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What is gestational diabetes?
Gestational diabetes is a form of diabetes that affects women during pregnancy [1, 2].
Important: risk assessment for gestational diabetes should be undertaken during the first prenatal visit [3]
It has been demonstrated that the treatment (or successful management) of gestational diabetes reduces severe consequences during pregnancy and following pregnancy [4]
Those who develop gestational diabetes are more likely to develop Type 2 Diabetes later in life.
What causes gestational diabetes?
As with Type 2 Diabetes, gestational diabetes results from a mother's glucose intolerance during pregnancy. This may result in the mother's body cannot produce enough insulin during pregnancy, or the hormones released by the placenta interfere with the actions of insulin [1, 2].
Risk factors for gestational diabetes:
Age
Ethnicity [5]
Economic status
Dietary patterns
Lack of exercise
Overweight
Sedentary lifestyle
Family history of gestational diabetes
Pre-diabetes diagnosis
Smoker [1, 6]
What are the symptoms of gestational diabetes?
Like with other forms of diabetes, gestational diabetes may present asymptomatically. However, some also experience:
Frequent urination
Unusual thirst
Sugar in urine
Blurred vision
Frequent infections
Fatigue [7]
What are the consequences of gestational diabetes?
The effects on the mother include:
Higher risk for developing Type 2 Diabetes later in life [8]
Uncontrolled high blood sugar can lead to additional cardiovascular diseases caused by Type 1 and Type 2 Diabetes
Increased risk for caesarean section [9]
The effects on the child include:
Higher risk for respiratory distress syndrome [10]
Brachial plexus injury [10]
Hypoglycaemia (low blood sugar) [10]
Seizures [10]
Jaundice (yellowing of the skin or the whites of the eyes) [10]
Developmental delays in motor skills, such as walking [8]
Higher risk for developing Type 2 Diabetes later in life [11]
Does gestational diabetes go away?
Usually, gestational diabetes goes away after pregnancy.
Strategies to help prevent gestational diabetes.
While there is limited evidence to suggest that gestational diabetes is preventable [12-14], scientists still recommend the following:
Advocating for a healthier lifestyle
Losing weight before pregnancy [15]
Regular and early screening for gestational diabetes (glucose tolerance tests)
Exercise therapy
Diabetes education [15]
Management of gestational diabetes.
It has been demonstrated that the treatment (or successful management) of gestational diabetes reduces severe consequences during and after pregnancy [4]. Nevertheless, some of the management strategies are:
Light to moderate exercise [16]
Dietary management (consuming low glycaemic index foods)
Regular visits to the dietician
Weight control [15]
Diabetes education [15, 17]
Regular screening and monitoring of blood glucose levels [1, 17]
Let's better learn how to protect ourselves from diabetes
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References:
[1] Reece EA, Leguizamón G, Wiznitzer A. Gestational diabetes: the need for common ground. The Lancet. 2009;373(9677):1789-97.
[2] Lindsay RS. Gestational diabetes: causes and consequences. The British Journal of Diabetes & Vascular Disease. 2009;9(1):27-31.
[3] American Diabetes Association. Gestational Diabetes Mellitus. Diabetes Care. 2004;27(suppl_1):s88-s90.
[4] Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcomes. New England Journal of Medicine. 2005;352(24):2477-86.
[5] Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2018;18(1).
[6] Zhang C, Rawal S, Chong YS. Risk factors for gestational diabetes: is prevention possible? Diabetologia. 2016;59(7):1385-90.
[7] Schneiderman EH. Gestational Diabetes: An Overview of a Growing Health Concern for Women. Journal of Infusion Nursing. 2010;33(1):48-54.
[8] Reece EA. The fetal and maternal consequences of gestational diabetes mellitus. The Journal of Maternal-Fetal & Neonatal Medicine. 2010;23(3):199-203.
[9] Jones CW. Gestational diabetes and its impact on the neonate. Neonatal Netw. 2001;20(6):17-23.
[10] Esakoff TF, Cheng YW, Sparks TN, Caughey AB. The association between birthweight 4000 g or greater and perinatal outcomes in patients with and without gestational diabetes mellitus. Am J Obstet Gynecol. 2009;200(6):672.e1-4.
[11] Dabelea D, Knowler WC, Pettitt DJ. Effect of diabetes in pregnancy on offspring: follow-up research in the Pima Indians. J Matern Fetal Med. 2000;9(1):83-8.
[12] Tieu J, Crowther CA, Middleton P. Dietary advice in pregnancy for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews. 2008(2).
[13] Stafne SN, Salvesen KÅ, Romundstad PR, Eggebø TM, Carlsen SM, Mørkved S. Regular Exercise During Pregnancy to Prevent Gestational Diabetes: A Randomized Controlled Trial. Obstetrics & Gynecology. 2012;119(1):29-36.
[14] Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P. Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews. 2015(4).
[15] Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. American Journal of Obstetrics and Gynecology. 2010;202(2):135.e1-.e8.
[16] Jovanovic-Peterson L, Durak EP, Peterson CM. Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes. Am J Obstet Gynecol. 1989;161(2):415-9.
[17] Cheung W. The management of gestational diabetes. Vascular Health and Risk Management. 2009:153.
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