Do you know what is gestational diabetes mellitus, how to treat it & how it can be diagnosed?
In Gestational diabetes mellitus, a placental hormone stops the body from utilizing insulin properly. Instead of being absorbed by cells, glucose accumulates in the circulation.
The medical abbreviation of DM is diabetes mellitus. It affects how your body converts food into energy.
Your body transforms carbs into glucose and distributes it to your bloodstream. Untreated diabetes causes your body to misuse insulin. High blood sugar occurs when glucose levels remain high. This can create life-threatening health complications.
Type 1 and 2 DM have different pathogenesis, presentation, and therapy, although both can cause hyperglycemia. Type 2 Diabetes Mellitus medical diagnosis reimbursement is based on the diabetes mellitus ICD-10 code.
Let’s learn more about it.
Table of contents
- What Are The Symptoms?
- What Are The Causes?
- Gestational Diabetes Mellitus Risk Factors
- Gestational Diabetes Mellitus Diagnosis
- How To Diagnose Gestational Diabetes Mellitus?
- How To Treat Gestational Diabetes Mellitus Effectively?
- What Are The Consequences of Gestational Diabetes Mellitus?
- Is it Possible to Prevent Gestational Diabetes?
- Pointers to Remember
- Last But Not Least
Estimated reading time: 15 minutes
What Are The Symptoms?
The majority of pregnant women do not experience any signs or symptoms as a result of Gestational Diabetes Mellitus (GDM). However, there are a few indications you should pay attention to and get your blood sugar level checked
- Weird thirst
- Urination on a regular basis
- Fatigue
- Nausea
- Infections of the skin, vaginal, and bladder on a regular basis
- Vision is hazy
If you’re experiencing any of these symptoms, you should get tested for gestational diabetes. “Gestational diabetes affects roughly ten percent of pregnancies in the United States every year,” according to the American Diabetes Association (ADA).
What Are The Causes?
There is no clear reason why some non-diabetic women acquire gestational diabetes while others do not during pregnancy. However, there is a probable cause that may provide some insight.
During pregnancy, the placenta provides sustenance for the fetus and creates hormones to keep the pregnancy going. However, certain of these hormones, such as estrogen, cortisol, and human placental lactogen, can cause insulin resistance by blocking insulin activity (contra-insulin effect). Insulin is a hormone generated by the pancreas’ beta cells that aids in the absorption of glucose by the body’s cells, hence controlling blood sugar levels.
To overcome insulin resistance, the mother’s body generates more insulin at the beginning. Insulin production fails to overcome the contra-insulin impact as the pregnancy proceeds, resulting in gestational diabetes. A pregnant woman’s chances of having GDM are increased by a number of risk factors. The following section delves deeper into them.
Gestational Diabetes Mellitus Risk Factors
According to the Centers for Disease Control and Prevention (CDC), some pregnant women have insulin resistance before to conception, which increases their risk of GDM. Aside from it, the following are other GDM risk factors:
- Over the age of 25
- Diabetes runs in the family.
- Obesity or being overweight
- Pregnancy and physical inactivity
- Having previously given birth to a child weighing more than nine pounds
- Miscarriage or stillbirth that was previously unexplained
“Women of specific gene pools, such as Hispanic, Native American, Asian American, and African-American women, may have a higher risk of gestational diabetes”
John Hopkins Medicine
Gestational Diabetes Mellitus Diagnosis
Between the 20th and 24th weeks of pregnancy, insulin resistance (contra-insulin effect) frequently develops. As a result, at a normal exam between the 24th and 28th week of pregnancy, all pregnant women are tested for gestational diabetes as part of prenatal care. A doctor may test for gestational diabetes earlier in the pregnancy if a woman has risk factors for it.
How To Diagnose Gestational Diabetes Mellitus?
Gestational diabetes mellitus is diagnosed in a number of ways. Screening should happen during the initial prenatal appointment for women with risk factors for type 2 diabetes. This recommendation comes from the American Diabetes Association.
Those diagnosed with gestational diabetes during pregnancy should be checked for diabetes 6 to 12 weeks postpartum.
Women with GDM should be examined for diabetes or pre-diabetes every three years.
To diagnose gestational diabetes, the doctor will conduct the following blood tests.
Glucose Challenge Test
It’s the first test the doctor will run to determine whether or not you have GDM.
- The doctor will ask you to consume a sweet liquid containing 50 grams of sugar/glucose for the test.
- They will next perform a blood test to determine your blood sugar level after one hour.
- The doctor will schedule an oral glucose tolerance test if your blood sugar level is greater than or equal to 140 mg/dL (7.8 mmol/L).
- You may have type-2 diabetes if your blood sugar level is more than 200 mg/dL.
Glucose Tolerance Test in the mouth (OGTT)
The OGTT measures both fasting and non-fasting glucose levels, unlike the glucose challenge test.
- You must first fast for at least eight hours before taking the test.
- Your healthcare provider will next draw your blood and give you a sweet liquid comprising 75 grams of sugar/glucose dissolved in 300 milliliters of water to consume.
- For the next two to three hours, the doctor will check your blood sugar level every hour.
- GDM is diagnosed when two or more readings (fasting, one hour, or two hours) are higher than or equivalent to the levels shown below.
| MEALTIME | BLOOD SUGAR LEVELS (MG/DL) |
| After fasting | 92 |
| After one hour | 180 |
| After two hours | 153 |
If a woman has one or more diabetes risk factors, glucose testing at the initial prenatal visit is suggested. The doctor may also recommend a urinalysis to check for glucose in the urine, which could indicate gestational diabetes.
How To Treat Gestational Diabetes Mellitus Effectively?
Healthy food, an active lifestyle, and medication (if necessary) can help most women to treat gestational diabetes mellitus effectively.
1. Consumption of nutritious foods
Women with GDM should follow a food plan according to their sugar levels, level of activity, and overall health. A professional nutritionist or diet specialist can assist you in creating a well-balanced diet plan that includes information such as what to eat, how much to consume, and when to eat.
Furthermore, they have the authority to request that you:
- Eat every two to three hours and space your meals out at regular intervals. It’s an important step to take while eating carbs because spacing carb-rich items out helps manage blood sugar levels.
- Increase your intake of complex carbohydrates such as whole grains, low-sugar fruits, and starchy vegetables.
- Two to three portions of high-quality protein foods, such as fatty fish, non-fat or low-fat dairy, lean meat, and soy products like tofu, are recommended.
- Avocados, unsalted almonds, seeds, and olive oil are all heart-healthy omega-3-rich foods.
- Women with GDM have a higher chance of developing type 2 diabetes later in life. As a result, eating well is essential for maintaining a healthy weight and sugar levels both during and after pregnancy.
2. An active way of life
Engaging in 30 minutes of moderate-intensity physical activity or exercise five days a week will help keep your blood sugar levels within the target range. It can also aid with stress relief, muscle strengthening, and joint flexibility.
Consult your doctor about the best activities for you based on your health and stage of pregnancy. Walking for ten to fifteen minutes after each meal can help with blood sugar control.
3. Prescription drugs
For most women, making healthy dietary and lifestyle modifications can help keep blood sugar levels within suggested ranges. If these modifications don’t work, you may need to take oral hypoglycemic medications or insulin to treat gestational diabetes mellitus more effectively.
Your doctor will advise you on the best medication/insulin regimen for you. They’ll also show you how to inject insulin on your own. Because injectable insulin does not pass the placenta and has no effect on the infant, it is considered safe (2).
4. Keep an eye on your sugar levels
Sugar levels must be monitored on a regular basis in order to effectively treat gestational diabetes mellitus. Throughout the day, use a glucometer to check your blood sugar levels at various intervals.
Keep note of your readings in a diary or on your phone so you and your doctor can see how well your diabetes management strategy is working.
Recommended Blood Glucose Levels For Women
The following is recommended Blood Glucose Levels for women with GDM on a daily basis:
| MEALTIME | TARGET SUGAR LEVELS (MG/DL) |
| Before meals, at bedtime, and overnight | Less than or equal to 95 |
| One hour after eating | Less than or equal to 140 |
| Two hours after eating | Less than or equal to 120 |
Your doctor will set specific blood sugar targets for you based on your overall health and BMI. You should stick to your food, activity, and drug schedules to achieve and keep those goals.
Women with GDM should test their sugar levels six weeks after delivery, according to experts. After a year, if the sugar levels are normal, the doctor will recommend a re-evaluation. If your blood sugar levels are abnormal, your doctor may offer diabetes treatment and prevention advice.
What Are The Consequences of Gestational Diabetes Mellitus?
There is more sugar in the mother’s blood when she has gestational diabetes. The fetus absorbs the additional sugar and gains weight as a result. A fetal weight of nine pounds (four kilograms) or more is thought to pose a risk to both the mother and the infant. Here’s a quick rundown of those issues (11). (12).
1. Preeclampsia and high blood pressure (HBP)
During pregnancy, high blood pressure, or hypertension, can impose unnecessary strain on a mother’s circulatory system. As a result, she could develop preeclampsia, a condition in which the mother’s organs, such as the kidneys and liver, malfunction.
The following are some of the symptoms of preeclampsia that an expecting mother may experience:
- Proteinuria (protein in the urine)
- The way you see things shifts.
- Headaches that are severe
- Preterm birth can be exacerbated by high blood pressure and preeclampsia.
2. Macrosomia
High maternal blood sugar levels result from GD, leading infants to grow weight. If you gain too much weight (nine pounds or more), the baby may become blocked in the birth canal. It can cause birthing problems, such as a significant rip in the vagina or the area between the vagina and the anus (if the baby is delivered vaginally). Alternatively, the mother may require a cesarean section in specific instances (C-section).
3. Dystocia of the shoulder
During labor and delivery, a baby’s shoulders become locked inside the mother’s pelvis, resulting in a birth injury or trauma. It can result in complications such as protracted labor and serious injury to both the mother and the infant.
Shoulder dystocia in women can result in postpartum hemorrhage (excessive bleeding). The babies, on the other hand, could suffer from the collarbone and arm fractures. They may also suffer damage to the nerves that control sensation and movement in the hands, shoulders, and arms.
4. Depression during pregnancy
Perinatal depression is a type of depression that can strike a mother during or after pregnancy (postpartum depression). It affects up to 20% of new and expecting mothers (13). A depressed mother is gloomy, apathetic, and impatient, which makes bonding with the baby difficult. The mother’s and baby’s health may require care as a result of the disease.
5. Disabilities caused by birth
Birth abnormalities affecting key organs and physiological systems, such as the heart, blood vessels, brain, spine, and digestive system, are more common in babies born to diabetes moms. Birth malformations are most common in the first trimester of pregnancy and can result in stillbirth, according to Stanford Children’s Health.
6. Hypoglycemia (low blood sugar)
The baby’s sugar levels rise as a result of the mother’s high blood sugar, forcing the baby’s body to produce more insulin. The baby’s blood sugar levels, on the other hand, drop following delivery. Insulin levels, on the other hand, remain elevated. As a result, the blood glucose level of the infant drops too low, resulting in hypoglycemia.
7. Breathing difficulties
The development of the baby’s intrauterine lungs can be hampered by too much sugar or insulin. Breathing issues, such as respiratory distress syndrome, can be caused by underdeveloped lungs (RDS). Babies born before 37 weeks of pregnancy (preterm) are more likely to have breathing issues than babies born after 37 weeks (full-term).
8. Yellowing of the skin
Jaundice is characterized by a yellowish skin hue and dilated pupils. Babies born to moms with gestational diabetes are more likely than those born to mothers without GDM to develop jaundice.
Aside from these risks, the youngster faces the possibility of developing obesity and diabetes later in life.
Is it Possible to Prevent Gestational Diabetes?
Preventing gestational diabetes is impossible. However, you may lower your chances of getting it by practicing healthy lifestyle habits including healthy eating and staying active before and during pregnancy.
If you want to start a family but are overweight or obese, start by losing weight and adopting healthy living practices.
If you’re pregnant, though, you shouldn’t try to lose weight. Instead, keep track of your weight fluctuations and stay within the appropriate target ranges. Take the advice of a professional, such as a nutritionist, to help you manage your weight. Remember that gaining too much weight too fast can put you at risk for gestational diabetes.
Gestational diabetes is a condition in which a pregnant woman who is not diabetic develops high blood sugar levels. Its specific cause is unknown but hormonal and weight changes during pregnancy are thought to have a role.
The majority of women can treat gestational diabetes mellitus by eating a nutritious diet and maintaining an active lifestyle. Some people, however, may require medication to keep their blood sugar levels under control.
Pointers to Remember
- Symptoms of gestational diabetes include unusual thirst, frequent urination, nausea, tiredness, and recurring infections.
- GDM can be caused by hormones secreted by the placenta interfering with insulin action.
- As part of prenatal care, all pregnant women are tested for gestational diabetes between the 24th and 28th week of pregnancy.
- Macrosomia, shoulder dystocia, jaundice, congenital impairments, and breathing issues are all symptoms of gestational diabetes.
- Healthy food, an active lifestyle, and medication (if necessary) can help most women to treat gestational diabetes mellitus effectively.
Last But Not Least
Gestational diabetes mellitus therapy aims to maintain blood glucose levels similar to healthy pregnant women.
In addition to particular food patterns and organized physical exercise, insulin injections and glucose monitoring are often part of the treatment regimen.
The ADA recommends gestational diabetes blood glucose guidelines. Each person’s glycemic objectives may be more or less strict.
- 95 mg/dl or less just before eating (preprandial).
- 140 mg/dl or less one hour after a meal (postprandial).
- 120 mg/dl or less two hours after a meal (postprandial).
Your treatment for gestational diabetes can be adjusted as needed with the help of your physician, nurse educator, and the other professionals of your healthcare team. Effective therapy for GDM can save the baby and the mother’s health.
Follow your doctor’s treatment plan to ensure a successful pregnancy and birth.
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