Gestational diabetes

Did you know that gestational diabetes mellitus (GDM) is a condition that develops during pregnancy?

What is gestational diabetes mellitus (GDM)?

Gestational diabetes mellitus (GDM) is diabetes diagnosed for the first-time during pregnancy (gestation).  Like other types of diabetes, GDM affects how your cells use sugar (glucose).

The digestive system breaks food down into glucose.  The body uses glucose as fuel that requires insulin among other things to be absorbed into your blood.  During pregnancy, the body becomes more resistant to insulin so that glucose remains available to nourish the baby.  The pancreas secretes more insulin when the body needs it and for most mother’s this doesn’t become a problem.  There are times though where the pancreas is unable to keep up with the production of insulin, and this results in blood sugar levels rising and ultimately resulting in GDM.

Researchers don’t yet know why some women get GMD and others don’t.

Who is at risk of developing GDM?

Anyone is at risk of developing GDM.  Gestational diabetes mellitus (GDM) is increasing worldwide and according to numerous studies, about 18 to 25% of South African women are affected.  GDM requires a medical diagnosis since, in many cases, there are no symptoms.  The following questions can provide more insight into your risk of GDM:

  • Are you 35 years or older?
  • Are you overweight (BMI of 30 or higher)?
  • Is there a family history of diabetes?
  • Have you had a baby who weighed more than 4.2kg at birth?
  • Have you experienced a previous stillbirth or miscarriage?
  • Have you ever had problems with insulin, blood sugar, glucose intolerance?
  • Do you have high blood pressure, high cholesterol or heart disease?
  • If you are currently pregnant, has your doctor informed you that you have polyhydramnios (excessive amniotic fluid)?

Why is important to manage your blood sugar levels during pregnancy?

GDM that’s not carefully managed can lead to high blood sugar levels.  High blood sugar can cause problems for you and your baby, including an increased likelihood of needing a C-section to deliver.

Complications that may affect your baby

If you have GDM, your baby may be at increased risk of:

  • Excessive birth weight: Higher than normal blood sugar in mothers can cause their babies to grow too large. Very large babies are more likely to become wedged in the birth canal, have birth injuries or need a C-section birth.
  • Early (preterm) birth: High blood sugar may increase women’s risk of early labour and delivery before the due date. Early delivery may be recommended because the baby is large.
  • Serious breathing difficulties: Babies born early to mothers with GDM may experience respiratory distress syndrome, a condition that makes breathing difficult.
  • Low blood sugar (hypoglycaemia): Sometimes babies of mothers with GDM have low blood sugar (hypoglycaemia) shortly after birth. Severe episodes of hypoglycaemia may cause seizures in the baby.  Prompt feedings and sometimes an intravenous glucose solution can return the baby’s blood sugar level to normal.
  • Obesity and type 2 diabetes later in life: Babies of mothers who have GDM have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth: Untreated GDM can result in a baby’s death either before or shortly after birth.

Complications that may affect the mother

GDM may also increase your risk of:

  • High blood pressure and preeclampsia: GDM raises your risk of high blood pressure, as well as preeclampsia, a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten the lives of both mother and baby.
  • Having a surgical delivery (C-section): You’re more likely to have a C-section if you have GDM.
  • Future diabetes: If you have GDM, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older.

Can GDM be treated?

You can manage and control GMD with a healthy eating plan and exercise.  Your healthcare provider may also prescribe medication should you struggle to get the condition under control.

Early diagnosis and good control of blood glucose concentration will prevent most of the pregnancy and labour complications caused by diabetes.  Please contact your healthcare provider if you have any concerns during your pregnancy.