Gestational Diabetes (Diabetes in Pregnancy)

Overview

Gestational diabetes is diabetes that is diagnosed for the first time during pregnancy. It causes high blood sugar that can affect your pregnancy and your baby's health.

Symptoms

Gestational diabetes may not show the classic signs and symptoms of diabetes, such as drinking a lot of water, frequent urination and weight loss.

Risk factors

• Overweight and obesity

• Lack of physical activity
• A history of diabetes in a previous pregnancy
• Polycystic ovary syndrome
• A history of diabetes in family members
• A history of giving birth to a baby weighing more than 4 kilograms
• Pregnancy over the age of 35

Complications

If gestational diabetes is not monitored properly, it can cause problems in both the mother and the baby.

Complications that may affect your baby

• A large, heavy baby
• Birth injuries
• Need for a cesarean delivery
• Preterm birth
• Breathing problems
• Hypoglycemia shortly after birth and related seizures
• Development of type 2 diabetes, fatty liver and obesity in later years
• Stillbirth, before birth or shortly after birth

Complications that may affect the mother

• Increased blood pressure
• Preeclampsia, a serious complication that causes increased blood pressure along with other symptoms that can threaten the baby's life
• Increased likelihood of a cesarean delivery
• Risk of recurrence in future pregnancies
• Risk of developing type 2 diabetes in later years

Prevention

It may not be entirely possible to prevent gestational diabetes. However, it is advisable for prospective mothers with risk factors to see an endocrinologist before pregnancy. With an appropriate diet and exercise program, pregnancy can be achieved under suitable conditions.

Diagnosis

Pregnant women without risk factors are screened at 24–28 weeks of pregnancy, while screening early in pregnancy is recommended for those with risk factors.

Screening tests include fasting blood sugar, postprandial blood sugar and the oral glucose tolerance test (OGTT). Large-scale studies have shown that the OGTT is not harmful.

Treatment and follow-up

In gestational diabetes, treatment is planned under the supervision of an obstetrician, an endocrinologist and a dietitian.

In patients whose blood sugar levels do not reach the desired level despite the recommended diet and exercise program, metformin and/or insulin therapy may be started.

It will be helpful to see an endocrinologist 1.5–2 months after giving birth to determine whether the diabetes persists.