Gestational Diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy. It is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy, especially during third trimester. There is still the question whether the condition is natural during pregnancy (Serlin & Lash 2009).
Causes, Incidence, and Risk Factors Pregnancy hormones can block insulin from doing its job. When this happens, glucose levels may increase in a pregnant women’s blood. You are at greater risk for gestational diabetes if you: are older than 25 when you are pregnant, have family history of diabetes, gave birth to a baby that weighed more than 9 pounds or had a birth defect, have high blood pressure, have too much amniotic fluid, have had an unexplained miscarriage or stillbirth, or were overweight before the pregnancy (Benjamin & Pridijan 2010).
Symptoms Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. The blood sugar (glucose) level usually returns to normal after delivery. Symptoms may include: blurred vision, fatigue, frequent infections, including those in the bladder, vagina, and skin, increased thirst, increased urination, nausea and vomiting, and weight loss despite increased appetite (Benjamin & Pridijan 2010).
Signs and Tests Gestational diabetes usually starts halfway through the pregnancy. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to screen for the condition. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy (Serlin & Lash 2009).
Once you are diagnosed with gestational diabetes, you can see how well you are doing by testing your glucose level at home. The most common way involves pricking your finger and putting a drop of blood on a machine that will give you a glucose reading
(Serlin & Lash 2009). Treatment The goals of treatment are to keep blood sugar (glucose) levels within normal limits during pregnancy, and to make sure that the growing baby is healthy (Cohen-Almagor R. 2000). Watching the baby The health care provider should closely check both mother and baby throughout the pregnancy. Fetal monitoring will check the size and health of the fetus. A nonstress test is a very simple, painless test for the mother and baby. A machine that hears and displays the baby’s heartbeat (electronic fetal monitor) is placed the the mother’s abdomen. The health care provider can compare the pattern of the baby’s heartbeat to movements and find out whether the baby is doing well (Cohen-Almagor R. 2000).
Diet and Exercise The best way to improve the diet during pregnancy is by eating healthy foods. The expectant mother should talk to her doctor or dietitian if vegetarian or on a special diet. In general, when diagnosed with gestational diabetes the diet should be moderate in fat and protein, provide carbohydrates through foods that include fruits, vegetables, and complex carbohydrates such as bread, cereal, pasta, rice. Foods that contain a lot of sugar, such as soft drinks, fruit juices and pastries should be avoided. If managing the diet does not control blood sugar levels, then the physician may prescribe diabetes medicine by mouth or insulin therapy (American Diabetes Association 2008).
Prognosis Most women with gestational diabetes are able to control their blood sugar and avoid harm to themselves or their baby. Pregnant women with gestational diabetes tend to have larger babies at birth. This can increase the chance of problems at the time of delivery, including: birth injury (trauma) because of the baby’s large size, delivery by c-section. The baby is more likely to have periods of low blood sugar (hypoglycemia) during the first few days of life. Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy. There is a slightly increased risk of the baby dying when the mother has untreated gestational diabetes, controlling blood sugar levels reduces this risk (Serlin & Lash 2009).
High blood glucose levels often go back to normal after delivery. However, women with gestational diabetes should be watched closely after giving birth and at regular doctor’s appointments to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within 5-10 years after delivery (Serlin & Lash 2009).
Prevention Beginning prenatal care early and having regular prenatal visits helps improve the health of expectant mother and her baby. Having prenatal screening at 24-28 weeks into the pregnancy will help detect gestational diabetes early. If overweight, decreasing BMI to a normal range before getting pregnant will decrease the risks of developing gestational diabetes (Benjamin & Pridijan 2010).