Gestational Diabetes: Symptoms, Causes & Treatment

Gestational diabetes is a type of high blood sugar detected for the first time during pregnancy in a woman who did not previously have diabetes. It occurs because the placenta secretes hormones that help the fetus grow but at the same time resist the action of insulin (the hormone that brings sugar into cells), so if the pancreas cannot produce enough extra insulin to overcome this resistance, blood sugar rises. It often appears in the second half of pregnancy.

An important feature of gestational diabetes is that it usually causes no clear symptoms, so most cases are detected through a routine sugar test done for all pregnant women in a specific period of pregnancy (the glucose tolerance test). The chances of developing it increase with factors such as overweight or obesity before pregnancy, a family history of diabetes, gestational diabetes in a previous pregnancy, advanced maternal age, and polycystic ovary syndrome. It is important to control it because uncontrolled high sugar may affect the mother and fetus, increasing the risk of a large baby (which may make delivery difficult), low sugar in the newborn after delivery, pregnancy-related high blood pressure, and premature birth.

The reassuring news is that gestational diabetes is well controllable in most cases, and that controlling it greatly protects the mother and fetus. Treatment rests first on lifestyle: a balanced diet distributed over regular meals with carbohydrate control (preferably under a dietitian's supervision), moderate physical activity by the doctor's recommendation, and home blood-sugar monitoring. If that is not enough to reach the target sugar levels, insulin (which is safe during pregnancy) or a medication determined by the doctor is added. In most cases blood sugar returns to normal after delivery, but a woman who had gestational diabetes remains more prone to type 2 diabetes later, so checking sugar after delivery and periodically, and maintaining a healthy weight and active lifestyle for prevention, are advised.

• Often without clear symptoms (detected by a routine test).
• Sometimes thirst, frequent urination, and fatigue.
• Detected by the glucose tolerance test for pregnant women.

• Placental hormones resisting the action of insulin.
• The pancreas being unable to produce enough extra insulin.
• Risk factors: overweight, family history of diabetes, previous gestational diabetes, advanced age.

• The routine glucose tolerance test for all pregnant women in a specific period.
• Measuring fasting blood sugar and after drinking a sugar solution.
• Home blood-sugar monitoring after diagnosis.

Lifestyle (the basis)

• A balanced diet distributed over regular meals with carbohydrate control (under a dietitian's supervision).
• Moderate physical activity by the doctor's recommendation, and home blood-sugar monitoring.

Medications when needed

• Insulin (safe during pregnancy) or a medication determined by the doctor if lifestyle is not enough.

Sugar often returns to normal after delivery with later follow-up. This content is educational and does not replace medical advice.

• A large baby and difficult delivery.
• Low sugar in the newborn after delivery and pregnancy-related high blood pressure.
• Increased risk of type 2 diabetes for the mother later.

• Maintaining a healthy weight before pregnancy and an active lifestyle.
• A balanced diet and regular physical activity during pregnancy.
• Checking sugar after delivery and periodically for those who had gestational diabetes.