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Gestational Diabetes Mellitus - Who is at risk?

Gestational Diabetes Mellitus (GDM) is a transient form of diabetes that some women may acquire during the course of pregnancy.

What is Diabetes?

Diabetes is a condition in which there are high levels of glucose in the blood (blood sugar). Glucose is the major energy source of the body. The foods that we eat are broken down to glucose in the process of digestion. This glucose is carried to the cells of the body through the bloodstream. This glucose can enter the cells only with the help of a hormone called Insulin which is produced by the organ called pancreas.

Insulin is what helps the cells to take up glucose thereby removing it from the blood. Diabetes happens when the process does not happen effectively either because there is not enough insulin to remove the glucose from the bloodstream or because the cells in the body are resistant to insulin. This results in glucose staying in the blood causing high blood sugar levels.

What is Gestational Diabetes?

In pregnancy, the woman develops a temporary organ called the placenta. The placenta is what connects the mother and the baby and ensures that the baby is getting all the nourishment it needs. The placenta also produces some hormones which help to maintain pregnancy. Some of these hormones make it hard for insulin to do its job in controlling blood glucose/blood sugar. This usually begins at 20 to 24 weeks of pregnancy.

As the placenta grows larger the effect becomes more intense and is more prominent in the last couple of months of pregnancy. Usually the pancreas is able to cater to the growing needs of insulin during pregnancy. However, in some cases the pancreas is unable to cope with the placental hormone production. This is when Gestational Diabetes occurs.

Who is at Risk?

It is one of the most common medical complications of pregnancy. Although anyone can develop this condition in pregnancy, the following category of women are at a higher risk:

  • Significantly overweight at the time of getting pregnant

  • Having a family history or diabetes or prediabetes

  • Women who have had gestational diabetes in their previous pregnancy

  • Women who have previously given birth to very large babies

  • Women with very poor dietary habits

Complications that May Arise

  • Due to the constant presence of high glucose levels in the mother's blood, the foetus may grow too large and complicate the birth process. A Caesarean section may be needed.

  • High blood sugar can also increase the mother's blood pressure.

  • It can also lead to preterm birth

  • Baby can have excessive birth weight

  • Baby may have blood sugar imbalances

  • Mother and child are prone to diabetes in the future

Regular exercise during pregnancy

Prevention & Management

  • Keep blood sugar levels within range by following a healthy meal plan

  • Ensure a good intake of vegetables, fruits and whole grains

  • Ensure a good intake of proteins in the diet

  • Avoid large portions of carbohydrates in the diet

  • Regular exercise

  • Maintain a healthy weight before pregnancy

  • Maintain a healthy weight during pregnancy

  • Monitor blood sugar levels regularly

Gestational Diabetes usually resolves after delivery. In some cases, medications or insulin injections may be needed. Complications may arise only in severe cases or in cases in which the condition is poorly managed. If left untreated it can cause problems for mother and baby.

Most women with gestational diabetes will have a healthy baby. It is very important for pregnant women to work with their health care providers to keep their blood sugar levels within a safe range.

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