Gestational Diabetes Mellitus (GDM): Symptoms, Causes and Management

Q: What is The Specialty of Doctors Treating Diabetes?

Doctors who treat diabetes typically specialize in endocrinology, the branch of medicine dealing with the endocrine system and its disorders.

By Dr. Girish Parmar in Endocrinology

Apr 24 , 2023 | 3 min read

What is Gestational Diabetes?

Gestational Diabetes Mellitus (GDM) is a type of diabetes that develops during pregnancy due to hormonal changes affecting insulin function. It typically appears between the 24th and 28th weeks of pregnancy and usually resolves after childbirth. If left unmanaged, GDM can lead to complications for both the mother and baby.

Gestational Diabetes Symptoms

Many women with gestational diabetes may not experience noticeable symptoms. However, some may develop:

Increased thirst
Frequent urination
Fatigue
Blurred vision
Unusual hunger

Causes of Gestational Diabetes

The primary cause of GDM is hormonal changes during pregnancy, which lead to insulin resistance. This means the body struggles to use insulin effectively, resulting in high blood sugar levels. Key contributing factors include:

Placental hormones interfering with insulin
Genetic predisposition
Pre-existing insulin resistance

Risk Factors for Gestational Diabetes

Certain factors increase the likelihood of developing GDM, such as:

Age: Women over 30 are at higher risk.
Obesity: Excess weight can contribute to insulin resistance.
Family History: A family history of diabetes increases the risk.
Ethnicity: Higher prevalence in South Asian, Indigenous, Hispanic, and African-American populations.
PCOS:Polycystic Ovary Syndrome increases susceptibility.
Previous GDM: Having GDM in a past pregnancy raises the risk.
Certain Medications: Some corticosteroids and antipsychotics can contribute.

Gestational Diabetes Diagnosis

GDM is diagnosed through routine glucose screening between the 24th and 28th weeks of pregnancy.

Types of Gestational Diabetes Tests:

Glucose Challenge Test (GCT): A preliminary test measuring blood sugar levels one hour after consuming a glucose solution.
Oral Glucose Tolerance Test (OGTT): A follow-up test measuring blood sugar levels over a two-hour period to confirm GDM.

How Does GDM Affect the Mother?

Increased risk of preeclampsia (high blood pressure and complications during pregnancy).
Higher chances of preterm delivery and C-section.
Increased risk of developing Type 2 diabetes later in life.

How Does GDM Affect the Baby?

Excessive birth weight: Can lead to delivery complications.
Breathing problems: Babies may experience respiratory distress at birth.
Low blood sugar (hypoglycemia): Can cause seizures in newborns.
Higher risk of obesity and Type 2 diabetes later in life.

Gestational Diabetes Management & Treatment

Managing GDM involves maintaining stable blood sugar levels through lifestyle changes and, if necessary, medication.

Lifestyle Modifications:

Healthy Diet: Focus on fiber-rich, low-fat foods and controlled carbohydrate intake.
Regular Exercise: Walking, prenatal yoga, and moderate workouts can help regulate blood sugar levels.
Blood Sugar Monitoring: Regularly checking blood glucose levels is crucial.

Medication Options:

If lifestyle changes are insufficient, insulin or oral medications may be prescribed.

Target Blood Glucose Levels for GDM:

Fasting blood sugar: Below 95 mg/dL
1-hour post-meal: Below 140 mg/dL
2-hour post-meal: Below 120 mg/dL

Complications of Uncontrolled Gestational Diabetes

If left untreated, GDM can lead to severe complications such as:

High blood pressure and preeclampsia
Premature birth
Stillbirth (in severe cases)

Preventing Gestational Diabetes

Although not all cases can be prevented, certain steps can help lower the risk:

Maintain a healthy diet with fiber-rich, low-sugar foods.
Engage in regular physical activity before and during pregnancy.
Achieve and maintain a healthy weight prior to conception.

When to See a Doctor

Consult a Diabetologists if you experience any unusual symptoms or difficulty managing blood sugar levels. Routine prenatal check-ups and early screening can help ensure timely intervention.

Final Thoughts

Gestational diabetes is a manageable condition with the right lifestyle changes and medical support. Early diagnosis, proper diet, regular exercise, and blood sugar monitoring can help ensure a healthy pregnancy for both mother and baby.