Signs of gestational diabetes

In Europe and the United States the results of numerous studies state that between three and five percent of all pregnant women develop Gestational Diabetes. In Sweden, the numbers are slightly lower, just under three percent, but new criteria for assessing Gestational Diabetes can cause the number of women diagnosed with it increase two to three times. As a result more people can get treatment that reduces the risk of negative effects of the elevated blood glucose levels in the mother and child.

The insulin hormone produced in the pancreas lowers the blood sugar level. If you cannot produce enough insulin, you are under the risk of developing Gestational Diabetes. During pregnancy, and especially in the second and third trimesters, there is a reduced sensitivity to insulin, which is primarily caused by the hormones produced in placenta. This means that the pancreas has to increase its insulin production to be able to compensate for the increased insulin need. If the pancreas cannot increase the production of insulin, blood sugar rises and a woman develops Gestational Diabetes.

There are a number of factors that contribute to some women being under a higher risk of developing Gestational Diabetes:

• There is a family history of diabetes
• The expectant mother had Gestational Diabetes before
• Complications associated with previous pregnancy, such as the baby is big at delivery or Caesarean section was made
• Obesity
• Relatively high age of the mother, i.e., over 35 years
• Mother had many pregnancies
• Ethnicity
• Hypertension
• Vitamin D deficiency

There are various theories about why some women are under a higher risk of developing the disease than others, regardless of the risk factors.

Usually, it is difficult to notice that you have Gestational Diabetes, because the disease rarely produces any obvious symptoms. The symptoms that occur are usually mild and not life threatening.
Some common symptoms are:

• Increased thirst
• Often peeing and in greater amounts
• Increased appetite
• Fatigue and weakness
• Frequent infections
• Nausea and vomiting

Since the disease rarely gives any clear symptoms, pregnancy diabetes is almost always detected through the samples taken at the Maternity Care Center (MVC). When you register at the clinic, they will take a sample to measure blood sugar. If the sample is within the norm, your blood sugar will be checked a few times during pregnancy. How many times it is checked depends on where you live. If the blood sample shows higher blood sugar levels, it is always named a glucose load.

A glucose load means that you cannot eat anything for eight hours before the next blood test is performed. The blood sugar level is measured about eight hours after meal and is named fasting blood glucose. Then you have to drink a sugar solution containing water and glucose. Blood glucose level is then measured twice during the next two hours. Sugar levels measured after meals are named in medical literature as postprandial blood sugar.

If blood sugar levels are above the limit according to the criteria used, Gestational Diabetes is diagnosed.

Uncontrolled gestational diabetes can lead to serious complications for both mother and baby. High blood sugar increases the risk of excessive birth weight, premature birth, and low blood sugar in newborns. It also raises the mother’s chances of developing preeclampsia, requiring a C-section, and facing long-term health issues like type 2 diabetes. Babies exposed to high glucose levels may have a higher risk of obesity and diabetes later in life. Managing blood sugar through diet, exercise, and medical guidance is essential to prevent these risks and ensure a healthy pregnancy.

Most fetuses are not seriously affected by their mother’s Gestational Diabetes. Higher blood sugar during the first trimester increases the risk of birth defects in the fetus. But it is rarely Gestational Diabetes, it is commonly caused by an expectant mother having diabetes before pregnancy. If blood sugar level increases during the last trimester, the baby can grow abnormally, which increases the risk of complications during childbirth.”

Most people avoid developing Gestational Diabetes. Some are more at risk than others of getting it. If you want to be extra careful, whether certain risk factors apply to you, or not, you should avoid obesity, eat healthy food and exercise regularly. One method that can help you control your blood sugar and thereby reduce the risk of Gestational Diabetes is medical nutrition therapy.

If you have passed a glucose tolerance test made by the midwife, and it shows that you have Gestational Diabetes, in the first stage the treatment consists of advising you to change your eating habits and to exercise, which would help bring your blood sugar down to a normal level.
The general advice is:

• Eat smaller amounts, but have more frequent meals distributed evenly during the day.
• Food should be rich in fiber and vegetables and low in fast carbohydrates.
• Exercise daily, take long walks
  Ask to talk to a dietitian.

Unless dietary management and exercises are enough to lower the blood sugar level, antidiabetic therapy, mostly with insulin, is required.
With the help of medical nutrition therapy blood sugar content can be reduced without insulin treatment.