Gestational diabetes is a condition characterized by high blood sugar (glucose ) levels that is first recognized during pregnancy. The condition occurs in approximately 7% of all pregnancies.
Because gestational diabetes does not cause symptoms, the mother needs to be tested for the condition.
Our body digests the food we eat to produce sugar (glucose) that enters our bloodstream. In response, our pancreas — a large gland behind our stomach — produces insulin. Insulin is a hormone that helps glucose move from our bloodstream into our body’s cells, where it’s used as energy for all our activities.
During pregnancy, the placenta, which connects the baby to the mother’s blood supply, produces high levels of various other hormones. Almost all of them impair the action of insulin in the body’s cells, raising her blood sugar. Modest elevation of blood sugar after meals is normal during pregnancy.
As the baby grows, the placenta produces more and more insulin-blocking hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and welfare of the baby. Gestational diabetes usually develops during the last half of pregnancy — sometimes as early as the 20th week, but generally not until later.
Any woman can develop gestational diabetes, but some women are at greater risk. Risk factors for developing gestational diabetes include:
- Age greater than 25: Women older than 25 years of age are more likely to develop gestational diabetes.
- Family or personal health history: The risk of developing gestational diabetes increases if the mother has pre diabetes — slightly elevated blood sugar that may be a precursor to develop type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. She is also more likely to develop gestational diabetes if she had it during a previous pregnancy, if she delivered a baby who weighed more than 9 pounds (4.1 kilograms), or if she had an unexplained stillbirth.
- Excess weight. The mother is more likely to develop gestational diabetes if she is significantly overweight with a body mass index (BMI) of 30 or higher.
- Nonwhite race. For reasons that aren’t know yet, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.
Diabetes in Pregnancy Study Group India (DIPSI) diagnostic criterion of 2-h PG ≥ 7.8 mmol/L with 75 g oral glucose load is a modified version of WHO, in that the WHO procedure requires women to be in a fasting state, whereas DIPSI procedure is performed in the fasting/nonfasting state irrespective of the last meal timing.Hence, this prospective study was undertaken to ascertain the validity of DIPSI criterion to diagnose GDM based on pregnancy outcome in Indian population.
If the mother has gestational diabetes, her baby may be at increased risk of:
- Excessive birth weight: Extra glucose in the mother’s bloodstream crosses the placenta, which triggers the baby’s pancreas to make extra insulin. This can cause the baby to grow too large (macrosomia). Very large sized babies — those that weigh 9 pounds (4.08 kg) or more — are more likely to become wedged in the birth canal, sustain birth injuries or require a C-section birth.
- Early (preterm) birth and respiratory distress syndrome: A mother’s high blood sugar may increase her risk of early labor and delivering her baby before its due date. Or her doctor may recommend early delivery because the baby is large.
Babies born early may experience respiratory distress syndrome — a condition that makes breathing difficult. Babies with this syndrome may need help breathing until their lungs mature and become stronger. Babies of mothers with gestational diabetes may experience respiratory distress syndrome even if they’re not born early.
- Low blood sugar (hypoglycemia): Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Severe episodes of hypoglycemia may provoke seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby’s blood sugar level to normal.
- Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Untreated gestational diabetes can result in a baby’s death either before or shortly after birth.