Diabetes that occurs during pregnancy (aka-gestation) in a woman who did not have it before becoming pregnant is known as gestational diabetes. Diabetes is characterized by high blood sugar, also known as hyperglycaemia, which can cause organ damage and complications in both the mother and baby. It is estimated that 9-25% of all pregnancies in South Africa are affected by hyperglycaemia/ gestational diabetes. Like in other forms of diabetes, the body can’t process sugar (glucose) correctly. A hormone called insulin, produced by the pancreas, helps glucose in the blood enter the cells in the body, where it is converted into energy. Sometimes, a pregnant mother’s body may not be able to make or use insulin as well as in pre-pregnancy. This condition called insulin resistance can cause a build-up of glucose/sugar levels in the blood.
In gestational diabetes, there may be no symptoms present, so it is common to check glucose levels during pregnancy even with no symptoms. However, it is important to notify your doctor if you notice any of the following signs and symptoms of gestational diabetes at any point in your pregnancy.
It is unknown why some women develop gestational diabetes while others don’t. However, some risk factors in the mother may make gestational diabetes more likely.
At your first prenatal appointment, your healthcare provider will examine you and ask questions to find out if you have risk factors for gestational diabetes. If you have risk factors, you will be tested for gestational diabetes. In most cases, this testing is done between 24 and 28 weeks. If your risk is high, it may be done earlier. In some parts of the world, testing for gestational diabetes is a routine screening procedure in all pregnancies. The standard test to detect gestational diabetes is an oral glucose tolerance test (OGTT). In this test, blood glucose is tested in the morning after 8-10 hours with no food or drink, then the patient drinks a measured glucose solution. Two hours later, the blood is tested to determine how your body is handling the glucose. If blood glucose levels after the OGTT are elevated, this confirms a diagnosis of gestational diabetes.
Treatment for gestational diabetes includes monitoring blood sugar levels with an at-home testing kit, changes in diet and exercise, and when needed, insulin injections or oral medications to control blood sugar. Treating gestational diabetes and keeping blood sugar readings at a healthy level can help prevent diabetes-related complications in the mother and baby.
Often, women with gestational diabetes have otherwise normal pregnancies and healthy babies. However, the following complications are possible, especially when blood sugar levels are not kept in check with proper treatment.
Prevention of gestational diabetes is not always possible, but maintaining a healthy weight and active lifestyle can help. It is important to visit your doctor regularly during pregnancy (patients with gestational diabetes may have visits scheduled more often), monitor blood sugar, make recommended lifestyle changes, and take medications as prescribed, to prevent gestational diabetes-related complications.