Diabetes During Pregnancy

What is Gestational Diabetes? Gestational diabetes is a type of diabetes that occurs during pregnancy and resolves after childbirth, unlike Type 1 and Type 2 diabetes. However, women with gestational diabetes have been observed to develop Type 2 diabetes later on. Gestational diabetes can also be defined as a condition of varying degrees of glucose intolerance seen in pregnant women. In pregnancy, fasting blood sugar should be below 90 mg/dL, post-meal blood sugar should be below 120 mg/dL, and the HbA1c value should be under 6%. Values above these thresholds are considered gestational diabete

Who is at High Risk for Gestational Diabetes?

• The following individuals are at higher risk for gestational diabetes:
• Those with a first-degree relative who has diabetes
• Those who are obese
• Those who had gestational diabetes in previous pregnancies
• African-American, Asian, and Latina women
• Use of corticosteroids during pregnancy
• A history of poor glucose tolerance before pregnancy

How is Gestational Diabetes Diagnosed?

The diagnosis of gestational diabetes is made using a glucose tolerance test. In this test, the patient is given 50 grams of sugar, and their glucose level is checked one hour later. If the blood sugar level exceeds 140 mg/dL, a 100-gram glucose tolerance test is conducted. During this test, blood sugar is measured at one, two, and three hours. If at least two of these values are above 140 mg/dL, the diagnosis of gestational diabetes is confirmed. Pregnant women at risk for gestational diabetes should be evaluated for diabetes as soon as pregnancy is confirmed. For those not at high risk, diabetes screening should be done between the 24th and 28th weeks of pregnancy.

What Are the Risks of Diabetes During Pregnancy for the Mother and Baby?

Risks for the Mother:

• Miscarriage
• Hyperglycemia
• Hypoglycemia
• Organ damage
• Preeclampsia
• Urinary tract infections
• Severe anemia
• Cesarean section
• Postpartum bleeding
• Postpartum tissue infections

Risks for the Baby in the Womb:

• Congenital anomalies
• Growth retardation
• Oligohydramnios (low amniotic fluid) or polyhydramnios (excessive amniotic fluid)
• Large baby (macrosomia)
• Premature birth
• Birth trauma

Risks for the Newborn:

• Respiratory distress
• Hypoglycemia
• Jaundice
• Death

How is Diabetes Treated During Pregnancy?

Pregnant women diagnosed with diabetes should monitor their blood sugar levels regularly. The target fasting blood sugar level should be below 90 mg/dL, and post-meal blood sugar should be below 140 mg/dL at one hour and below 120 mg/dL at two hours. Medical nutrition therapy should be applied for gestational diabetes, aiming to ensure adequate weight gain for the mother and prevent an increase in blood sugar levels.

Pregnant women should engage in regular physical exercise. Exercise increases muscle mass and enhances tissue sensitivity to insulin. The exercises should not be too strenuous for the pregnant woman. Insulin may be used in the treatment of diabetes in pregnant women. Oral diabetes medications are not recommended for pregnant women.