There is no specific cause for gestational diabetes. It is believed that due to hormonal changes during pregnancy there is an increase in resistance to insulin which results in impaired glucose tolerance. The causes may be autoimmunity, single gene mutations, obesity or some other mechanism.
Risk factors for gestational diabetes are family history of type 2 diabetes, poor obstetric history, previous child with high birth weight, age more than 25 years, previous diagnosis of gestational diabetes, impaired glucose tolerance or impaired fasting glucose levels.
Polycystic ovarian syndrome and smoking are the additional risk factors.
There are no symptoms of diabetes in most of the women having gestational diabetes. In some women there may be nausea, vomiting, fatigue, infection of the bladder, increased thirst, increased urination, yeast infection or blurred vision.
Treatment is given to control the blood glucose level to reduce fetal complications. Keeping a regular check on blood glucose is important. Counseling the women is helpful and the condition can be managed by dietary regulations and exercise.
Diet containing more of fruits, vegetables, whole grains and less in carbohydrates including sweets is ideal. When diet and exercise are not enough then treatment is provided with insulin injections to lower the keep the blood sugar levels in check.
Oral hypoglycemic drugs may be given but they may be dangerous for the developing fetus. However, Metformin may be given singly or in combination with insulin.
The gestational diabetes generally resolves after delivery. Chances of having gestational diabetes in the next pregnancy are high if the next pregnancy is within one year of the previous one. Women with gestational diabetes have high risk of having type 2 diabetes in future.
Babies of mothers having gestational diabetes are relatively large or small for gestational age, have low blood sugar, jaundice, high blood cell mass, low blood calcium and magnesium and chemical imbalance.
Children may have respiratory distress syndrome, birth defects, developmental problems or congenital malformations.
Children of women who had gestational diabetes may be obese in childhood and may develop type 2 diabetes later in life.
Women having gestational diabetes have an increased risk for having preclampsia and urinary tract infections during pregnancy and type 2 diabetes later in life.
If there are any symptoms of diabetes in pregnancy it is better to share them with the doctor. If there are any risk factors like previous history of gestational diabetes or family history of type 2 diabetes, gestational diabetes or if one is over weight or obese then it is better to take medical advice before becoming pregnant to avoid gestational diabetes.
Eating healthy foods (low fat, low calorie and more fruits, vegetables and whole grains), physical exercise and weight loss (if overweight) before being pregnant can prevent gestational diabetes.
