Gestational Diabetes Mellitus (GDM) is a condition in which women without a previous diagnosis of diabetes mellitus, show signs and symptoms of high glucose levels during pregnancy. This is because her body is reacting to several hormonal changes, and the demand for insulin increases. If the pancreas cannot keep up with the insulin demand, her blood glucose levels will go up resulting to gestational diabetes.  A pregnant woman will not remain diabetic though; the condition usually goes away after the baby is born although there is a probability that you will have gestational diabetes in your future pregnancies.

This condition complicates 2% to 5% of all pregnancies in the United States and accounts for 90% of all cases of diabetic pregnancy. It is more likely to occur among Hispanic, Native American, Asian, and African- American population than in Caucasians.  Women who has GDM are more likely to have glucose intolerance later in life; this is especially true in women whose GDM is diagnosed early in pregnancy and those who are obese and overweight. Other classic factors include maternal age older than 30 years, family history of diabetes, unexplained still birth, previous spontaneous miscarriage, GDM in previous pregnancies, previous delivery of a large infant, infants with congenital anomalies and previous history of pregnancy-related hypertension or urinary tract infection.

Women with GDM are at risk for developing hypertensive disorders compared with normal pregnant women. Infants born to mothers with this condition may be large for gestational age and may have excessive birth weight. This is also one of the reasons why mothers with GDM are often at risk for perineal lacerations and C-section birth.  The newborn may also be at risk of hypoglycemia (low glucose levels), hypocalcemia (low calcium levels), jaundice and respiratory distress.

Gestational Diabetes usually develops on the 20^th week of pregnancy. The pregnant woman may experience the common signs and symptoms of diabetes such as excessive thirst, hunger or frequent urination. It is often diagnosed through glucose screening and glucose tolerance tests done on the 24^th to 28^th week of pregnancy. But if you’re at risk, your doctor may recommend doing the diagnostic tests earlier.

When the diagnosis of GDM is made, treatment begins immediately. The woman and her family are educated by their health care providers, providing them with detailed explanation of the condition to ensure understanding and adherence to necessary interventions.

Diet is the focus of treatment for GDM. The pregnant woman is given a standard diabetic diet immediately on diagnosis. Some doctors recommend fewer calories on obese or overweight women. Exercise is also advised since it helps in reducing blood sugar levels and may eliminate the need for insulin. Most doctors recommend continuous blood glucose monitoring during pregnancy to determine if glucose levels are within the normal range. If the levels remain high despite conservative management, insulin therapy may be required.

If you know that you are at risk for gestational diabetes, it is essential to inform your doctor as early as possible; the best time would be your first prenatal check- up.

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