World Diabetes Day 2021: Here’s how early screening can help lower the risks of gestational diabetes

World Diabetes Day is celebrated on November 14 each year. It is a day that is observed to raise awareness about diabetes. Gestational diabetes is caused by hormones produced during pregnancy that can make insulin less effective, leading to insulin resistance. It raises the risk of developing other illnesses like pregnancy-induced hypertension.

How is gestational diabetes diagnosed?

Gestational diabetes usually has no symptoms, it is detected by a blood test. You will be asked to do a sugar test as soon as you confirm the pregnancy and during your second trimester between 24 to 28 weeks.

There are two approaches to conducting the screening. The doctor will either ask you to do a Glucose challenge test (GCT) or a Glucose tolerance test (GTT). In both the tests, you will be asked to give the blood sample after drinking 50 grams or 75 grams of glucose.

What are the risk factors associated with gestational diabetes mellitus?

Although any woman can develop GDM during pregnancy, some of the factors that may increase the risk include the following:

Patients with these risk factors might be asked to do a glucose tolerance test at the start of the pregnancy itself or earlier than the 2nd trimester.

Why are early screenings important for pregnant women?

Early screenings can help diagnose gestational diabetes in pregnant women. Doctors stress the need for early screening, counselling, suitable diet and behaviour change, and postpartum follow-up. The importance of early screening of Gestational Diabetes Mellitus (GDM) has improved significantly over the years.

GDM increases the likelihood of women having diabetes in the future. Diabetes and obesity might be passed down to their children.

Once a woman is diagnosed with GDM, she should stay healthy and keep her weight increase within the acceptable range during pregnancy, exercise and monitor sugar levels closely. 

GDM can often be treated with diet restriction, hence universal screening for pregnant women is recommended. Some may require medicines or sometimes Insulin.

Possible complications for the baby

Unlike type 1 diabetes, gestational diabetes generally occurs too late to cause birth defects. Birth defects usually originate sometime during the first trimester (before the 13th week) of pregnancy. The insulin resistance from the contra-insulin hormones produced by the placenta does not usually occur until approximately the 24th week. Women with gestational diabetes mellitus generally have normal blood sugar levels during the critical first trimester.

The complications of GDM are usually manageable and preventable. The key to prevention is careful control of blood sugar levels just as soon as the diagnosis of diabetes is made.

Infants of mothers with gestational diabetes are vulnerable to several chemical imbalances, such as low serum calcium and low serum magnesium levels, but, in general, there are two major problems of gestational diabetes: macrosomia and hypoglycemia:

Macrosomia

Macrosomia refers to a baby who is considerably larger than normal. If the mother has GDM and maternal sugar levels are not under control then the baby can develop Macrosomia(big) baby.

Hypoglycemia

Hypoglycemia refers to low blood sugar in the baby immediately after delivery. This problem occurs if the mother's blood sugar levels have been consistently high and not under control.

Blood glucose is monitored very closely during labour. Insulin may be given to keep the mother's blood sugar in a normal range to prevent the baby's blood sugar from dropping excessively after delivery.

Early screening helps us prevent complications for the fetus.

How can I lower the risk of developing gestational diabetes?

Staying healthy and preparing your body for pregnancy are the best ways to reduce your risk of gestational diabetes.

If you're overweight, you can prepare for pregnancy by doing the following:

Follow-up is essential after the pregnancy has ended. GTT is advised 6 weeks post-delivery for mothers who had GDM. Breastfeeding has been demonstrated to lower the risk of diabetes. Young women planning to become pregnant in the next six months to a year should be healthy, take folic acid, and stay active.

About the author: Dr Kavya Krishnakumar, Consultant Obstetrics and Gynaecology, Motherhood Hospital, Chennai.

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