Gestational Diabetes | Causes, Symptoms, and Treatment

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By : Raghuvarya Bollina

Gestational diabetes is defined as impaired glucose tolerance with onset or first recognition during pregnancy.  It occurs in women who have never had diabetes before but who develop high sugar levels during pregnancy.

Similar to other types of diabetes, gestational diabetes affects how your cells use glucose.  It causes high blood sugar that can affect your pregnancy and your baby.

According to the Centers for Disease Control and Prevention, gestational diabetes is estimated to affect 1% to 14% of pregnancies in the U.S. annually.

While gestational diabetes can be an alarming complication, it can be controlled by maintaining a healthy diet, exercising, and taking medication if needed.  A mother’s blood glucose levels usually return back to normal after delivery.  However, she should be closely monitored by her health care provider.

 Causes of Gestational Diabetes:

Researchers don’t know exactly what causes gestational diabetes and why some women develop it.  However, it’s helpful to know what happens in the body when a woman does develop gestational diabetes.

According to the Mayo Clinic, the placenta produces high levels of various hormones which many of which impair the action of insulin within the body’s cells.  As the baby grows, the placenta produces more and more insulin-countering hormones.

In gestational diabetes, the placental hormones create a rise in blood sugar that can affect the growth and health of your baby.  The condition usually develops during the last half of pregnancy.

Potential Risk Factors:

Some known risk factors for gestational diabetes include the following:

  • Family history- if a parent or sibling has type 2 diabetes
  • Personal history- if you have a history of prediabetes or
  • Women who are pregnant and over the age of 25 are more likely to develop gestational diabetes
  • Overweight with a body mass index of 30 or higher
  • If you are Black, Hispanic, American Indian or Asian descent.

Symptoms:

For most women, gestational diabetes doesn’t cause any symptoms.  However, gestational diabetes screening is part of normal prenatal care.  If you develop gestational diabetes, you will have more frequent check-ups.

Diagnosis:

According to Mayo Clinic, medical experts haven’t agreed on screening guidelines.  Your doctor will evaluate your risk factors for gestational diabetes early in your pregnancy.  If you have risk factors for gestational diabetes, your doctor will evaluate when screening is right for you.

Routine screening for gestational diabetes involves an oral glucose test.  The test involves drinking a sweetened liquid, called Glucola, which contains 50 g of glucose.  How the body metabolizes this solution is measured by a blood test.  A blood sugar level below 130 to 140 mg/dL, is usually considered normal on a glucose challenge test.

A blood sugar level higher than 140 mg/dL, will identify 80% of women with gestational diabetes.  When the threshold is lowered to 130 mg/dL, 90% of women will be identified.  If your blood glucose level is greater than 130 mg/dL, your doctor will recommend you to take another screening test that will require fasting before the test.

Treatment:

Gestational diabetes is treated by controlling blood sugar levels.  You and your doctor will work on a plan to closely monitor you and your baby during your pregnancy.  You may also be asked to monitor your own blood glucose levels at home.  Insulin therapy and diet and exercise management will also play an important part in treatment.

What to Eat?

A balanced and healthy diet is important during and after pregnancy and will help control blood glucose levels.  A diet rich in the following foods can help you maintain healthy blood sugar levels and also provide proper nutrition for both you and your baby.

It’s important to monitor how many and what kinds of carbohydrates you consume as well.  Keeping a food log may be a helpful way to monitor your carb intake.

The American Diabetes Association recommends that women with gestational diabetes should eat three small to moderate meals and two to four snacks per day.  The ADA recommends that an evening snack may be needed to prevent accelerated ketosis overnight.

Foods to Eat for a Balanced Diet:

  • Vegetables
  • Non-fat dairy products
  • Fruits
  • Whole grains
  • Lean meats
  • Fish
  • Eggs
  • Poultry

Eating more protein helps to balance blood glucose levels.  These foods include fish, chicken, turkey, eggs, tofu, beans, nuts, seeds, quinoa and legumes or lentils.

Foods to avoid if Diagnosed with Gestational Diabetes:

  • Cakes
  • Biscuits
  • Sweets
  • Puddings
  • Soda
  • Fruit juice with added sugar
  • White potatoes
  • White bread
  • White rice
  • White pasta

Being diagnosed with gestational diabetes may be worrisome, but with a strong plan in place to manage your blood glucose levels, and some dedication and discipline, it’s possible to make it through pregnancy with you and your child unaffected.

Make sure you work with your doctor and a dietician to monitor and maintain your weight and body mass index (BMI) throughout your pregnancy.

Testing may be done a few months after pregnancy to make sure blood glucose levels have returned to normal.  It is possible to have an increased risk of developing type 2 diabetes later in life, so make sure you consult your doctor to have regular screenings.

Sources:

1. DeSisto CL, Kim SY, Sharma AJ. Prevalence Estimates of Gestational Diabetes Mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis 2014;11:130415. DOI:http://dx.doi.org/10.5888/pcd11.130415.

2. Mayo Clinic.  “Gestational Diabetes.” Accessed March 15, 2018.  https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339

3. American Diabetes Association.  “Nutrition Principles and Recommendations in Diabetes.” Diabetes Care 2004 Jan; 27(suppl 1): s36-s36. https://doi.org/10.2337/diacare.27.2007.S36

4. Hippokratia.  “Gestational diabetes mellitus: why screen and how to diagnose.” Accessed March 15, 2018.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943351/

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