WHY WORRY ABOUT GESTATIONAL
gestational diabetes can lead to problems for both mother and
child. You are 28 weeks pregnant. Your health care provider has
just told you that you have gestational diabetes mellitus.
Should you be concerned?
answer: yes. Good care means a lot for your health and your
What Is Gestational Diabetes?
who have never had diabetes before but who have high blood sugar
levels during pregnancy are said to have gestational diabetes.
Gestational diabetes affects about 8 to 10 percent of all
pregnant women in Singapore.
We don't know
what causes gestational diabetes, but we have some clues. Your
placenta supports your baby as he or she grows. Hormones from
the placenta help your baby develop. But these hormones also
block the normal action of your insulin in your body during
pregnancy. This creates a problem called insulin resistance.
Insulin resistance makes it hard for the mother's body to use
insulin. You may need up to three times as much insulin as when
you were not pregnant.
Diabetes Association says that pregnant women who are 25 years
or older, were overweight before they became pregnant, have a
family history, are Hispanic, African, Native, Asian American,
or a Pacific Islander should be screened for gestational
diabetes between the 24th and 28th weeks--around the 6th
month--of pregnancy. By then, your placenta has begun to make
the hormones that lead to insulin resistance.
Gestational Diabetes Can Affect Your Baby
diabetes does not cause the kinds of birth defects sometimes
seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can
hurt your baby. Babies can develop macrosomia ie extra-big, and
face health problems of their own, including damage to their
shoulders during birth. Because of the extra insulin made by the
baby's pancreas, newborns may have very low blood sugar levels
at birth and may also have a higher risk for experiencing
breathing problems. Babies with excess insulin become children
who are at risk for obesity and adults who are at risk for type
Treating Gestational Diabetes
condition can hurt you and your baby, you need to start
treatment quickly. Treatment is geared toward keeping blood
sugar levels equal to those of pregnant women who don't have
gestational diabetes. Treatment includes special meal plans and
scheduled physical activity. It may also include daily blood
sugar testing and insulin injections. You will need help from
your endocrinologist, nurse educator, dietitian, and other
members of your health care team so that your treatment can be
changed as needed. Oral diabetes pills cannot be used during
For you as the
mother-to-be, treatment for gestational diabetes helps lower the
risk of a cesarean section birth that very large babies may
require. Sticking with your treatment will give you a healthy
pregnancy and birth and help your baby avoid future health
diabetes usually goes away after pregnancy. But once you've had
gestational diabetes, your chances are 2 in 3 that it will
return in future pregnancies. Additionally, in a few women,
pregnancy uncovers type 1 or type 2 diabetes. It is hard to tell
whether these women have gestational diabetes or have just
started showing their diabetes during pregnancy. These women
will need to continue diabetes treatment after pregnancy.
Your blood sugar
level should be checked with an oral glucose tolerance test six
weeks after your baby is born. If your blood sugar level is
normal, it should be rechecked at least every three years.
Latest news about gestational diabetes
Many women who
have gestational diabetes go on to develop type 2 diabetes years
later. There seems to be a link between the tendency to have
gestational diabetes and type 2 diabetes as both conditions
involve insulin resistance. Certain basic lifestyle changes may
help prevent diabetes after gestational diabetes. Exercise
regularly, avoid becoming overweight and eat a healthy diet.
Women with gestational diabetes are at greater risk of
developing type 2 diabetes, with almost 20% of women developing
the condition within 9 years of pregnancy, found a large,
population-based study of 659,000 women published in the
Canadian Medical Association Journal in 2008.
The study, conducted by a group of researchers from the
University of Toronto, Mount Sinai Hospital and the Institute
for Clinical and Evaluative Sciences, looked at 21,823 women
diagnosed with gestational diabetes and examined follow up
records up to 9 years. They found the rate of diabetes increased
rapidly in the first 9 months after delivery, peaking at 9
"In this large, population-based study, we found that diabetes
developed within 9 years after the index pregnancy in 18.9% of
women with previous gestational diabetes; this rate was much
higher than the rate among women without gestational diabetes
(2%)," state Dr. Denice Feig and coauthors.
As well, they note that the rate of gestational diabetes in
Ontario, the study province, seems to be increasing and is
linked to older mothers. Living in low-income neighbourhoods and
in urban areas were also risk factors for gestational diabetes.
Higher urban statistics "may reflect the large numbers of South
and East Asian and black populations living in urban areas, who
have a higher risk of type 2 diabetes," postulate Dr. Feig and
"The main strength of our study lies in the fact that it was a
large population-based study involving more than 21,000 women
with gestational diabetes, with up to 9 years of follow-up,"
state the researchers. "Unlike other studies, it covered a
large, well-defined geographic region with a population of 13
million, which allowed us to make a more robust assessment of
the risk of type 2 diabetes after gestational diabetes than has
been possible in previous studies."