Dr Minal Mohit, Consulting Endocrinologist, BeatO App explains about gestational diabetes and its impact on mother and unborn child
Being pregnant is the most extraordinary and miraculous time for a woman. While motherhood is an ultimate prize, the reality is many women suffer from real lows, physically, while commemorating one of the biggest high points in their lives.
Gestational diabetes or gestational diabetes mellitus (GDM) is a kind of diabetes that develops during pregnancy, particularly in the third trimester, and is characterised by elevated blood glucose levels that are normal before pregnancy. The mother’s inability to produce enough insulin to overcome resistance levels during pregnancy often triggers GDM. Gestational diabetes is most commonly a transitory health condition, although, receiving a professional opinion is of utmost importance to avoid the child being affected by it.
Additionally, polycystic ovary syndrome, commonly known as PCOS is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges. PCOS is an indication for an early glucose tolerance test during pregnancy, independently of Body Mass Index (BMI).GDM and PCOS are the most common endocrine disorders in women of reproductive age.
A possible explanation for both the conditions, GDM and PCOS, remains genetics. It may be the first symptom of an increased risk of developing insulin-resistant illnesses, such as type 2 diabetes as well as obesity. Cardiovascular risk factors such as metabolic syndrome, hypertension, and dyslipidemia are also linked to both disorders.
The symptoms
Mothers who experience excessive hunger, excessive weight, vaginal infections, excessive urination, and thirst are more prone to GDM.
The risks
Women who are older than 25 are at a greater risk for developing gestational diabetes than younger women.[1] Depending on the study observation and the diagnostic criteria used, GMD affects between 9 per cent and 25 per cent of pregnant women. Whereas, the prevalence of PCOS ranges from 5 per cent to 15 per cent. Studies have also found that PCOS raises the risk of GDM regardless of adiposity level. While the majority of research shows that PCOS does not enhance the risk of GDM on its own, being overweight is the biggest predictor of GDM. According to another study, non-obese women with PCOS are not at risk for GDM. It’s common to hear that the lifetime cumulative incidence of diabetes among women with GDM is as high as 60 per cent. In addition, the majority of women suffering from PCOD (Polycystic Ovarian Disease) suffer from obesity and are overweight.
The impact
Blood sugar that is not well controlled in a woman with GDM can lead to problems for the pregnant woman and the baby:
Large babies: Macrosomia refers to a baby who is considerably larger than normal. The fetus takes all of its nourishment directly from the mother’s blood. When the maternal blood contains too much glucose, the fetus’s pancreas detects this and creates extra insulin in an attempt to utilise the glucose. The fetus converts the additional glucose to fat.
C-Section: Following macrosomia, a possibility of giving birth to a large baby, the mother may be advised to go for a cesarean (C) section delivery. Babies weighing more than 4 kg are more likely to have an injury during delivery, necessitating a C-section procedure.
Hypoglycemia: Hypoglycemia refers to low blood sugar in the baby immediately after delivery. Sometimes babies of mothers with GDM have hypos, as a result of exposure to high blood sugars inside the womb. In long run, such babies are at higher risk of obesity and type two diabetes, and all the metabolic complications.
Premature deliveries: Premature births are possible for mothers diagnosed with GDM. Early labour is more likely to occur when blood sugar levels are extremely high. Stillbirth is also a possibility from time to time. Untreated gestational diabetes can also result in mortality for the baby.
Breathing difficulties: Babies born early to mothers with GDM may experience serious breathing difficulties and respiratory distress syndrome.
The treatment
Foods abundant in fibre and protein, especially lean protein like fish, as well as anti-inflammatory foods and spices like turmeric and tomatoes, are recommended. High-refined-carbohydrate foods, such as white bread, sugary snacks, and drinks, should be avoided. In addition to a healthy diet, red meat and processed foods should be avoided.
The best strategy to reduce the risk of GDM is to maintain a healthy lifestyle, remain physically active, and plan ahead, which entails losing weight if the mother is overweight. Lastly, sleep well. If the mother is well-rested, it ensures that she and the baby’s health are not compromised in any way whatsoever.
Reference:
[1] https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes