Gestational Diabetes - Causes, Symptoms and Diagnosis

What is Gestational Diabetes?

Gestational diabetes – also known as diabetes in pregnancy, is a disease in which an increase in blood glucose is detected during pregnancy and disappears after childbirth.

This is a hidden disorder of sugar metabolism which if not managed appropriately can potentially progress into chronic diabetes mellitus, besides that it’s associated with more dangerous consequences like maternal and fetal mortality.

It occurs in approximately 5-7% of pregnancies, usually in second and third trimesters.

What causes Gestational Diabetes?

In the second and third trimesters of pregnancy, the mother’s organism undergoes various hormonal changes which trigger progressive insulin resistance, resulting in hyperglycemia, particularly after mealtimes.

There is no one specific cause that leads to gestational sugar metabolism abnormalities, more likely it’s a constellation of different risk factors like:

Age under 18 and over 30.
An unbalanced diet with a lot of fast carbohydrates.
Bad habits (smoking, alcohol abuse).
Overweight and obesity. Excess weight impacts metabolic processes.
Lack of physical activity.
Previous gestational diabetes or prediabetes. The tendency to diseases of this series does not disappear over time.
Polycystic ovary syndrome.
A close relative has diabetes- The risk of gestational diabetes doubles or more if close relatives have any form of diabetes.
The birth of a child over 4 kg earlier or a large fetus during the current pregnancy.
Race. The European race has a higher rate of gestational diabetes
Medications – chronic intake of corticosteroids

What are the symptoms?

In most cases, the disease is asymptomatic for a long time, and this is its danger. As already mentioned, usually the problem is detected after the 20th week of pregnancy thanks to a blood sugar test.

Severe symptoms are rare, and all of them are nonspecific: intense thirst, edema, weight gain, increased daily urination. Sometimes patients complain of fatigue and lack of energy.

How is gestational diabetes diagnosed?

There is good news, too. All pregnant women, when registering for pregnancy workups, are required to take a blood test for glucose levels, therefore, if you regularly undergo all the prescribed examinations, you will find a problem at the very initial stage.

The normal value of glucose is 3.3-5.1 mmol / l in the analysis of blood from a vein on an empty stomach.
Patients whose glucose levels exceed 5.1 mmol / L are at risk. In this case, the doctor will order a glucose load test or glucose tolerance test to confirm the diagnosis. It is performed at 24-28 weeks of pregnancy.

This test includes two stages:
First, the woman takes the usual fasting blood glucose test, after which she drinks a special solution containing 75 grams of glucose, and after two hours she takes the test again.
If a disease is suspected, the same analysis is repeated after a few hours.

The diagnosis

If the fasting blood glucose level is less than 7 mmol / L but higher than 5.1 mmol / L,
and the venous blood glucose level two hours after consuming 75 g of glucose is above 8.5 mmol / L.

Can it go away?

The most important method of management during gestational diabetes is:

Close monitoring
Tight sugar control
Medications like insulin or hypoglycemic agents if needed

But besides that, lifestyle modifications can play a huge role in management too
The first step in lifestyle changes is a balanced diet and moderate exercise.
The main goal of the diet is to lower sugar to normal values, so the expectant mother will have to give up sweets and fast carbohydrates.

Often, pregnant women, having learned the diagnosis of it, sharply restrict carbohydrate intake, reducing the amount of food and meals.

You can’t do that…

During pregnancy, the mother’s body and the fetus should receive a sufficient amount of carbohydrates (175 g or 50% of the estimated daily caloric intake). If there are not enough carbohydrates, the breakdown of protein and fat begins in the body to obtain energy, ketosis develops, ketone bodies appear in the urine.

Therefore, carbohydrates should be consumed, but these should be “slow” carbohydrates that slowly increase blood glucose and have a low Glycemic Index.

Pregnant women are usually advised to:

Exclude foods with a high glycemic index (sugar, honey, potatoes, white bread, baked goods, bananas, grapes).
Give up fast food and fatty sweet pastries.
Drink enough fluids if there are no contraindications from the kidneys.
Diversify the diet with fresh vegetables, lean meat, and cereals.
Like all pregnant women, patients with GDM need to receive the full range of vitamins and minerals that are necessary to maintain their health and the correct development of the fetus.

Walking, swimming, water gymnastics, physiotherapy exercises for pregnant women – any light activity will be beneficial.

If diet and exercise do not help lower blood sugar levels, insulin therapy is prescribed.

Important: With high sugar, a woman should check her glucose level daily. Measurements are taken on an empty stomach and one hour after each meal using a home blood glucose meter.