WHAT IS GESTATIONAL DIABETES; DIABETES IN PREGNANT WOMEN?
Gestational diabetes is an intolerance to glucose with a increase or decrease in the amount of sugar in the blood (glucose). About 7 to 20% of women develop this type of diabetes when they are pregnant. However, it most often disappears after delivery.
Risk factors of gestational diabetes
Toutes les femmes peuvent développer un diabète gestationnel pendant la grossesse, mais le risque est augmenté dans les cas suivants :
All women can develop gestational diabetes during pregnancy, but the risk is increased in the following cases:
- Being over 30 years of age
- Excessive weight gain during pregnancy
- Being overweight before pregnancy, defined by a BMI of over 25,
- Having already had a baby weighing more than 8.8oz at birth
- Having a family history of diabetes
- Having developed gestational diabetes in a previous pregnancy
* Note: BMI or Body Mass Index is a value that allows you to estimate the body size of a person. It is defined by the ratio weight (lbs) / square of height (ft in)
The symptoms of gestational diabetes are difficult to spot because they are similar to the common symptoms of pregnant women (fatigue, frequent urge to urinate, and intense thirst). Generally, screening is done between the 24th and 28th week by a blood test prescribed by the doctor.
What are the risks for the mother and the child?
For the baby, macrosomia is the most important risk. This is a birth weight that is too large, weighing more than 4 kg (8.8 oz). Indeed, this weight can lead to difficult childbirth and complications such as dystocia of the shoulders. After birth, the main risk is hypoglycemia.
For the mother-to-be, the most important risk is pre-eclampsia or toxemia of pregnancy (associating arterial hypertension, edema, and rapid weight gain).
In addition, the risk of preterm birth increases if diabetes is not monitored well during pregnancy. After pregnancy, the woman is more likely to develop type 2 diabetes in the years following delivery. In case of new pregnancy, there is a risk of recurrence of gestational diabetes.
How to treat gestational diabetes
Generally, a woman with gestational diabetes is followed by a multidisciplinary team of health professionals (general practitioner, gynecologist, nutritionist, diabetologist …). Talking to the medical team is the best way to adopt the best practices for each woman.
Therefore, the treatment makes it possible to avoid most of the complications described above by rigorous glycemic control. For this, the doctor prescribes a blood glucose meter that will measure blood glucose several times a day.
Very often, following a healthy diet and a healthy lifestyle (rest, good sleep cycle and physical activity if allowed by care team) is enough to balance diabetes. Thus, dietary rules will allow to better distribute the intake of carbohydrates during the day and to focus on foods with low glycemic index.
However, if dietary and hygiene measures are not enough, the doctor can prescribe insulin injections to obtain blood glucose levels that are in the objectives set by the medical team.
Good to know!
Although gestational diabetes disappears after childbirth in most cases, it is recommended to still monitor the blood glucose levels after delivery.
In addition, it is recommended to maintain a healthy lifestyle by eating balanced meals and doing regular physical activity to prevent the development of diabetes.
Sources :
- Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012, Cécile Billionnet, Delphine Mitanchez, Alain Weill, Jacky Nizard, François Alla, Agnès Hartemann, Sophie Jacqueminet, Diabetologia, February 16, 2017
- Lain KY, Catalano PM. « Metabolic changes in pregnancy » Clin Obstet Gynecol. 2007;50:938-48.
- Bottalico JN. « Recurrent gestational diabetes: risk factors, diagnosis, management, and implications » emin Perinatol. 2007;31:176-84.
- (en) Cousins L, Dattel BJ, Hollingsworth DR, Zettner A. « Glycosylated hemoglobin as a screening test for carbohydrate intolerance in pregnancy » Am J Obstet Gynecol. 1984;150:455-
- Wendland EM, Torloni MR, Falavigna M, Trujillo J, Dode MA, Campos MA, Duncan BB, Schmidt MI, « Gestational diabetes and pregnancy outcomes–a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria », BMC Pregnancy Childbirth, no 12, 2012, p. 23. (PMID 22462760, PMCID PMC3352245, DOI 10.1186/1471-2393-12-23, lire en ligne
