Diabetes in pregnancy


What is gestational diabetes?

Gestational diabetes mellitus (GDM) is diabetes occurring during pregnancy, and it usually resolves with the birth of the baby, unlike Type 1 or Type 2 Diabetes, which are lifelong conditions.

From mid-pregnancy onwards, the body has to produce extra insulin to meet your growing body’s and your baby’s needs. If this doesn’t happen, then gestational diabetes sets in. Some hormones of pregnancy also interfere with insulin mechanisms further increasing the problem of insulin resistance.

Blood and urine sugar detection will be a part of your antenatal blood tests that help screen for gestational diabetes.

A aglucose tolerance test (GTT) is a screening test that is recommended at 24-28weeks of gestation, especially for South Asian women, because the incidence of GDM in this froup of women is quite high.

What are the effects of gestational diabetes on my baby?

If the high blood sugars are not controlled in pregnancy, large amounts of glucose cross the placenta and reach the baby. This, causes the baby to secrete large amounts of insulin, which in turn, makes the baby grow very big. Such big babies are difficult to deliver normally and often require a Cesarean section.

Babies born to GDM mothers are more at risk to be jaundiced (hyperbilirubinemia) or have breathing problems (respiratory distress). These babies are prone to having low sugars after birth (neonatal hypoglycemia) and it is very important to prevent this from happening.

Research also indicates that large babies are prone to being obese as adults and also more likely to develop diabetes later in life.

Who is at risk of developing Gestational Diabetes?

The following women are at increased risk:

  • Gestational diabetes in previous pregnancy
  • Large baby in previous pregnancy
  • Obese women (BMI over 30)
  • Older mothers > 35 years
  • Women with parents or sibling with type 1 diabetes / family history of type 2 diabetes
  • Women with high blood pressure
  • Urine positive for sugar in antenatal test
  • Women of Asian-Indian / African – Carribean race or from Middle East

Are there any early symptoms of diabetes?

Most women with gestational diabetes may not experience any symptoms, but some may have extreme thirst, hunger and fatigue. All women are screened for gestational diabetes in the second trimester, so that those without any symptoms can also be detected.