Gestational Diabetes

Gestational diabetes is diabetes which starts during pregnancy, in women who have not previously had high blood sugar. it affects about 4% of pregnant women, and is a significant health risk which needs to be monitored and treated properly.

Gestational diabetes is caused by hormones produced by the placenta. These hormones stop insulin from working to lower blood sugar, and as a result, blood sugar levels rise. The amount of insulin needed by a pregnant woman may be three times as much as normal, and although the cells producing insulin work as hard as they can, eventually they are not able to keep up with demand. It is believed that some women who develop gestational diabetes were suffering from undiagnosed pre-diabetes before pregnancy, and these women sometimes need to continue treatment for diabetes after pregnancy. However, the majority of women regain normal blood sugar levels after birth.

There is a high probability of having gestational diabetes in a subsequent pregnancy after it has occurred once, and women who are at risk should start blood sugar monitoring as early as possible.

The complications of gestational diabetes affect both mother and baby, and before the risks were understood, it was a major cause of death in labour. The problem is that while insulin cannot cross the placenta, sugar can. This means that if diabetes is not treated, the developing baby recieves too much sugar. The baby's pancreas starts to produce large amounts of insulin, and the excess sugar is converted to fat. The baby may become very fat, a condition known as macrosomia. At birth the baby's shoulders may be too large to pass down the birth canal, and a cesarian section is neccesary. After birth, the large amount of insulin produced by the baby's pancreas can cause hypoglycemia ( low blood sugar ) and if untreated this can lead to coma and death.

For these reasons, it is extremely important to keep sugar levels balanced during pregnancy. Methods of treatment are a dietician planned diet, moderate exercise, and for some women, insulin therapy. The good news is that treatment is usually effective in reducing complications, and women who follow their doctors instructions will usually give birth to healthy babies.

Women who have had gestational diabetes are at risk of developing type 2 diabetes years later, even if blood sugar levels are normal after birth. For this reason, doctors reccommend this group of women to lose excess weight, eat a healthy diet and take regular exercise in order to reduce risk factors.