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Becoming a mother is a wonderful phase of life but it can cause a series of hormonal changes in her body which may also put the expecting mother at risk of several diseases. Gestational Diabetes Mellitus (GDM) is one of the most common medical complications of pregnancy affecting approximately 5 million females in India. The incidence of GDM has increased up to 20% in the last 10 years. GDM is a condition in which raised blood sugars are detected first time during pregnancy. It is classified into two categories, depending on the response to nonpharmacological therapy, diet management and physical activity. It is defined as Class A1 if it responds, otherwise, the patient is classified as Class A2 and needs oral medications and insulin for control of blood sugars.
During pregnancy, the foetus and placenta produce certain hormones that prevent the body from using insulin effectively. To compensate, the mother must produce more Insulin to maintain the blood sugar levels. If this extra insulin is not enough, glucose builds up in the cells instead of being absorbed and resulting in higher glucose levels in the body.
Gestational diabetes does not have any specific symptoms. Most cases are diagnosed only during screening tests. Some women can develop symptoms, if the sugar levels are too high like feeling thirsty, frequent uncontrollable urination, extreme tiredness, frequent infections and she feels like eating more than usual.
The prevalence of GDM has increased recently. The reasons behind this are increasing maternal age, PCOS, pregnancy conceived through ART techniques, lack of exercise, increased stress level and family history of diabetes and obesity.
Testing for GDM is recommended twice during pregnancy. The first testing should be done during the first antenatal contact as early as possible in pregnancy. The second testing should be done during 24-28 weeks of pregnancy if the first test is negative.
In accordance with DIPSI (Diabetes in Pregnancy Study Group of India) criteria, 75 grams of glucose is given orally and Plasma glucose level is checked after 2 hours. A threshold plasma glucose level of > 140 is taken as the cut-off for the diagnosis of GDM. It serves both as a screening and diagnostic procedure.
The presence of GDM has important implications for the mother and baby. GDM more than doubles the risk of perinatal morbidity and mortality and the risk progressively increases as the level of blood sugar increases.
For the baby in the womb, raised blood sugars in the mother may cause increased levels of Insulin which leads to an increase in the size of the baby, birth trauma mainly shoulder dystocia, infections, and delay in the lung maturity of the baby. It also causes low blood sugar and oxygen levels in babies. Higher insulin levels in babies in the womb may also increase the genetic risk of development of obesity, diabetes and metabolic syndrome in future.
For the mother, GDM increases the risk of the trauma of the birth canal in view of the large size of the baby and increases the chances of the requirement of Cesarean delivery. There is also the risk of increased blood pressure during pregnancy.
The risk of premature delivery and infection is high. Mothers getting GDM during pregnancy have higher chances of developing permanent Diabetes in their later life.
Gestational diabetes can be effectively treated and is a preventable condition. Check out the below-mentioned tips to keep blood sugar spikes under control during pregnancy.
Regular antenatal check-ups and ultrasounds to monitor the well-being of the baby.
GDM is a very common disease that can have serious consequences. The need is, to be aware of it, check for it and to control it in time.
