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Gestational diabetes is a transient form of diabetes mellitus some women may acquire during pregnancy. Diabetes refers to high levels of blood glucose, commonly known as blood sugar. Glucose is the major energy source of the body. It comes from digestion of carbohydrates and is carried by the bloodstream to the body’s cells. But glucose cannot enter the cells on its own; to do so, it requires assistance from a hormone produced by the pancreas called insulin. Insulin induces the cells to take up glucose, thereby removing it from the blood. Diabetes happens when insulin is either deficient or not used effectively. Without insulin, glucose cannot enter the cells; it stays in the blood, causing high blood sugar levels.
During pregnancy, a temporary organ develops to connect the mother and the fetus, called the placenta. The placenta supplies the fetus with nutrients and oxygen, as well as produces a number of hormones that work to maintain pregnancy. Some of these hormones impair the action of insulin, making it less effective. This insulin-counteracting effect usually begins at about 20 to 24 weeks of pregnancy. The effect intensifies as the placenta grows larger, and becomes most prominent in the last couple of months. Usually, the pancreas is able to adjust by producing more insulin, but in some cases, the amount of placental hormones may become too overwhelming for the pancreas to compensate, and gestational diabetes results.
Any woman can develop gestational diabetes, but those who are overweight or have family or personal history of diabetes or prediabetes are at higher risks. Other risk factors include age, race, and having previously given birth to large babies.
While gestational diabetes usually resolves on its own after delivery, complications may arise if the condition is severe and/or poorly managed.
Because of the constant high glucose levels in the mother’s blood, the fetus may receive too much nutrients and grow too large, complicating the birth process, and a C-section may be needed for delivery.
High levels of glucose also stimulate the baby’s pancreas to produce more insulin than usual. Shortly after delivery, as the baby continues to have high insulin levels but no longer receives sugar from the mother, the baby’s blood sugar levels can drop suddenly and become exceedingly low, causing seizures. The newborn’s blood sugar level must therefore be monitored and corrected with prompt feeding, or if necessary, with intravenous glucose.
High blood sugar may also increase the mother’s blood pressure and risks of preterm birth. Future diabetes in both mother and child is also more likely to occur.
Gestational diabetes can be successfully managed, or even prevented, with healthy diets, physical exercise, and by keeping a healthy weight before and during pregnancy. In some cases, however, medication or insulin injection may be needed.