Understanding Gestational Diabetes: A Guide for Expecting Mothers

Introduction

Gestational Diabetes Mellitus (GDM) is a condition where blood sugar levels increase during pregnancy. This type of diabetes is triggered by pregnancy-related hormonal changes and can affect both the mother and baby if not managed properly. With the right approach, however, it can be effectively controlled. Here’s everything you need to know, explained by Dr. Mini Salunkhe from Momstory Sahyadri Hospital.

What Is Gestational Diabetes?

Gestational Diabetes is a type of diabetes that occurs during pregnancy, usually after 24 weeks. It is often called pregnancy-induced diabetes and is triggered by increased insulin resistance due to hormonal changes.

Who Is at Risk?

You’re more likely to develop gestational diabetes if:

• You have a family history of diabetes

• You are overweight or obese

• You have PCOS (Polycystic Ovary Syndrome)

• You’ve been pre-diabetic or had GDM in a previous pregnancy

• You are of advanced maternal age

Why Does It Happen?

Pregnancy is a naturally diabetogenic condition, meaning it increases insulin resistance. When the body cannot produce enough insulin to overcome this resistance, blood sugar levels rise, leading to gestational diabetes.

Symptoms of Gestational Diabetes

Gestational diabetes often doesn’t show obvious symptoms, but some women may experience:

• Excessive weight gain

• Frequent urination

• Increased thirst

• High blood pressure or swelling

However, these symptoms are not always present, which is why routine screening is essential.

How Is It Diagnosed?

Every pregnant woman is usually tested using a Glucose Challenge Test (GCT):

• A 75-gram glucose drink is given

• Blood sample is taken after 2 hours

• If the glucose level is above 140 mg/dL, further testing or treatment is required

Managing Gestational Diabetes

Once diagnosed, GDM can often be managed through:

1. Lifestyle Modifications

• Diet: Low-carb, low-sugar, high-fiber meals

• Exercise: Daily walks or prenatal workouts

2. Regular Monitoring

• Fasting and post-meal blood sugar levels should be checked every 2 weeks

• Monitoring helps adjust treatment plans quickly

3. Medications (if required)

• If diet and exercise aren’t enough, oral medication or insulin may be prescribed

• Coordination with physicians, endocrinologists, or diabetologists is often needed

Complications of Uncontrolled GDM

If gestational diabetes is not controlled:

• The baby may grow too large (macrosomia)

• Increased amniotic fluid levels may be seen

• Higher chances of C-section

• Risk of shoulder dystocia during vaginal delivery

• After delivery, the baby may develop low blood sugar (neonatal hypoglycemia) which can cause developmental issues if untreated

Gestational Diabetes & Delivery

• If the baby weighs over 4 kg, C-section chances increase

• Serial ultrasounds are done to monitor fetal growth and amniotic fluid levels

• After birth, the neonatologist checks the baby’s sugar levels

Will It Go Away After Delivery?

In most cases:

• Blood sugar levels return to normal after 6 weeks

• However, if GDM occurs in multiple pregnancies, or there’s a family history, the mother is at a higher risk of developing Type 2 diabetes later in life

Can It Be Prevented?

Yes, to a large extent.
If you have risk factors like PCOS, obesity, or a family history of diabetes:

• Plan your pregnancy

• Adopt a healthy lifestyle before and during pregnancy

• Maintain an ideal body weight

• Monitor your HbA1c levels pre-pregnancy

Takeaway Message

Managing gestational diabetes is possible with:

• Early diagnosis

• Consistent lifestyle changes

• Regular monitoring

• Timely medical support

After pregnancy, a diabetic diet and sugar monitoring for 6 weeks postpartum is important to ensure complete recovery.