Diabetes in Pregnancy
Diabetes that occurs during pregnancy is known as gestational diabetes (GD or GDM) and can affect between 6% to 9% of pregnant women. It usually starts to develop between week 24 and week 28 of pregnancy.
It’s important to understand that with the right care, monitoring and treatment you can still have a safe and healthy pregnancy with gestational diabetes.
What are the causes of gestational diabetes?
Our pancreas produces insulin, a hormone that regulates our body’s metabolism of fats and carbohydrates which allows the body to turn sugar into energy. During gestational diabetes, the placenta hormones can block insulin – action which then prevents the body being able to effectively regulate the increased blood sugar that is caused by pregnancy. This results in high levels of sugar in the blood (known as hyperglycaemia) which can result in the damage of the body’s nerves, blood vessels and organs.
What women are at risk of gestational diabetes?
Although it is not entirely certain why some women develop gestational diabetes, some factors that increase risk include:
- Being overweight. Women who have a BMI of 30 or over as they become pregnant is one of the most common risk factors as the additional weight impacts on the body’s insulin’s ability to keep blood sugar levels in check.
- Older women. Women who are pregnant over the age of 40 have a significantly greater risk of developing gestational diabetes.
- Family history. Genetics plays a part, and if diabetes runs in the family you may be at a higher risk of gestational diabetes.
- Ethnicity. Aboriginal women and Torres Strait Islanders have a greater risk of gestational diabetes than non-indigenous women, as do Asian and Hispanic women.
- A previous history of gestational diabetes. If you have had a previous pregnancy with gestational diabetes, research shows that you are more likely to develop it in subsequent pregnancies.
- Slightly elevated blood sugar levels before pregnancy may mean you are at a higher risk of developing gestational diabetes.
- Previous gestational diabetes.
- Multiple pregnancy eg. twins.
- Previous pregnancy-related complications such as previous still birth, birth weight >4500 gm or >90 percentile.
- Polycystic ovarian syndrome.
What are the symptoms?
The majority of women with gestational diabetes do not have symptoms. They are often diagnosed as routine care for pregnancy. Occasionally obstetricians may test for gestational diabetes earlier than 28 weeks if above risk factors are present.
How do we diagnose gestational diabetes and what are the effects?
Gestational diabetes is usually diagnosed by glucose tolerance test between 24 – 28 weeks of pregnancy.
With regular monitoring and proper treatment, gestational diabetes can be managed throughout your pregnancy and is not harmful to mother or baby.
However, it is important to have your gestational diabetes properly managed during your pregnancy as if it goes untreated and excessive sugar is circulating through the mother’s and baby’s blood there are potentially serious health risks including:
- A too large baby. This makes for a more difficult natural delivery and will likely require the baby to be delivered via Caesarean section.
- Preeclampsia. High blood pressure that can result in the death of the mother and stillbirth of the baby.
- Post birth complications for the baby such as jaundice, breathing difficulties and low blood sugar as well as the potential risk of obesity and type 2 diabetes.
How can gestational diabetes be prevented?
If your risk factors are based on family history of gestational diabetes or older age of pregnancy, there is no other action you can take to prevent your risk. However, if you are overweight, have a poor diet or don’t have regular exercise, the adoption of new healthy habits can make a big difference in risk reduction.
Before conception and during pregnancy, take the following steps:
- Keep active. Just a 15-minute walk after lunch and dinner allows your body to burn glucose.
- Eat a healthy well-balanced diet with a variety of fruit and vegies, lean protein, poultry, fish, legumes and complex carbs. Limit your fat intake – particularly saturated and trans fats such as butter, palm and coconut oils, processed meats like ham and cheeses. Avoid sugary processed foods. Watch your portions.
- Watch the scale and try to maintain a normal pregnancy weight and BMI and make the effort to lose any extra pounds after you have your baby.
Treatment and management of gestational diabetes
If you have been diagnosed with gestational diabetes, Dr Nandi is an expert in the treatment and management of your condition. For best outcomes, your monitoring and treatment should occur immediately. Please ask your doctor for a referral and arrange for a consultation with our practice for a review and treatment plan.
