Common Cold

Pregnancy can bring several physical and emotional changes in a woman’s life. While many changes are expected, some conditions like gestational diabetes mellitus (GDM) can be surprising and challenging. GDM occurs when the body cannot produce enough insulin to manage increased blood glucose levels during pregnancy. Although it usually resolves after childbirth, unmanaged gestational diabetes can affect both the mother and the baby’s health.

With increasing prevalence, especially in countries like India, understanding gestational diabetes is vital. This comprehensive page covers everything from causes and symptoms to lifestyle tips, treatments, and support strategies.

Gestational diabetes is a condition where a woman without previously diagnosed diabetes develops high blood sugar levels during pregnancy. It most commonly arises in the second or third trimester, usually between the 24th and 28th weeks.

It differs from type 1 or type 2 diabetes as it is specifically triggered by pregnancy-related hormonal changes. The hormones produced by the placenta can block the action of the mother's insulin, causing insulin resistance. When the pancreas cannot keep up with the increased insulin needs, blood sugar levels rise, leading to gestational diabetes.

While the condition typically disappears after delivery, it increases the mother’s risk of developing type 2 diabetes in the future.

Globally, gestational diabetes affects an estimated 14% of pregnancies, equating to over 18 million births each year. In India, the condition is especially prevalent due to a combination of genetic susceptibility, urban lifestyle changes, and dietary patterns. Various studies report prevalence rates ranging from 10% to as high as 35% in different parts of India.

This growing burden places gestational diabetes among the top pregnancy complications in India, warranting urgent public health intervention.

There are two main classifications of gestational diabetes:

1. A1GDM: Blood sugar levels are manageable with dietary and lifestyle changes.
2. A2GDM: Requires insulin or other medications along with lifestyle modifications.

These classifications help determine the treatment approach and the level of monitoring required during pregnancy.

Gestational diabetes is primarily caused by hormonal fluctuations during pregnancy. Hormones such as human placental lactogen, cortisol, and progesterone reduce the efficiency of insulin, leading to insulin resistance.

Other contributing causes include:

• Genetic predisposition
• Overweight or obesity before pregnancy
• Polycystic Ovary Syndrome (PCOS)
• Ethnicity (higher risk in South Asians, including Indians)
• Age over 25
• Sedentary lifestyle
   

Gestational diabetes often develops without noticeable symptoms, making routine screening essential. However, some women may experience:

• Frequent urination
• Excessive thirst
• Fatigue
• Blurred vision
• Nausea

Since these symptoms may overlap with normal pregnancy signs, they are not always a reliable indicator.

Diagnosis is usually performed between the 24th and 28th week of pregnancy using the following tests:

1. Glucose Challenge Test (GCT): A preliminary screening where the mother drinks a sugary solution, and blood sugar is measured after one hour.
2. Oral Glucose Tolerance Test (OGTT): If the GCT result is abnormal, this test involves fasting blood sugar followed by tests at one, two, and three hours after drinking a glucose-rich solution.

In high-risk pregnancies, screening may be recommended earlier.

Effective management of gestational diabetes ensures a healthy pregnancy and delivery. Treatment options include:

1. Medical Nutrition Therapy (MNT):

• Balanced diet rich in complex carbs, fibre, lean proteins, and healthy fats
• Avoidance of sugary and processed foods
• Frequent, smaller meals

2. Physical Activity:

• Walking, prenatal yoga, or swimming under supervision
• Helps lower blood glucose levels and improves insulin sensitivity

3. Monitoring Blood Glucose:

• Regular home testing 4–6 times a day as advised
• Tracking fasting and postprandial (after meal) glucose

4. Medications:

• If diet and exercise are not enough, insulin or oral anti-diabetic drugs like metformin may be prescribed. (Bigomet M tablet and Rejumet Tablet)

While conventional medical management is crucial, alternative therapies may offer supportive benefits. These include:

• Ayurvedic herbs such as fenugreek, jamun seed powder, or turmeric (only under supervision)
• Acupuncture: May aid in metabolic regulation
• Mindfulness techniques like prenatal meditation, which helps manage stress-related hormonal imbalances

Alternative options should always be used as complementary therapies, not substitutes.

Risk Factors

Factors that increase the likelihood of developing gestational diabetes include:

• Maternal age above 25 years
• Overweight or obesity
• Sedentary lifestyle
• Family history of type 2 diabetes
• History of gestational diabetes in previous pregnancy
• Giving birth to a large baby (>4 kg)
• Hypertension or PCOS

Untreated or poorly controlled gestational diabetes can result in several complications:

For the Baby:

• Excessive birth weight (macrosomia)
• Premature delivery
• Hypoglycaemia after birth
• Increased risk of respiratory distress
• Higher chances of obesity and type 2 diabetes in later life

For the Mother:

• Preeclampsia (high blood pressure during pregnancy)
• Increased likelihood of needing a C-section
• Higher risk of type 2 diabetes in the future
• Risk of recurrence in future pregnancies
   

Living with gestational diabetes can be overwhelming. Here are practical tips to manage it effectively:

• Educate yourself about the condition
• Follow the treatment and diet plan prescribed by your healthcare provider
• Monitor blood sugar regularly and maintain a journal
• Choose high-fibre, low-glycaemic foods
• Stay active with daily walks or gentle exercise
• Prioritise mental wellness – stress can spike blood sugar
• Stay hydrated
   

Myth 1: Only overweight women get GDM
 Fact: Women with normal weight can also develop gestational diabetes

Myth 2: GDM always leads to type 2 diabetes
 Fact: While it increases the risk, lifestyle changes can prevent future diabetes

Myth 3: Insulin is harmful during pregnancy
 Fact: Insulin is safe and does not cross the placenta

Consult your doctor immediately if:

• You are planning a pregnancy and have risk factors
• You experience excessive thirst, urination, or fatigue during pregnancy
• You had GDM in a previous pregnancy
• Your glucose monitoring shows abnormal results

Early diagnosis and management reduce the risk of complications.

• What are my chances of developing gestational diabetes?
• How often should I monitor my blood sugar?
• What foods should I avoid or include?
• Will I need insulin or oral medications?
• What risks does GDM pose to my baby?
• What happens after delivery will I still have diabetes?

If someone you know is coping with GDM, you can help by:

• Learning about the condition
• Encouraging them to stay active and eat healthily
• Offering emotional support without judgement
• Attending doctor’s visits together for moral support
• Helping with meal preparation or childcare

Gestational diabetes is a manageable pregnancy complication when addressed early and properly. Through routine screening, personalised medical care, healthy lifestyle choices, and strong support systems, most women with GDM can expect positive pregnancy outcomes. Understanding risk factors, maintaining a proactive approach to health, and staying informed are key to navigating gestational diabetes safely.