All you need to know about gestational diabetes

Diabetes is a chronic condition that causes an increase in blood sugar levels in the body. Among its various forms, gestational diabetes affects about three million women annually in India.

It typically emerges between 24 and 28 weeks of pregnancy, causing an increase in blood sugar levels. 

It can develop in women without any prior history of diabetes. While in most women, it disappears after the birth of the baby, in others, it can develop into Type 2 diabetes, in the absence of necessary precautions or lifestyle changes.

Fasting blood sugar levels =92, 180 and 153 mg/dl after a 75-g oral glucose tolerance test (OGTT) can indicate gestational diabetes.

"The exact cause of gestational diabetes is not known. During pregnancy, the placenta produces high levels of hormones which can impair the normal functioning of insulin in cells. This can lead to an increase in blood sugar levels, causing a temporary diabetic condition during pregnancy," said Dr. Minal Vohra, Consultant & Head, Endocrinology, Manipal Hospital, Jaipur.

Another reason could be that the hormones released by the pancreas prevent the conversion of fats and carbohydrate into sugar. This can also cause a rise in blood glucose levels. Some risk factors for this condition include obesity, diabetes in an earlier pregnancy, previous delivery of an infant with a high birth weight, parent or sibling with type 2 diabetes, a personal history polycystic ovary syndrome, ethnicity, and having pre-diabetes.

High sugar levels can cross the placenta and enter fetal circulation leading to an acceleration in fetal growth and thereby macrosomia (big baby syndrome). Increased birth weight can further lead to difficult delivery. In mothers with this condition, the infant can exhibit symptoms such as low blood sugar, low calcium levels, and prolonged jaundice.

"Apart from effective management of the condition, insulin therapy can help prevent complications. In some cases, this may be discontinued after childbirth. Women with diabetes or those who are at risk should stop taking oral diabetes medication and start insulin a month before they plan to conceive. It is also important to make certain lifestyle changes during pregnancy to manage the condition better," said Dr (Col) Sudhir Tripathi, Sir Ganga Ram Hospital, New Delhi.

• Avoid junk food: Processed foods contain refined sugar which is a major risk factor for increasing blood sugar levels in pregnancy. This is more so in case of those with a history of the condition. It is better to consume a diet rich in fruits, vegetables, and whole grains. Maintain your calorie intake and have small, frequent meals.

• Check your blood glucose regularly: Keep a tab on your blood glucose levels during pregnancy. Knowing your vitals can help you in managing your lifestyle better.

• Reduce stress: Pregnancy can be a tough period for women. The resultant stress and upsurge in hormones can all lead to an increase in blood sugar. Try engaging in techniques like yoga and meditation to reduce stress in consultation with a specialist.

• Keep a check on your weight: While some amount of weight gain is normal in pregnancy, ensure that it does not increase to proportions that can cause complications. Obesity and high sugar levels go hand in hand and therefore, overeating and processed food should be avoided.

• Exercise: Engage in light physical activities in consultation with your gynecologist throughout pregnancy. Being active can help maintain weight and prevent blood sugar levels from shooting up. Physical activity also boosts good cholesterol and improves blood circulation.