September 29 2022

Understanding gestational diabetes.

One of the risks during pregnancy is gestational diabetes, a condition that can harm both mother and baby if left untreated.

It’s every new parent’s wish to have a pregnancy without problems, but unfortunately that’s not always the case. One of the possible complications that mothers-to-be face is gestational diabetes, which causes elevated blood glucose in pregnant women who do not otherwise suffer from type 1 or type 2 diabetes.

The symptoms of the condition are typical of diabetes: excessive thirst, frequent urination and increased hunger. Severely elevated blood glucose can also cause blurred vision, nausea and even vomiting. While gestational diabetes typically disappears after the birth, it can affect the health of the baby and its mother – both during pregnancy and later in life.

“Women who are overweight, have high blood pressure and a family history of diabetes are more prone to gestational diabetes.”

Estimates of the prevalence of gestational diabetes vary from region to region. In the United States, the Centers for Disease Control and Prevention says that between 2% and 10% of pregnancies are affected by the condition.11 In Europe, prevalence is estimated at an average of around 11%, although in some parts of the continent it’s higher than 30%.22 Across 16 countries in the Middle East it’s estimated at 13%, and in sub-Saharan Africa at about 9%.33,44 Estimates for Asia average out at 11.5%.55 It should be noted that the accuracy of these figures is subject to the quality of available data, and dependent upon the timely diagnosis and registration of patient information.

What causes gestational diabetes? And why does it affect some women but not others?

During pregnancy the placenta secretes several hormones to keep mother and baby healthy. These include estrogen, progesterone, cortisol and human placental lactogen. In some cases the build up of these hormones can affect the body’s ability to use the insulin produced in the pancreas, leading to elevated blood glucose levels. As the placenta grows it produces more of these hormones, which is why the onset of gestational diabetes typically occurs in weeks 20 to 24 of pregnancy.

Some of the risk factors for contracting the insulin-resistant condition are the same as those associated with type 2 diabetes. Women who are overweight, have high blood pressure and a family history of diabetes are more prone to gestational diabetes. Certain ethnic groups are also more at risk than others.

Gestational diabetes poses several dangers to a mother and her baby.

One of the dangers of gestational diabetes is macrosomia – a baby that is much larger than it should be. If the mother’s blood glucose is consistently elevated, then the fetus will convert the excess glucose into fat. This can mean that the baby becomes too big for the mother’s birth canal and trauma is suffered during birth, or that delivery needs to take place via cesarean section.

Babies born overweight due to gestational diabetes are also more at risk of developing type 2 diabetes later in life. So too are their mothers.

“Exercise is key too. Low intensity activities such as walking can have a remarkable effect on controlling blood glucose.”

Another danger to the baby is hypoglycemia – low blood glucose – immediately upon delivery. If the mother has elevated blood glucose, then the fetus produces a lot of insulin to compensate. When the baby is born and separated from the placenta, this excess insulin can cause its blood glucose to quickly fall to a dangerous level.

Gestational diabetes also raises the risk of preeclampsia in the mother. This pregnancy complication is characterized by high blood pressure, as well as high levels of protein in the urine that can signal damage to the kidneys or other organs. Aside from being a danger to the mother, preeclampsia can mean that the baby does not receive blood, oxygen and nutrients in the amounts that it needs in order to grow properly.

How can pregnant women avoid getting gestational diabetes?

As with other forms of diabetes, the key to lowering the risk of contracting gestational diabetes – or controlling the condition once diagnosed – is to maintain good overall health both prior to and during pregnancy. This means avoiding high-carb snacks and eating a diet high in vegetables, legumes, whole grains, lean meats and healthy fats. Exercise is key too. Low intensity activities such as walking can have a remarkable effect on controlling blood glucose.

In cases of diagnosed gestational diabetes, blood glucose must be monitored daily. Doctors may also prescribe oral medication, or even insulin injections. The baby’s growth should also be closely monitored.

This story is based on information from the following sources:

  1. Centers for Disease Control and Prevention, gestational diabetes
  2. Frontiers, Gestational Diabetes Mellitus in Europe: A Systematic Review and Meta-Analysis of Prevalence Studies
  3. Frontiers, Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression
  4. BMC, Burden, risk factors and maternal and offspring outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa (SSA): a systematic review and meta-analysis
  5. PubMed, Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis

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