By Dr. Sindhuri, Consultant Obstetrician & Gynecologist Ankura Hospital for Women and Children

With the rapid lifestyle change, women are prone to various gestational ailments such as Poly cystic Ovarian Syndrome (PCOS) or Disease (PCOD), Fibroids, cervical cancer etc. But have you come across or heard of Gestational Diabetes Mellitus (GDM)? Unlike Type 2 Diabetes, Gestational Diabetes Mellitus (GDM) is a condition where a woman develops during the pregnancy period and typically goes away once she gets delivered. During pregnancy, the body cannot produce sufficient amounts of insulin, leading to higher blood-sugar levels. The condition affects the health of both the mother and baby. However, women who are suffering from Poly cystic Ovarian Syndrome (PCOS) or Disease (PCOD) are prone to GDM. Even a healthy woman can still develop this ailment, but with proper health care and fitness, one can minimize the risks of GDM.

As per the latest news sources, about 15-20 percent of all pregnancies across India are affected by Gestational Diabetes. In Telangana, about 5.4 percent of the population suffers from GDM as per a study conducted in 2020. So before delving further, let us know about what gestational diabetes is and its causes.

Causes of Gestational Diabetes Mellitus (GDM)

1. Hormonal Changes: During pregnancy, the placenta produces hormones that can interfere with insulin, making it harder for the body to use it effectively (insulin resistance).
2. Insufficient Insulin Production: The body may not produce enough insulin to keep blood sugar levels within a normal range.
3. Pre-existing Risk Factors:
   • Being overweight or obese
   • Family history of diabetes
   • History of gestational diabetes in a previous pregnancy
   • Polycystic ovary syndrome (PCOS)
   • Older maternal age (above 25-30 years)
4. Age: It’s might be surprising to you but age is also one of the main causes of GDM. Women who are pregnant after age 25 are prone to GDM than those who are pregnant before age 25. Also, if your family has a history of type 2 diabetes and obesity or overweight factors then you are prone to develop this condition.

Symptoms of Gestational Diabetes

Most women with gestational diabetes do not experience noticeable symptoms, but some may include:

• Increased thirst
• Frequent urination
• Fatigue
• Blurred vision
• Sugar detected in urine during routine check-ups

If you have any of the above symptoms then please do the recommended tests for gestational diabetes between 24 and 28 weeks of pregnancy but if you are suffering from PCOD or PCOS then you need to do the recommended tests earlier than 24 and 28 weeks of pregnancy. However, early testing for GDM especially during 14 weeks of pregnancy will save both the mother and baby from further complications as per Lancet study.

Precautionary Measures and Management

1. Healthy Diet:
   • Consume balanced meals with complex carbohydrates, lean proteins, and healthy fats.
   • Monitor portion sizes and include plenty of vegetables and whole grains.
   • Limit intake of sugary and high-carbohydrate foods.
2. Regular Physical Activity:
   • Engage in pregnancy-safe exercises such as walking, swimming, or prenatal yoga.
   • Consult a healthcare provider to determine appropriate activities.
3. Blood Sugar Monitoring:
   • Regularly check blood sugar levels as instructed by your healthcare provider.
   • Keep a record to track patterns and make adjustments as necessary.
4. Medications/Insulin Therapy:
   • If diet and exercise are not enough to control blood sugar levels, medication or insulin may be required.
   • Follow the healthcare provider’s prescription and recommendations strictly.
5. Prenatal Care:
   • Attend all scheduled appointments for monitoring and guidance.
   • Get tested for gestational diabetes as advised, usually between 24 and 28 weeks of pregnancy.
6. Weight Management:
   • Maintain a healthy weight before and during pregnancy.
   • Focus on gradual, healthy weight gain recommended by a healthcare provider.
7. Education and Awareness:
   • Learn about gestational diabetes and its impact on pregnancy and childbirth.
   • Educate family members for additional support.

By adopting these precautionary measures, women with gestational diabetes can improve outcomes for both themselves and their babies.