Did you know you could have diabetes and not realize it? Out of the almost 30 million Americans suffering from diabetes, over eight million cases are undiagnosed, and almost 1.5 million new cases of diabetes appear every year. As the onset of type 2 diabetes reaches epic proportions in American families, health experts continue to build awareness of the risks and rally for prevention.
But what about gestational diabetes? Although it's easy to shrug off this form of diabetes that targets a specific portion of the community—and often remedies itself after giving birth—the temporary condition, if left untreated, can produce permanent damage.
What Is Gestational Diabetes Mellitus (GDM)?
This form of diabetes occurs exclusively in women—pregnant women, to be exact. Women can be diagnosed with gestational diabetes having no history of diabetes at all. Doctors don't understand why it occurs in some women, but they know it's affected by the hormones that support the unborn baby in the placenta.
These essential hormones help in the baby's development, but they also contribute to insulin resistance in the mother. Without regular access to insulin, the mother's glucose cannot be converted to energy, so it builds up in the blood to dangerous levels. This is called hyperglycemia.
What Are Common Symptoms and Factors that May Increase the Risk of Developing GDM?
You'll need to examine both your family and personal medical history. Some factors that increase your chances of developing GDM include a family history of diabetes and high blood pressure, obesity prior to pregnancy, and a personal history of giving birth to larger babies.
Symptoms often mirror those of normal pregnancy. But many mothers note extreme fatigue and nausea (especially after eating sugary foods), frequent urination, persistent thirst, and abnormal water retention.
Why Does the Public Not Hear About it Compared to Other Forms of Diabetes?
Gestational Diabetes Mellitus likely doesn't get the exposure it deserves because it occurs in such a specific part of the population. And when the mother delivers her baby, the danger typically goes away. "gestational diabetes is not discussed as often as other types of diabetes because it is viewed as being limited to pregnancy rather than being a lifelong chronic disease," says Sara Simonsen, PhD, Associate Professor at the University of Utah. "In the maternal child health world, it is viewed as an important problem, but perhaps outside of this arena people are more focused on type 1 and type 2 diabetes."
However, the risks are serious, so it's important for expectant mothers to honor their prenatal and doctor visits. The National Institute of Diabetes and Digestive and Kidney Diseases says that mothers are tested for GD between week 24 and 28 of their pregnancy. If a mother's glucose level remains elevated, she will need to visit her doctor following delivery. "In women who are higher risk, they may be evaluated earlier in pregnancy, or ideally, even before becoming pregnant, to see if they have previously undiagnosed actual diabetes," says Kirsten Stoesser, MD, a family medicine physician with University of Utah Health.
What Complications Develop as a Result of GDM?
If left untreated, GDM creates elevated glucose levels that "overfeed" the unborn baby, resulting in a big baby and a difficult delivery. If left untreated, GDM not only presents a threat to the mother's health, it can create serious complications for the unborn child. "Women with GDM are at higher risk for developing preeclampsia, stillbirth, and neonatal morbidity," says Simonsen. "Infants born to women with GDM may be at increased risk for later life obesity, impaired glucose tolerance, or metabolic syndrome. In addition, women with GDM are at increased risk for developing type 2 diabetes after pregnancy—in fact as many as 50% of women with GDM may go on to develop type 2 diabetes."
"GDM can also cause low blood sugar in the baby in the first few hours or days after birth, which can lead to possibly needing intensive treatment for the baby to help keep the blood sugar in the desired range," adds Stoesser.
Can It Be Prevented?
A proper diet can control GDM or prevent it from developing. The American Diabetes Association says that making healthy food choices that include fresh fruits and vegetables, limiting fat intake to 30 percent or less of daily calories, and tracking portion size can control symptoms. "Healthy eating habits can go a long way in preventing diabetes and other health problems," they say.
Experts also recommend getting regular exercise and maintaining a healthy weight. "Overweight and underweight women have an increased risk of premature labor, among other complications," says Erin A.S. Clark, MD, a maternal fetal medicine specialist at University of Utah Health. "Ideally, your body mass index should be between 18.5 and 24.9 when you get pregnant."
Clark adds that if you are overweight, even a small amount of weight loss may improve your chances of a safe delivery.
The anticipation of a bouncy baby is a busy and exciting time. Amid the preparations, be sure to take the time to monitor your health. Today's choices to ensure the delivery of a healthy baby mean a bright future for you and your baby.