Double trouble

Posted on 18 April 2017

Gestational diabetes is the most common medical complication during pregnancy and affects as many as one in 20, putting mother and baby at increased risk for birth trauma and other serious health concerns.

Gestational diabetes starts in pregnancy, or is diagnosed for the first time during pregnancy. While the diabetes may resolve once the baby is born, a whopping 52% of moms with gestational diabetes will go on to develop Type 2 diabetes later in life.

‘Pregnancy can give us a glimpse into the future,’ says Dr Iniel Hattingh, a gynaecologist and obstetrician at Mediclinic George. ‘Moms who develop high blood pressure or diabetes during pregnancy are more likely to develop these problems when they’re older as well.’

But why does diabetes often manifest during pregnancy? ‘Pregnancy is considered a diabetogenic condition, due to higher insulin levels that occur in any normal pregnancy,’ Dr Hattingh explains. ‘However, persistently elevated glucose or sugar levels in a pregnant woman could indicate gestational diabetes. The diagnosis is made using a blood test called a glucose tolerance test, which will be performed if there are risk factors.’

Symptoms and risks of gestational diabetes

Excessive fatigue, thirst and urination or sudden weight loss can indicate diabetes, but Dr Hattingh cautions that diabetes is typically silent and symptom-less. Insulin resistance, polycystic ovary syndrome and a family or personal history of Type 2 diabetes are known risk factors, but the greatest risk factor for gestational diabetes is being overweight or obese.

‘Careful weight management through diet and exercise is important during pregnancy,’ says Dr Hattingh. The average woman should not gain more than 12.5kg during pregnancy, or less if she is overweight before becoming pregnant.

Bothersome for both

Developing diabetes during pregnancy is problematic for both mother and baby. Persistently high blood sugar values in the mother will lead to persistently high blood sugar levels in her unborn baby, and the baby will store the excess sugar as fat, increasing the probability of having a macrosomic baby (a baby that weighs 4.5kg or more).

Macrosomic babies can suffer fractures or nerve damage during birth, and their shoulders may become lodged in the birth canal. The mother is also more likely to have a Caesarean section. Besides the potential for birth trauma, the baby may also develop diabetes as an adult.

Most cases of gestational diabetes are diagnosed in the third trimester of pregnancy, and the mother will be referred to a dietician. If the diabetes can’t be managed through diet and exercise alone, medications such as insulin will be introduced to stabilise blood sugar and minimise the risks to mother and baby.

‘With the worldwide obesity pandemic on the rise, we are seeing an increase in gestational diabetes. The most effective way to decrease your chances of developing diabetes in pregnancy is to follow a healthy diet, exercise and manage your weight,’ says Dr Hattingh.

Published in Diabetes

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