Gestational Diabetes

Gestational diabetes, also known as pregnancy diabetes, is characterized by abnormally high blood sugar levels during pregnancy. It generally develops midpregnancy, during the second or third trimester. Gestational diabetes usually disappears after the baby is born.

Causes

Insulin is a hormone that allows sugar (glucose) to be used as a source of energy. During pregnancy, the body also produces hormones decreasing the effects of insulin. Normally, the body compensates by increasing its insulin production. However, in women with gestational diabetes, this increased production is not sufficient. Sugar therefore accumulates in the blood, resulting in hyperglycemia - a condition that develops when there is too much glucose (sugar) circulating in the blood.

People at risk

Certain risk factors can tell if some people are more likely to suffer from gestational diabetes than others, such as:

• Gestational diabetes in prior pregnancies
• Previous delivery of a child weighing more than 4 kg
• Being 35 years of age and older
• Being of Native American, Latin American, African, Arab, or Asian descent
• Having an IMC > 30 before pregnancy
• Taking corticosteroids (medication)
• Suffering from polycystic ovary syndrome (a set of symptoms including excessive and abnormal hair growth as well as irregular menstruations)
• Having a history of acanthosis nigricans (skin disorder)

Symptoms

Gestational diabetes usually doesn't cause any symptoms. However, some people may feel very tired, unusually thirsty, or notice they're urinating more often than usual.

Complications

Uncontrolled gestational diabetes can lead to many complications for both the mother and the baby. At birth, the baby is at higher risk of experiencing more severe jaundice, low calcium levels, macrosomia (an exaggerated growth of all parts of the body), hypoglycemia (low blood sugar), and respiratory problems. After birth, the baby also has an increased risk of becoming overweight and developing diabetes in the long term.

A woman with gestational diabetes is at higher risk of high blood pressure (preeclampsia) during pregnancy. There is also an increased risk of preterm delivery or cesarean section. After giving birth, the woman has a higher chance of developing diabetes. As a result, they are generally re-evaluated within six months of delivery. Breastfeeding, regular physical activity, and healthy eating habits are encouraged to help reduce long-term problems.

Treatment

A diabetes screening test is recommended for all women between the 24^th and 28^th week of pregnancy. However, if there are risk factors, screening is done earlier in the pregnancy. Managing gestational diabetes is very important since it helps reduce complications for the baby and the mother.

1. Lifestyle changes

   The first step involves assessing the adoption of healthy eating habits. Breaking up your carbohydrate intake (sugars) across three meals and at least three snacks is an effective way to control your blood glucose (sugar) levels. Moderate physical activity is also recommended. It is strongly recommended that the intensity, frequency and duration of physical activity be assessed by a health care provider.

2. Medication

   If the recommended blood glucose target levels are not reached within 2 weeks of nutritional therapy, medication may be considered. In most cases, insulin is used.

3. Monitoring

   Women with gestational diabetes must check their blood glucose (sugar) levels on a regular basis. To do so, a blood glucose monitor (small device available at your pharmacy) is required. It is an essential tool needed to adjust insulin doses and to determine whether the changes you have made to your diet have been successful.

For more information:

• Diabetes Canada