Gestational diabetes is the medical term used to describe diabetes mellitus that presents during pregnancy and disappears after the baby has been delivered. The American Diabetes Association estimates that approximately 4% of women who are pregnant will develop gestational diabetes. This condition requires very specialized care for the remainder of the pregnancy in order to protect the health of both the mother and child. (1)
During pregnancy some women develop a resistance to insulin that results in gestational diabetes. Insulin is the hormone that draws sugar from the bloodstream into the cells where it is burned to supply energy at the cellular level. Without the sugar the body is forced to burn fat for fuel. This has a significant negative effect on both the mother and baby. The extra sugar in the bloodstream also causes complications in the health of the mother and child.
Because of the significant negative effects for both mother and child current standard treatment in pregnancy calls for a screening test after the 1st trimester. Women who are greater risk for gestational diabetes will undergo a 5 hour glucose tolerance test. The screening test is a simple blood test that is drawn to look for the presence of too much sugar in the blood. The five hour glucose tolerance test (GTT) is a much more complex test. (2)
During a five hour GTT the woman is given between 8-16 ounce of a high sugar drink and then urine and blood is tested at 30 minute intervals for the next 5 hours. This test looks at how the woman\’s body handles the extra sugar load, how much insulin is secreted and how much sugar is left in the blood stream and spills into the urine.
It is important for women to understand and recognize the symptoms of gestational diabetes for those whose condition develops after the screening test has happened. These symptoms can be very subtle, such as an increased amount of thirst, more trips to the bathroom, hungrier and blurred vision. All of these symptoms are caused by increased blood sugar but can also be attributed to other underlying medical conditions. (3)
Because the sugar isn\’t absorbed into the cells the mother also experiences greater fatigue than she would have just being pregnant. As the kidneys try to filter out the excess sugar, take out more water the woman also gets dehydrated. She becomes thirsty from the dehydration and visits the bathroom more frequently because of the increased water intake.
Some of these symptoms are also those of pregnancy. Some women may believe that they are going to the bathroom more frequently because of the weight of the baby over the bladder. However, thirst isn\’t a symptom of pregnancy. Between the 20th and 24th week the woman\’s energy level also returns so she shouldn\’t feel fatigued at this point. When the woman is suffering from gestational diabetes she may feel some relief from the fatigue but then it returns in full force as she doesn\’t have energy because of the insulin resistance.
Researchers have found that babies who suffer from gestational diabetes have negative effects in later years. Left untreated the condition causes complications during the delivery and for the mother. For these reasons it is very important to identify and treat gestational diabetes as early as possible. A simple fasting blood sugar is enough to rule out the condition. (4)
Women who have higher risk factors, such as family history of diabetes, obesity, lack of exercise or a previous pregnancy with gestational diabetes should have a five hour gtt to rule out the possibility and prevent medical complications.
(1) American diabetes Association: Gestational diabetes
http://www.diabetes.org/diabetes-basics/gestational/
(2) Beaumont Health system: Glucose Tolerance Test
http://beaunet.beaumont.edu/portal/pls/portal/lab.lab_pkg.lab_test_info_content?xid=1570
(3) Mayoclinic.com: Gestational Diabetes
http://www.mayoclinic.com/health/gestational-diabetes/ds00316/dsection=symptoms
(4) American Pregnancy Association: Gestational Diabetes
http://www.americanpregnancy.org/pregnancycomplications/gestationaldiabetes.html