Gestational Diabetes Mellitus or GDM is a condition in which the blood sugar levels are deranged in a pregnant woman during her second or third trimester of pregnancy, who has had prior normal levels of blood glucose.
In a pregnant woman, there is an organ called the placenta in the uterus which acts as a conducting system between the mother and her baby. This placenta produces a number of vital hormones that are needed to sustain a pregnancy.
The hormones tend to increase the mother’s blood sugar levels by making maternal insulin resistant to action.
The presence of the following factors results in GDM in pregnant women:
Family history
Pre-pregnancy obesity
PCOS
Sedentary and unhealthy lifestyle
High cholesterol levels
Previous history of GDM or hypertension
Symptoms of GDM:
Most women with GDM do not experience any noticeable signs of developing diabetes. It is mostly when they test for GDM that the diagnosis is made.
However, the following symptoms may be examined to rule out the GDM:
Excessive weight gain
Dark pigmentation
Worsening acne in face, back, chest
Abnormal increased male pattern of hair growth in face, chin, chest, abdomen
Large babies
In pregnant women with no history of diabetes, test for GDM should be done at 24 to 28 weeks of gestation.
Will gestational diabetes affect the baby?
GDM can have 2 implications in a baby. (i) In the shorter period, an increase in maternal glucose leads to increased glucose levels in the baby. This is similar to overfeeding a baby, which results in larger babies and potential complications during delivery.
(ii) In the long run, the baby is more at risk of being overweight or obese, and developing diabetes.
Treatment for GDM:
The four important aspects of managing diabetes during pregnancy are:
Healthy lifestyle & dietary changes
Regular monitoring of blood sugar levels
Use of medication, preferably insulin, for better outcomes
Keeping blood glucose levels under control
Fasting – less than 90 mg/dl
Pre-meal or before eating- less than 95 mg/dl
1 hr post meals – less than 140 mg/dl
2 hr post meals – less than 120 mg/dl
If target blood sugar levels cannot be achieved with diet and exercise alone, then the need for insulin arises. Insulin does not cross the placenta, and hence cannot reach the baby, which makes it the safest way to reduce high blood sugars in pregnant mothers.
GDM Diet:
Avoid food items containing high sugar levels such as potatoes, sooji, white rice, sweeteners, aerated drinks and refined cereals like maida.
Avoid sweets and desserts.
Try to have high protein and high fiber diet by including food items like whole grains, pulses, sprouts, fresh green vegetables, lean meats like fish. Also, have more dairy products like milk or curd as these are high in protein and have a low impact in raising the blood sugar levels.
Consult Dr P Rajalakshmi, Gynecologist for further details.
