Gestational Diabetes Overview

Introduction

Diabetes is a disease when blood sugar levels are constantly high in the bloodstream. There are different types of diabetes, the commonest ones being type 1 and type 2 diabetes. However, gestational diabetes is an important condition that can have severe consequences for the mother and baby and is increasing in society.¹

What is gestational diabetes?

Gestational diabetes is a type of diabetes diagnosed in pregnant people assigned female at birth (AFAB) who did not have a diagnosis of diabetes previously, and it usually disappears after giving birth. It can appear at any stage of pregnancy, but it generally occurs in the second or third trimester.²

Like in the other types of diabetes, the sugar levels in the bloodstream are high, affected by the way the cells can process it or not, and this can cause concerns for the mother’s and baby’s health. Fortunately, gestational diabetes is generally controlled by lifestyle changes with a healthy diet and exercise.³

Symptoms

Gestational diabetes normally doesn’t present symptoms; diagnosis is made through routine pregnancy tests. However, some people AFAB might show general diabetes symptoms like

•  Feeling thirsty even when drinking a significant amount of water.
• Passing out a lot of urine, especially overnight.
• Feeling hungry all the time.
• Losing weight even without trying and eating a lot.
• Feeling tired.
• Frequent infections, especially thrush.
• Blurred vision.⁴

Causes

Gestational diabetes, unlike type 1 diabetes, is not caused by the lack of insulin but is more related to type 2 diabetes and insulin resistance. Although it is not clear the mechanism that causes it, it is known that during pregnancy, the placenta, along with providing nutrients for the baby, is also responsible for producing different hormones that will help to maintain an ideal environment for the pregnancy to continue.

Some of these hormones (estrogen, cortisol, and human placental lactogen) can make the body and cells more resistant to insulin. The amount of these hormones is higher from the 20^th week of pregnancy; this is why gestational diabetes is more common after this period, and the more the placenta grows, the more hormone it produces.

Like in type 2 diabetes, the pancreas tries to compensate for the insulin resistance by producing more insulin; when this mechanism fails, the result is gestational diabetes.⁵

Risk factors

Any pregnant woman can develop gestational diabetes; however, this is more common in people AFABwho present the following risk factors:

• Overweight or obese
• Have a family history of diabetes
• Had gestational diabetes in a previous pregnancy
• Has pre-diabetes
• Had a previous baby who was born weighting 4.5 Kg or more
• Being 25 years or older
• Being African-American, American Indian, Asian American, Hispanic or Latino, or Pacific Islander 
• Have polycystic ovary syndrome.^2,3,4,5

Can you reduce your risk of developing gestational diabetes by making a few changes to your lifestyle?

The following lifestyle factors have the most significant impact on your risk of gestational diabetes. We will also look at what you can do to reduce your risk from today.

Nutrition

Having a healthy diet can help prevent gestational diabetes and even control it. You should keep a low-fat diet, full of fibre, adding fruits and vegetables to your meals. Keep your meals diverse and with different types of food, and eat small amounts, but frequently should also help in controlling the sugar levels.³

Physical activity

Regular exercise before and after getting pregnant can help to prevent gestational diabetes. It can also help maintain a healthy weight, reducing the risk caused by being overweight and obese. Starting some moderate-intensity activity and trying to reach 150 minutes per week can help with keeping blood sugar levels controlled before, during, and after pregnancy.³

Obesity

Association between type 2 diabetes and being overweight and obese is highly known. This happens because being overweight and obese are linked to insulin resistance, especially if you have an excess of fat around your abdomen. It is suggested that the fat around the abdomen can release pro-inflammatory substances non-esterified fatty acids, glycerol, and hormones. These chemicals combined will trigger a process that will develop insulin resistance in the organism.⁶

Alcohol

If you are planning to have a baby, you should avoid any alcohol consumption, independently of the risk of gestational diabetes or not, since this can have disastrous consequences for the development of the baby. However, alcohol is a very caloric drink and can interfere with weight. It can also be tricky to control your sugar levels in case of needing insulin since alcohol can lead to acute hypoglycemia.⁷

Sleep

If you do not get enough sleep, you are at risk of having increased insulin resistance, making it harder to lose weight, making you crave unhealthy food, and making you hungrier. All of these, combined, increase the risk of getting gestational diabetes.⁸  

Mental health

Long-term high-stress levels can increase your sugar levels. Stress hormones can make your sugar levels rise or fall without notice. It is essential to try to reduce the mental pressure caused by daily problems and treat them accordingly, never trying to do too much, taking time to relax, and avoiding triggers. When stressed, the person is also not able to take good care of themselves.⁹

Wellness

Keeping your emotional health balanced is necessary for your physical health. Self-care is important for overall good health. Doing things for pleasure and yourself are important things to keep your well-being; sometimes, in the rush of daily life is easy to forget about it, but so important as your obligations are also your leisure.

Summary

Gestational diabetes is a type of diabetes that appears during pregnancy and usually goes away when the woman gives birth. Generally, it is asymptomatic, but it can present itself with general diabetes symptoms like feeling thirsty, passing out a lot of urine, feeling tired, and losing weight. It is caused by insulin resistance, associated with the hormones released by the placenta during pregnancy. Still, it can be controlled by lifestyle changes like a healthy diet, physical activity, controlling weight, having a good sleep pattern, reducing stress levels, and not consuming alcohol.