When a woman who was not previously diabetic develops high blood sugar levels during the second or third trimester of pregnancy, it is known as Gestational Diabetes Mellitus (GDM). If a woman aged 35 years or older has a history of Diabetes in their first degree relative like parents/siblings, has had Gestational Diabetes in a previous pregnancy, has delivered a large baby before, has Polycystic Ovarian Syndrome (PCOS), or has had multiple pregnancies. Also, certain ethnic groups, such as South Asians, and individuals with a sedentary lifestyle are also more prone to developing Gestational Diabetes during their pregnancy.
Dr Farah Ingale, Senior Physician & Diabetologist, Director-Internal Medicine, Fortis Hiranandani Hospital Vashi shares how to manage and reduce the risk of gestational diabetes.
GDM is mostly caused by hormonal changes happening in pregnancy that causes Insulin Resistance, genetic disposition can also be a cause for GDM. Classic symptoms of GDM include increased thirst, urination, fatiguability, wounds that do not heal, blurred vision, recurrent infections like of the urinary tract. Gestational Diabetes is diagnosed primarily through an Oral Glucose Tolerance Test (OGTT) and elevated blood sugar levels. Additional findings may include the presence of ketones in the urine, fetal macrosomia (a larger-than-average baby), or Polyhydramnios (excess amniotic fluid).
GDM has long-term impact and complications that could impact both the foetus and the mother. If diagnosed with GDM. There is a 70 per cent risk of the mother developing Type 2 Diabetes Mellitus (T2DM), and certain metabolic syndromes and cardiovascular issues if GDM is left untreated. Children born to mothers with GDM also run the risk of developing T2DM as they grow older. They can also develop cognitive defects. GDM is also associated with increased risk of kidney disease and cancers. GDM can have a significant psychosocial impact due to the lifestyle and dietary restrictions an individual must follow. It may also lead to immediate and short-term complications for both the mother and the baby.
Developing nations have been severely impacted by the growing burden of GDM. To tackle this silent crisis, we need to implement preventative strategies like lifestyle modifications and maintaining a normal weight by eating a healthy balanced diet and regular physical activity. Avoid being sedentary and remain stress free and also go for regular medical check-ups. Consult a doctor who can help make a diet chart for you depending on your body’s needs. Consume foods with low Glycaemic Index (GI) as they release sugar into the blood stream slowly and do not lead to a sudden glucose spike. Foods that fall in that category are Quinoa, whole Wheat, Oats, brown Rice, Almonds, Walnuts, Flaxseeds, pulses. Practise portion control and abide by strict meal timings.
For pregnant women, with a history of Diabetes or Obesity preconception counselling and testing is very important. Early detection and management can reduce the risk of adverse pregnancy outcomes. If necessary, insulin is the preferred medication for managing Gestational Diabetes. Maintaining good blood sugar control can significantly reduce or even prevent complications. Postpartum care is also a crucial aspect of overall management. —
