of the health concerns for babies born to women whom were diabetic prior to conception are not associated with gestational diabetes pregnancies
Pregnant women with poorly controlled gestational diabetes are more likely to have a labour that does not progress normally and are at a higher risk of either an assisted vaginal delivery or an emergency caesarean section.
For the unborn child the risk of them developing macrosomia is higher than otherwise normal pregnancies. Macrosomia (being born significantly larger than average weight for age) is caused by the excess glucose available to baby via the mother’s blood stream being passed to the baby through the placenta and stored as fat. This storage occurs because the baby’s developing pancreas cannot produce enough insulin to use all the glucose it’s receiving from mum. Macrosomic babies have an increased risk of shoulder dystocia during vaginal birth (the shoulders getting caught behind the bones of the pelvis), drops in blood sugar levels after birth, jaundice and a higher risk of breathing problems.
Gestational diabetes can be managed and treated through monitoring of blood sugar and controlling glucose levels with diet and exercise as recommended by a doctor, usually in consultation with a diabetes educator and dietitian. When diet and exercise are not enough to control a pregnant woman’s glucose levels tablet medications or insulin injections may be prescribed by a doctor (usually an endocrinologist). During this time both the expectant mother and baby are kept under close surveillance for complications.
If a pregnant woman is diagnosed with gestational diabetes it is best she follows the plan she and her doctor have agreed on to control her blood sugars as best as possible and lessen impact on both herself and her developing baby.
The above information does not take the place of a medical consultation and is intended for informational purposes only.