Some pregnancies can be harder than others and one thing that doesn’t make it easier is gestational diabetes
*Lydia, 31, thought she had an easy pregnancy but once she hit the seven-month mark, she started to have second thoughts. She kept feeling thirsty and no matter how much water she drank, her mouth felt dry. Trips to the bathroom increased and she keeps waking up at night to relieve herself. Lydia is also worried about a recurrent yeast infection that doesn’t seem to go away.
Some women may attribute how Lydia is feeling to ‘just being pregnant’ but little do they know that she’s showing signs of gestational diabetes. This form of diabetes affects women while they’re pregnant and it happens because the amount of glucose in the blood is too high due to an improper insulin response.
Usually, insulin, produced by the pancreas, is tasked to balance the amount of glucose in the blood. However, during pregnancy, some women could have a spike in the normal levels of glucose in the blood to the point where insulin is unable to bring it back under control. This leads to a surplus amount of glucose in the blood which causes gestational diabetes.
Gestational diabetes usually appears after 28 weeks (seven months), which is the third trimester of a pregnancy, and stops after the baby is delivered. An important point to note is that women who develop gestational diabetes have a higher chance of developing type 2 diabetes, down the line.
It isn’t completely clear what causes gestational diabetes but the American Diabetes Association states that it might be connected to the placenta. The placenta is where the baby receives nutrition and oxygen.
Hormones from the placenta help with the baby’s development but could also disturb the action of insulin on blood glucose. This is known as insulin resistance where the mother’s body has difficulty or is unable to use insulin to balance the amount of glucose in the blood.
Some women may have gestational diabetes without displaying any symptoms which is why during the second to third month of pregnancy, a venous glucose (blood test obtained from the vein) sample may be taken. If the blood test results point toward the woman having a higher risk of developing gestational diabetes, a glucose tolerance test may be done during the sixth to seventh month of pregnancy.
A glucose tolerance test is when a person has their blood tested in the morning, prior to breakfast, then fed a glucose drink. After drinking the glucose, another blood sample is retrieved two hours later to monitor how the body deals with the glucose.
If diagnosed with gestational diabetes, frequent check-ups with your doctor will be recommended especially during the last three months of pregnancy.
Risk factors of developing gestational diabetes include being obese which can be classified as having a body mass index (weight in kilograms divided by height2) of 30 or more. Another risk factor is when a mother had delivered a baby who weighed 4.5kg in previous pregnancies. A family history of diabetes or whether a mother experienced gestational diabetes during previous pregnancies also play a major role in determining if a woman will develop this condition.
In cases of gestational diabetes that don’t require medication, it’s a matter of following the right diet, getting enough exercise and constantly monitoring and controlling blood glucose levels. If a medical professional has deemed it necessary for an expectant mum to take medication that can help lower and control blood sugar, it’s still important to follow a balanced diet and have regular exercise. Good control of gestational diabetes can prevent birth complications and help keep the baby and mother healthy, post-delivery.
A complicated situation
Insulin produced by the mother doesn’t pass through the placenta but the extra blood glucose does. This in turn causes the baby’s pancreas to make insulin to lower their blood glucose. Due to the baby getting more energy from the conversion of glucose, more fats are stored which leads to macrosomia.
Complications that can arise from uncontrolled or undiagnosed gestational diabetes include premature birth where the baby is born before the 37th week of pregnancy, macrosomia where the baby is too large for its gestational age which may require induced labour or caesarean birth, or health problems such as low blood sugar in the baby, shortly after birth.
Leaving this condition unchecked can also cause miscarriage which is a lost pregnancy during the first 23 weeks (seven and half months) or stillbirth where the baby passes away around the time of birth. Gestational diabetes may affect the placenta and thus disrupt the delivery of oxygen and nutrients to the baby and this may harm the baby’s health. Additionally, gestational diabetes raises the risk of preeclampsia which is a complication where the mother’s high blood pressure can threaten the lives of both mother and child.
After delivering the baby, the risk of developing type 2 diabetes increases in mothers who had gestational diabetes. Type 2 diabetes is when the body doesn’t produce enough insulin or the body’s cells become resistant to insulin.
Thus, monitoring blood glucose is just as important during pregnancy as it is after delivering. A doctor will check blood glucose levels six to 12 weeks post-delivery to ensure that the glucose levels have gone back to normal. For women who chart a normal blood glucose test result, their diabetes risk is should be assessed every three years.
It is important to shed the extra kilos before pregnancy, not during. Speak to your partner and if you both decide to try for a child, lose any extra weight before getting pregnant to have a healthier pregnancy.
If you suspect something is amiss during your pregnancy, please check with your doctor. It is always better safe than sorry.