Gestational diabetes is the transient state of insulin resistance during pregnancy which leads to increased blood sugar levels.
Gestational diabetes is the transient state of insulin resistance during pregnancy which leads to increased blood sugar levels. It may start at any point during pregnancy and it usually resolves after birth. It starts most commonly during the second and third trimesters.
Most of the time gestational diabetes is asymptomatic. Therefore screening tests are offered to all pregnant patients to diagnose gestational diabetes.
However when blood glucose increases, the following signs may be present:
Gestational diabetes develops when the body cannot produce enough insulin to cover the body’s need to normalize blood sugar level.
The following patients are at high risk for gestational diabetes;
When gestational diabetes is not diagnosed and treated, it is associated with certain risks for the mother and the fetus.
The risks to the fetus can be summarised as follows:
The risks to the mother can be summarised as:
You can decrease the risk of gestational diabetes by the help of the following measures:
Ideally the diet programme should be planned and followed up by a dietician. The total daily calory intake is calculated according to prepregnacy weight of the patient. Daily intake of protein, carbohydrate, fat and vitamins should be balanced. The meals should be divided into 3 main meals and 2-3 snacks per day.
It is important to consume more complex carbohydrates to balance blood sugar levels. Complex carbohydrates are found in plant based nutrients such as whole wheat, beans,peas and corn
During the first anenatal visit, your history and body weight will determine if you are at high risk for gestational diabetes. For high risk patients, oral glucose tolerance test is indicated as early as possible during pregnancy. When the test result is normal, OGTT should be repeated during 24-28 weeks of gestation. For low risk pregnancies OGTT is recommended during 24-28 weeks of gestation.
Gestational diabetes necessitates a multidisciplinary approach. A team of perinatologist, endocrinologist,dietician, diabetes nurse and a personal trainer should ideally follow up the patient with gestational diabetes.
Treatment of gestational diabetes starts by following a balanced diet and regular exercise programme. The aim is to maintain ideal blood sugar levels. Controlled blood sugar levels decrease maternal and fetal risks during pregnancy. To monitor blood sugar levels,patients can use home kits, they can record their blood sugar profile and report this profile to their doctors.
When the blood sugar profile is over normal limits despite regular diet and exercise programme, medical treatment may be necessary. Medical treatment may be by oral antidiabetic medications or iv insulin.