General HealthPregnancy and Newborn Health

Gestational Diabetes: An Overview

Gestational Diabetes is a hyperglycemic condition which is first diagnosed during pregnancy and if is not addressed on time, it can lead to various complications for both the mother and the child.

Diabetes mellitus (DM) or diabetes, is a chronic, metabolic disease characterized by elevated blood glucose/sugar level over a long period of time. Diabetes occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the produced insulin. If not treated properly, the condition can damage the heart, blood vessels, oral cavity, eyes, kidneys and nerves in the long run.

The WHO classifies diabetes into the following types:

Type 1 or Juvenile Diabetes Mellitus: The beta cells of the pancreas do not produce sufficient amounts of insulin as they are damaged by an overactive immune system. Type 1 is commonly seen in children and young adults and is called insulin-dependent DM as it requires the regular administration of insulin.

Type 2 or Adult-Onset Diabetes Mellitus: This type is insulin-independent and occurs due to body’s inability to use insulin. Type 2 has its roots in lifestyle patterns and is seen across all age groups, more commonly in people aged 30 and above.

Impaired Glucose Tolerance (IGT) and Impaired Fasting Glycaemia (IFG): These are intermediate prediabetic conditions that can progress to type 2 diabetes, but it need not happen.

Gestational Diabetes: This type is seen when a person is pregnant and they have had no history of diabetes before pregnancy.

What is gestational diabetes?

The WHO defines gestational diabetes as “glucose intolerance and hyperglycemia during pregnancy with blood glucose values above the normal range but below diabetic range”. Gestational diabetes occurs when there is reduced function of pancreatic beta cells during pregnancy and can further increase maternal and perinatal complications. This type can give rise to fetal macrosomia, where the baby born weighs heavier than usual. Gestational Diabetes is not that common and is only seen in 2-9% of the pregnant population.

Gestational diabetes do not show any apparent symptoms making it hard to diagnose. Hence doctors screen for blood sugar levels along with other tests during the first trimester. Studies have shown that mothers with gestational diabetes and the children born to them are at the higher risk of developing Type 2 DM.

Despite enormous amounts of research, scientists and specialists have not arrived to a conclusive treatment for gestational diabetes. Research is underway on the importance of early detection and management of the condition during the pregnancy. This can help the doctor plan and formulate treatments accordingly so as to reduce the effects of gestational diabetes on the mother’s and the child’s future health. Since mothers with gestational diabetes are at a risk of developing Type 2 DM, it could lead to hypertensive disorders making pregnancy challenging.

The perinatal risks of gestational diabetes include shoulder dystocia, birth injuries, hyperglycemia and obesity. Stillbirth may occur if left undiagnosed or untreated. Uncontrolled blood glucose levels in the mother can progress to long-term adverse health conditions in the infants such as impaired glucose intolerance, subsequent obesity and hindered intellectual development.

Some of the predisposing risk factors for gestational diabetes include:

  1. Obesity
  2. Sedentary lifestyle with lack of physical activity
  3. Prediabetes
  4. Family History of Prediabetes
  5. The mother has a history of Polycystic Ovarian Syndrome or Disorder
  6. The mother may have delivered a baby weighing more than 4.1 kg

There are no clear preventative measures for gestational diabetes. However, specialists often advise pregnant people to follow a healthy lifestyle to help reduce the risks associated with gestational diabetes and even prevent the progression to Type 2 DM. The best remedy for tackling gestational diabetes and its complications are implementing habits such as proper eating and regular exercise throughout the whole term of pregnancy.

Author:

Dr. Aparna Mishra is a practicing dentist with over 11 years of experience. Her interests include writing especially literature writing.

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