Why is it important to understand GESTATIONAL DIABETES?

It is type of diabetes that occurs only in women during pregnancy.

• Usually develops from the 24th week (6 month) of pregnancy.
• Test for gestational diabetes is recommended to be done during24-28 weeks for women without previous history of diabetes.
• It is temporary condition.
• Women with a history of gestational diabetes are more likely to develop type 2-diabetes in future.
• The placental hormones that help in the development of the baby also contribute to insulin-blocking action resulting in insulin resistance.
• Impaired action of insulin on the cells causes rise in the blood sugar levels or hyperglycemia.

What are the risk factors of Gestational Diabetes?

The risk factors for developing gestational diabetes include,

1. Age: women older than 25 years.
2. Family history: Parent or sibling with type 2 diabetes.
3. Post medical history: Prediabetes, history of gestational diabetes, polycystic ovary syndrome (PCOS), or metabolic syndrome, High blood pressure, High cholesterol, Large baby ( ≥ 9 lb or 4000 gm)
4. Ethnicity: Black, Hispanic, American Indian, or Asian
5. Obesity: Excessive fat depots induce a number of abnormalities that reduce insulin sensitivity.

How to diagnose Diabetes in Pregnant Women?

Let us now discuss the diagnosis of diabetes in pregnant women.

The early intervention helps in improving treatment results of diabetes in pregnant women

• All pregnant women with risk factors for T2DM should be evaluated using the standard diabetes blood tests during their first visit to the healthcare provider during pregnancy to see if they had undiagnosed diabetes before becoming pregnant.
• Following this, the pregnant women should be examined for gestational diabetes mellitus (GDM) between 24 and 28 weeks of their pregnancy using the OGTT.
• Women with GDM should get follow-up tests (75-gram OGTT) done 4 to 12 weeks after the delivery to check for T2DM or pre-diabetes.
• If the test results are normal, the evaluation should be repeated at least every 3 years.
• The blood glucose tests, rather than the HbA1c test, should be used for evaluation within 12 weeks of delivery

References:

https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339. Accessed Jan 4, 2024.

https://www.nichd.nih.gov/sites/default/files/publications/pubs/Documents/gestational_diabetes_2012.pdf. Accessed Jan 4, 2024.