Gestational diabetes: signs and symptoms

AS wonderful a journey as pregnancy may be for some women, it can be arduous and fraught with many complications. Dr Keisha Buchanan, obstetrician-gynaecologist at Icon Medical Centre, says that one of the most common life-threatening conditions developed during pregnancy is gestational diabetes.  

“Gestational diabetes is diabetes that is first diagnosed in pregnancy. This is a condition in which an organ called the pancreas has difficulty regulating the blood sugar which tends to be high, [and poses a serious risk to the mother and foetus if left uncontrolled],” Dr Buchanan said.

She explained that gestational diabetes could have been pre-existing or could develop later in the pregnancy, typically around the seventh month.

An international study on gestational diabetes led by Professor of Metabolism and Nutrition at the Feinberg School of Medicine, Northwestern University in Chicago, said that gestational diabetes differs from regular diabetes in that this time the pancreas is not at fault.

The study showed that at the heart of gestational diabetes is the placenta, [which connects the mother to the baby and is the primary link for nourishment from mother to foetus]. According to the study, the hormones produced by the placenta interfere with the body’s usual response to insulin, a condition which is termed insulin resistance. And while the pancreas in response works to increase the supply of insulin to counter the insulin resistance, it is usually not enough, leading to abnormally high levels of glucose in the woman’s body. This could lead to several other complications for the mother and child.

That is why Dr Buchanan stresses the importance of controlling blood sugar levels, whether diabetes develops before or during pregnancy.

“Pre-pregnancy control is essential to reduce the risk of the embryo being adversely affected and to prevent the occurrence of birth defects such as spinal cord defects. High blood sugar levels throughout pregnancy can cause foetal growth restriction and smaller babies. There is a higher risk of premature birth and Caesarean sections, and a higher chance of stillbirth,” Dr Buchanan warned.

In cases where diabetes develops later in pregnancy, this may increase the risk of large babies, stillbirth, traumatic birth for mother and baby, and more Caesarean sections. Significantly, Dr Buchanan notes that one-third of these women will develop diabetes later in life, and have children who are also at a higher risk of obesity and diabetes.

“Managing diabetes is very important, and so you must always aim to maintain a good blood sugar level. This can be done through exercise, close adherence to a diabetic diet, and use of medication such as insulin if needed to help maintain good blood sugar levels. Losing weight before pregnancy, if the woman is overweight or obese, can also help to prevent diabetes,” Dr Buchanan advised.

She warned that some women are at a higher risk of diabetes by virtue of the fact that they have a close relative such as their mother who is diabetic, they have Polycystic Ovarian Syndrome, are obese, or are being treated with steroids. As such, it is important for them to always aim for a healthy lifestyle.

For women who fear their gestational diabetes scare could potentially lead to full-blown diabetes, there are a number of ways to stave off the condition.

“Fortunately, women who develop diabetes in their pregnancies can do a lot to prevent diabetes later in life. Within the first week after delivery, diabetes will completely resolve for most women. Hence, changes in the lifestyle such as regular exercise (three or more times per week), an avoidance of starchy, high sugar content and processed foods will help to prevent diabetes later and help to prevent it in future pregnancies,” Dr Buchanan advised.