Gestational diabetes is a condition that occurs for the first time during pregnancy and usually goes away after the baby is born, with minimal health risks to mother and baby. However, it is fraught with a serious danger: there is a high risk that a woman will develop type 2 diabetes at a later age.
How do you know if you’re at risk for gestational diabetes, and how can you prevent or treat it?
Not so uncommon
Gestational diabetes occurs in about one in ten pregnancies and usually goes away after the baby is born. However, if left untreated, there are risks of dangerous complications in the future.
All women are screened for diabetes between the 24th and 28th weeks of pregnancy. Expectant mothers who are suspected by doctors of a predisposition to developing gestational diabetes may be examined earlier than these dates. If you have been diagnosed with gestational diabetes, do not ignore it – it is better to start treatment.
What exactly causes gestational diabetes?
While scientists aren’t entirely sure what causes gestational diabetes, it’s believed that hormonal fluctuations during pregnancy can prevent the body from effectively absorbing the insulin it produces.
Insulin is a hormone that regulates blood sugar levels. If insulin does not fulfill its direct task under the influence of other hormones secreted by the body during pregnancy, this can provoke the development of gestational diabetes. This condition is similar to what causes type 2 diabetes, where insulin is produced in the body but not used properly.
Most cases of gestational diabetes occur later in pregnancy, so women should be screened between the 24th and 28th weeks. It is during this period that the placenta produces more hormones, including human placental lactogen (HPL), which can prevent insulin from being used effectively.
Any pregnant woman can develop gestational diabetes, but certain risk factors make it more likely, such as:
- Excess weight. The risk of gestational diabetes increases with increasing body weight. In 2007, the authors of a study published in the journal Diabetes Care found that overweight women were more than twice as likely as women with a normal BMI to be at risk of developing gestational diabetes. For women who are very overweight, this risk increases by eight times.
- Age. A 2020 clinically tested study published in Diabetes Research found that the risk of developing gestational diabetes increases with age. Most often, gestational diabetes develops in expectant mothers from 25 to 40 years. Women aged 35-40 are in a special risk group.
- Disease history. Having polycystic ovary syndrome or a hormonal imbalance can increase your risk of developing gestational diabetes by up to four times. In addition, if you had gestational diabetes during a previous pregnancy, the chances of developing this condition in future pregnancies are as high as 66%.
- Family history of diabetes. “Women with a family history of diabetes are at greater risk of getting sick during pregnancy,” says endocrinologist Lisa DeFazio. Women aged 30 and older with a family history of diabetes are three times more likely to develop gestational diabetes.
Risks of gestational diabetes
Those diagnosed with gestational diabetes can have healthy pregnancies and healthy children, especially if they don’t give up on their illness and are treated under the guidance of a doctor. However, the risks of complications still exist.
“Gestational diabetes puts mom and baby at increased risk of pregnancy complications,” says Sherry A. Ross, MD, OB/GYN.
Risks for babies born to mothers with gestational diabetes include:
- Large birth weight. “The baby is at risk of putting on a lot more mass than it usually does,” says Ross. This can increase the risk of birth complications. These babies may also have problems regulating their blood sugar levels and require emergency admission to a neonatal intensive care unit.
- Increased risk of preterm birth. Most babies born to mothers with gestational diabetes are born between 39 and 40 weeks, but there is an increased risk of preterm delivery. Premature birth puts the baby at increased risk of temperature regulation problems and digestive problems.
- Increased risk of stillbirth. Women with gestational diabetes are five times more likely to have a stillborn or stillborn baby after 20 weeks of pregnancy.
The risk for a pregnant woman also includes a higher chance of some birth complications, such as the need for a caesarean section, high blood pressure, or preeclampsia.
Treatment of gestational diabetes
In general, most cases of gestational diabetes resolve without sequelae after the baby is born, and the mother’s hormone levels return to normal.
“When the umbilical cord is cut, diabetes disappears,” says DeFazio. Gestational diabetes is caused by pregnancy hormones, so when the baby is born, the problem resolves itself. However, it is important to control gestational diabetes during pregnancy to reduce the risk of health complications. Ross recommends the following lifestyle changes:
- Working with a dietitian to help you choose a low-carb, low-protein diet to control your blood sugar. With proper nutrition, control of diabetes in pregnant women is much easier, and the risk of complications is significantly reduced. It is recommended that all pregnant women monitor their diet, so this condition will not be a particular inconvenience for mothers with diabetes.
- Exercise regularly. Moderate exercise, such as brisk walking or light jogging, can help control blood sugar levels. Ross recommends developing a daily exercise plan in consultation with your healthcare provider.
- Check your blood sugar. Your doctor will also teach you how to control your glucose first thing in the morning and later two hours after eating.
Take medication. Uncommon, but in about 15% of cases, women with gestational diabetes may also need medication. It can be insulin therapy or metformin.
These lifestyle habits should be followed after pregnancy. The reason is that about half of women with gestational diabetes develop type 2 diabetes later in life. Regular exercise and a healthy diet can reduce this risk, but those who have been diagnosed with gestational diabetes should continue to have their blood sugar checked every one to three years.
“Identifying early risk factors for diabetes in adults, such as gestational diabetes, can be a call to action to start changing your diet, exercise regimen, and quit bad habits,” notes Dr. Ross.