Pregnancy can be a beautiful experience, a divine opportunity that ushers a woman into motherhood. But at times, it comes with challenges. Developing Gestational diabetes is one of the many risk factors associated with pregnancy. If no interventions are done, this form of diabetes is likely to increase as populations grow annually.
Some reports show that the number of births in Kenya has been increasing each year at a rate of 1.9 per cent. A report by research expert Aaron O’Neal entitled ‘Crude Birth rate in Kenya’ revealed that in the year 2020, the birth rate in the country was estimated to be at 28.9 births per thousand people.
Yet, according to the Kenya National Diabetes Strategy report, Gestational diabetes affects about 4 percent of all pregnant women. This means that in this growing populations of expectant women, 4 per cent are likely to have developed gestational diabetes in 2020.
The known prevalence of diabetes as a whole is estimated to be 3.3 per cent. However, this figure is likely to be an underestimation because, according to the Kenya National Diabetes Strategy report, it is estimated that two thirds of people with diabetes do not actually know that they have the disease.
Thus far, half of the number of women who are found to have gestational diabetes have an increased chance of developing type 2 diabetes in later years. While any woman can develop gestational diabetes during pregnancy, those with higher chances of developing the condition include those who have high blood pressure or have a had a brush with prediabetes or gestational diabetes during pregnancy among other symptoms we will discuss in detail.
What is Gestational Diabetes?
This is a type of diabetes that results from high blood sugar levels during pregnancy. It is common during the second and third trimesters. Although it affects women, it does not occur in all of them. Most women do not experience symptoms because the condition tends to disappear in many cases after giving birth.
Pregnant women who have never had diabetes before, but who have high blood sugar levels during pregnancy are said to have gestational diabetes. It begins when the body lacks the ability to make and use all the insulin it needs for pregnancy. Without sufficient insulin, glucose cannot leave the blood and be converted to energy. Some common risk factors for gestational diabetes include:
- Family and medical history: A person is at risk of developing gestational diabetes if she has a family history of prediabetes or type 2 diabetes. If a person had prediabetes prior to giving birth, the chances of developing gestational diabetes are higher.
- Age: the likelihood of developing gestational diabetes is dependent on maternal age with the risk increasing as one gets older. At age 25 and over, there is a risk of developing gestational diabetes.
- Maternal weight: especially if one is obese or overweight.
What are the symptoms of Gestational Diabetes?
In most cases, the symptoms are subtle. For this reason, a blood sugar test is required during the early trimester of pregnancy for diagnosis. A few symptoms to look out for include:
- Fatigue – although this may be common to expectant women, it is important to be on the lookout for this symptom.
- Increased thirst – this involves drinking more fluids than usual and always feeling thirsty even after drinking a glass or two.
- Dry and cracked mouth.
What is the cause of Gestational Diabetes?
The root cause of gestational diabetes is not known. However, one explanation on how it occurs is this: during pregnancy, the placenta releases a few hormones which aid in the foetus growing process. Some of these hormones make it difficult for the body to make or use insulin. This leads to insulin resistance.
In order to keep blood sugar levels in check, the pancreas has to make at least three times as much insulin than usual. If not, enough insulin is made, the blood sugar levels will rise and gestational diabetes develops as a result.
Gestational Diabetes Complications to the Mother
If left untreated undiagnosed, gestational diabetes may increase maternal risk of developing:
- Pre-eclampsia: gestational diabetes increases the risk of high blood pressure during pregnancy, as well as preeclampsia, which is a detection of high blood pressure in women who have not been treated for or diagnosed with blood pressure before. Common symptoms of this include high protein levels in urine, and swelling of the hands, legs, and feet.
- Prospective diabetes: Gestational diabetes is considered likely that you will develop it again during a successive pregnancy. Patients are also at risk of developing type 2 diabetes in later years. However, this can be prevented by making healthy lifestyle choices and leading a less sedentary lifestyle.
- Other complications include Depression in pregnancy and may lead to caesarean section during delivery.
Gestational Diabetes Complications to the Baby
If left uncontrolled gestational diabetes may lead to some complications to the baby such as;
- Macrosomia (Big baby): this is a condition whereby a new-born baby is much larger than average. A baby who has this condition tends to weigh more than 4 kilos regardless of their gestational age.
- Jaundice (yellowing of eyes)
- Low blood sugar at birth
- Type 2 diabetes later on in life.
How is gestational diabetes Diagnosed?
Certain blood tests, analysis and observations are carried out so as to test for gestational diabetes. Blood tests are a better option because some of these common pregnancy symptoms experienced such as fatigue or hunger may seem ordinary to an expectant mum. So, it is important to be screened during periods of pregnancy from around 24 to 28 weeks of pregnancy.
For long term interventions, it is important for women with gestational diabetes to be screened at 6 weeks postpartum to determine if they actually have diabetes outside of pregnancy.
Other tests include HBA1c monthly average and the Oral Glucose Tolerance Test (OGTT) – OGTT is a blood test to detect signs of elevated blood sugar levels is considered part of prenatal care and can be administered during regular health checks. Tests include a 1-hour to 2 hours glucose tolerance test, and if it’s positive, a follow-up 3-hour test to confirm the diagnosis.
Treatment for gestational diabetes
Regular blood sugar testing to monitor the effectiveness of the prescribed mode of treatment is also advised. For the standard method, treatment for gestational diabetes is aimed at maintaining a steady blood glucose level. Besides the regular administration medications, one can be encouraged to adopt a healthier, less sedentary lifestyle to include:
- Maintaining a healthy lifestyle during pregnancy.
- Maintaining a healthy weight and body mass index (BMI)
- Engaging in regular physical activity
- Getting enough rest through sleep
Above all, the good news is, gestational diabetes in many cases tends to go away on its own after delivery. The blood sugars return to the normal range of less than 7milimols/liter. However, once a mother has had gestational diabetes, she has to be mindful of her health for the rest of her life.