Just done the Glucose Tolerance Test, and have been given a diagnosis of Gestational Diabetes ?
Dr Nupur Gupta (Gynecologist & Obstetrician, Well Women Clinic, Gurgaon) answers all your questions about Gestational Diabetes.
What is gestational diabetes?
Gestational Diabetes is defined as the elevated blood sugar level in a mother during pregnancy,this usually occurs during mid to late pregnancy period.
Am I at risk of developing gestational diabetes?
You are at risk of developing Gestational Diabetes if you have / are :
- Overweight or high BMI (body mass index) especially higher than 30
- Positive family history of diabetes particularly parents and siblings
- Advanced age (age>40 yrs)
- Some genetic factors contribute to gestational diabetes
- Polycystic ovarian syndrome
- Previous birth of overweight baby of 4 kg or more
- Previous stillbirth or unexplained perinatal loss
- Presence of hydramnios or recurrent vaginal candidiasis in present pregnancy
What are the symptoms of gestational diabetes?
Most women with gestational diabetes don’t show any symptoms. However, some women might show following symptoms :
- Increased thirst
- Increased urination
- Fatigue, generalized weakness
- Nausea and vomiting
- Bladder infection
- Yeast infections and blurred vision.
What is the treatment for gestational diabetes?
The main aim of the treatment is to have careful antenatal supervision to control the blood glucose level along with careful monitoring of the baby for the best maternal and fetal outcome.
The treatment of gestational diabetes is a combination of medicines, diet and mild to moderate exercise as per the capacity of the mother.
In medication , Insulin injection is the first line of treatment to control the blood glucose within the normal physiological range. The dose of the injection is decided as per the blood glucose level. The patient is guided about the testing, dose, and self-administration of insulin injection at home.
The consulting Gynecologist will decide about other medications as per the requirement of the patient.
A proper diet plan about what to eat and in how much quantity is given to the patient which helps to control any unnecessary weight gain and to get a nutritional diet to control the blood glucose level along with healthy growth of the baby.
A good exercise regime according to the mother’s requirement not only helps the mother to keep her more flexible, active, energetic but also contributes to the well-being of the growing baby.
How does gestational diabetes affect pregnancy?
Gestational diabetes needs careful management as it may lead to many adverse effects on the ongoing pregnancy. Though screening, timely diagnosis, good antenatal care and regular medications increases the chances of good outcome; but in some cases, the gestational diabetes may lead to both fetal and maternal complications.
The effects on mothers are increased chances of development of toxemia or pre-eclampsia/ eclampsia with advanced pregnancy, hydramnios, maternal infections especially urinary tract infections, maternal distress, ketoacidosis, more possibility of C-section, and preterm delivery.
The effects on baby are 30-40% chances of fetal macrosomia (large head size) due to maternal high blood sugar level, more possibilities of stillbirths and intrauterine deaths.
The effects on new born babies are chances of hypoglycemia, jaundice, low calcium levels, and metabolic syndrome (obesity, high blood glucose, high blood pressure and high cholesterol in early age),
The effect on labor can be prolonged labor due to large baby, shoulder dystocia, brachial plexus injury, maternal perineal injury, postpartum hemorrhage and operative interference.
How can I have a healthy pregnancy with gestational diabetes?
Mothers with Gestational diabetes can have a healthy pregnancy with healthy outcome with certain precautions. As soon as the mother is aware, anxiety and confusion sets in. Important is to eliminate the fear by getting more information about it through the treating doctor. They will guide you properly about how to follow a healthy routine.
Some things to keep in mind:
- Get knowledge and information about gestational diabetes to reduce the stress and anxiety which also has the negative effect on health
- Regular medications as advised by the treating doctor
- Regular monitoring of the blood glucose level
- Regular follow up or antenatal check ups
- Customized diet plan as per the need
- Regular physical activity in the form of exercise/ prenatal yoga/ brisk walking if not restricted by the treating doctor
- Good physical and emotional support also plays an important role to stay positive
When should I call the doctor if I have gestational diabetes
As soon as the screening for gestational diabetes comes positive, regular follow up as per the advice of the treating doctor is necessary. The conditions when immediate consultation is necessary are:
- Uncontrolled blood sugar level despite the medication
- Generalized weakness and increased thirst
- Burning and frequency of urination
- Blurred vision
- Increased anxiety and depression
- Excessive weight gain
- Decreased fetal movements or no fetal movements
- Pain in lower abdomen or contractions
- Curdy white vaginal discharge with vaginal itching
- Any kind of infection or injury
- Sudden gush of water or leaking of water per vagina especially in hydramnios