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Gestational Diabetes Mellitus: Symptoms, Causes and Treatment

Gestational Diabetes
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Gestational Diabetes Mellitus (GDM) is high blood sugar that develops during pregnancy in someone who did not have diabetes before. Pregnancy hormones cause insulin resistance, and GDM develops when the body can't make enough extra insulin to keep up.

Gestational Diabetes

If it is not treated, it can lead to complications such as high blood pressure, preeclampsia, a very large baby and cesarean birth. High blood glucose affects both mother and baby.

The good news is that GDM can be managed with a healthy eating plan, physical activity and, if needed, insulin. Blood glucose usually returns to normal soon after delivery. Still, about half of women with GDM later develop type 2 diabetes Mellitus, so follow-up testing matters.

Why Gestational Diabetes Occurs?

Gestational diabetes mellitus happens when your body doesn't make the extra insulin needed during pregnancy. Insulin is a hormone made by the pancreas that moves glucose from the blood into cells for energy.

Hormones from the placenta make the body less responsive to insulin, especially later in pregnancy. Genes and extra weight may also play a role.

Risk Factors For Gestational Diabetes

Any pregnant woman can develop gestational diabetes, even with no risk factors, but some women are at higher risk. Risk factors include:

  • Gestational diabetes in a previous pregnancy
  • A previous baby weighing 9 pounds or more
  • Being overweight or physically inactive
  • A family history of type 2 diabetes
  • Polycystic ovary syndrome (PCOS)
  • High blood pressure or heart disease
  • Being Black, Hispanic or Latino, American Indian, Alaska Native, Asian, Native Hawaiian or Pacific Islander

Who Gets Gestational Diabetes Mellitus?

Gestational diabetes affects about 5% to 9% of pregnancies in the United States each year. Screening for this diabetes mellitus usually takes place between the 24th and 28th weeks of pregnancy, when pregnancy hormones cause the most insulin resistance. Women at higher risk may be tested earlier.

The first test is usually a glucose challenge test. If blood glucose is high, a longer oral glucose tolerance test (OGTT) confirms the diagnosis.

Signs & Symptoms Of Gestational Diabetes Mellitus

Gestational diabetes often has no symptoms, which is why every pregnant woman should be screened. When symptoms appear, they are usually mild and easy to mistake for normal pregnancy changes:

  • Being thirstier than usual
  • Urinating more often
  • Fatigue
  • Blurred vision
  • Frequent vaginal or bladder infections

Tests may also show high blood sugar or sugar in the urine.

Treatment Options For Gestational Diabetes

The primary purpose of treating gestational diabetes is actually controlling the blood glucose level. There are a few steps that you can take in order to assure you to maintain a healthy blood sugar level. They are

  • Have Regular follow up
  • Regular monitoring of your baby and you
  • Insulin therapy, if diet and activity aren't enough
  • Self-monitoring of the blood glucose levels
  • Follow a healthy eating plan and stay physically active, as your provider advises
  • Limit sweets and sugary foods
  • Aim for the weight gain your ob-gyn recommends
  • Stay hydrated with water rather than juice or other sugary drinks
  • Control diabetes after the pregnancy

That is why diagnosing gestational diabetes and starting treatment early matters. Untreated gestational diabetes can lead to:

  1. Premature delivery or an induced birth before the due date
  2. Large birth weight
  3. Labor difficulties and birth injuries
  4. Increased chance of cesarean delivery
  5. Breathing problems, jaundice and low blood sugar in the newborn

It also raises the mother's risk of type 2 diabetes later in life and slightly raises the risk of stillbirth. Extra glucose in the mother's blood crosses the placenta and makes the baby's pancreas produce more insulin. This extra insulin makes the baby grow too large, which is called macrosomia.

This article is for general information. Your ob-gyn or diabetes care team should guide your testing and treatment.

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