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Understanding Gestational Diabetes

What is it?

Gestational diabetes, or “pregnancy diabetes,” affects between 3 and 20% of pregnant women. It generally occurs in the second or third trimester and goes away on its own after childbirth.

Any pregnant woman can develop it, but there are a number of risk factors such as age, ethnicity, excess weight, corticosteroid use, family history and some pre-existing conditions.

What’s happening?

Gestational diabetes occurs late in pregnancy, at the stage where the baby is already formed. Placental hormones, which help the child grow, start blocking the action of the insulin produced by the mother’s pancreas to regulate sugars in the blood (blood sugar or glucose level). This phenomenon is known as insulin resistance.

As a result, glucose is not converted into energy, accumulating in the blood instead.

What should you watch for?

Women with gestational diabetes often have no symptoms. Therefore, it is recommended that all pregnant women undergo screening between the 24th and 28th week of pregnancy, or earlier if they are at risk.

How do you manage gestational diabetes?

The goal is to reduce blood glucose to the normal levels exhibited by a woman without gestational diabetes.

This usually involves eating a healthy and balanced diet, performing moderate physical activity for about 150 minutes per week, reducing stress as much as possible, monitoring weight gain and measuring blood glucose levels using a glucose meter. These measures should be complemented by checkups at the hospital and adjustments along the way based on how the situation evolves. Changes in habits will sometimes not be enough; in such cases, insulin injections should be used during the pregnancy.

What are the potential complications?

Listed below are the most common complications, which are very often avoidable with prevention and appropriate treatment.

In the child:
• Macrosomia (above-average weight)
• Risk of being born with very low blood sugar levels and respiratory problems
• Risk of obesity and type 2 diabetes later in life

In the mother:
• Risk of a difficult delivery, possibly by C-section, depending on the baby’s weight
• Surplus of amniotic fluid, which could trigger premature delivery
• Gestational hypertension
• Preeclampsia
• Risk of developing type 2 diabetes later
• Risk of suffering from gestational diabetes again in a future pregnancy

In conclusion

In the vast majority of cases, gestational diabetes is easy to control and goes away at the end of the pregnancy. However, there is a real risk of recurrence in the next pregnancy, as well as a possibility of developing type 2 diabetes one day. Fortunately, many problems can be avoided through healthy lifestyle habits in both mother and child. Talk to your physician to see how you can put the odds in your favour.

 

References:
American Diabetes Association, “Gestational Diabetes”: http://www.diabetes.org/diabetes-basics/gestational/?referrer=https://www.google.ca/. Accessed January 19, 2017.
Canadian Diabetes Association, “Living with Gestational Diabetes”: http://www.diabetes.ca/diabetes-and-you/living-with-gestational-diabetes. Accessed January 19, 2017.
Centre hospitalier de l’Université de Montréal, “Le diabète de grossesse”: http://www.chumontreal.qc.ca/sites/default/files/documents/Votre_sante/PDF/60_4005062_diabete_de_grossesse_27_fin_2012-10-12.pdf. Accessed January 19, 2017.
Diabetes Québec, “Diabetes in pregnancy”: http://www.diabete.qc.ca/en/understand-diabetes/all-about-diabetes/types-of-diabetes/diabetes-in-pregnancy. Accessed January 19, 2017.

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