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Diabetes in Pregnancy

  • Credits: www.ckbhospital.com
  • Author: Dr. Astha Dayal
  • 29 Mar, 2021

Worried About Having Diabetes During Pregnancy? 

Here's What You Need to Know.

or

All You Need to Know About Having Diabetes During Pregnancy.


Introduction

Diabetes during pregnancy, also known as gestational diabetes, is a condition that is developed by expecting mothers during the term of their pregnancy. It usually goes away after pregnancy and can be avoided by taking a few simple steps like regular exercise and practicing certain dietary restrictions.

Gestational diabetes affects how a woman's body uses sugar during pregnancy. A lot of hormones come into play when considering a patient who might have the condition. 


There are two classes of gestational diabetes:


  • Class A1: Women with class A1 of gestational diabetes are at a lower risk and can easily avoid the condition after pregnancy.
  • Class A2: Women with class A2 have to take the support of other medication and insulin.

Both conditions are manageable, if not treatable. Pregnant women can take steps to ensure that they do not leave any lasting effects in the future.

 

What Are the Symptoms of Gestational Diabetes?

There are no clearly defined symptoms of gestational diabetes. Many of the symptoms aren't even noticeable among most patients. Most women find out about it through regular screening or check-ups. Hence, stay in touch with your doctor regarding any complications.


Some symptoms that could point to gestational diabetes include:

  1. You might feel thirstier than usual and feel the need to keep on drinking more water from time to time.
  2. Your hunger levels might increase, and the frequency at which you feel hungry during the day will also increase.
  3. As a result of drinking more water, you might also feel the urge to use the washroom more to urinate.


What Are the Causes of Gestational Diabetes?

Researchers have not yet established a specific cause of gestational diabetes in women. However, a few factors have been linked to the development of the condition.


Obesity

Some researchers believe that having excessive weight before pregnancy is a contributing factor to an increased risk of gestational diabetes. In these cases, an active lifestyle may prove beneficial in curbing the condition.


Hormonal Changes

At its core, gestational diabetes is the result of hormonal changes during pregnancy. These are the ways in which hormones can lead to the condition:

  • Insulin Resistance: Hormonal changes in the body affect insulin production and its required amount.
  • Hyperglycemia: The change in hormone levels also makes it harder for the body to process blood sugar efficiently. This, too, causes an increase in blood sugar levels.
  • Placenta: The placenta releases a hormone called human placental lactogen (HPL). It causes excretion of high levels of insulin counteracting hormones, leading to an increase in blood sugar.
  • Cortisol: Cortisol is another hormone, just like estrogen, that can cause a contra-insulin effect and, in turn, cause gestational diabetes. The placenta releases this hormone between weeks 20-24 of the pregnancy.


Who Are the High-Risk Patients for This Disease?

Certain genetic and health factors come into play when considering the patients who more susceptible to this condition as compared to others. They are:

  1. People who have been overweight before childbirth
  2. Certain people who have been prediabetic (have had high blood sugar in the past but not extremely high)
  3. Having a family history of diabetes
  4. Have given birth to a heavy baby (more than 4 kgs) during their first or previous pregnancy
  5. Women who are older than 25 years of age
  6. Women with pre-existing conditions that have had medical complications before


How Is the Diagnosis of Gestational Diabetes Made?

Gestational diabetes usually occurs in the second half of pregnancy. It is crucial that expecting women consult their doctors regularly between weeks 24 and 48 to diagnose this condition.

First, patients undergo a non-fasting oral glucose tolerance test, also known as OGTT. It involves testing blood sugar after consuming the consumption of a sugary substance. If the blood sugar is excessive, the patient is at a higher risk of developing blood sugar not only during pregnancy but even in the later stages.

At this point, your doctor will conduct a fasting OGTT. The procedure for this test is the same as before, except here, patients do not eat anything beforehand. Your doctor will monitor the difference in the sugar levels after a few hours. 


What Is the Treatment for Gestational Diabetes?

The best course of action to take when treating gestational diabetes is managing your blood sugar via a healthy routine of diet and exercise. Whatever steps you do decide to take, make sure they are moderate and easy on the body.


Exercise

Simple exercises like walking, light jogging, and swimming will help avoid a rise in blood sugar levels and also keep your body fit and active. The level of exercise has to be moderate and easy-going. Make sure that your exercise is not very strenuous since it can cause other adverse effects on pregnancy.  


Diet

To avoid gestational diabetes, pregnant women must eat a healthy and balanced diet. Do not make extreme changes to your diet as that can lead to drastic effects on your body. Just make sure your diet includes a little bit of all important nutrients and vitamins. Also, wherever possible, try not to eat excessive sugars and keep your diet as sugar-free as possible. 


Other Steps

Some other steps you can take to ensure a healthy pregnancy is checking your blood sugar level regularly. Also, check your urine for ketones, as that could lead to diabetic ketoacidosis.


Conclusion

Gestational diabetes is something most women come out of completely. As soon as the delivery is done, there is a visible difference in the sugar levels of the mother. But if this doesn't happen,Consult a doctor and try to learn more about the type of diabetes you have developed and steps you can take to minimize it. 

Throughout your pregnancy and even sometime after the delivery, it is imperative to stay in constant touch with your gynecologist and get professional help regarding any doubts or issues you might be facing. Be informed about the conditions you have, whether they are temporary or could lead to something life-long, and how you can help make it better.



Dr. Astha Dayal

MBBS, MD (Obstetrics & Gynaecology) MRCOG

Consultant - Obstetrics & Gynaecology

C K Birla Hospital, Gurugram



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