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Gestational Diabetes In Pregnancy And Treatment

picture gestational diabetes in pregnancy
gestational diabetes in pregnancy

Do you ever hear about gestational diabetes? It is reported that the prevalence of diabetes worldwide, especially among pregnant women, continues to increase each year.

Gestational Diabetes In Pregnancy And Treatment

Gestational Diabetes In Pregnancy

Many studies have shown that pregnant women with hyperglycemia increase the risk of preeclampsia for the mother and the risk of an overweight baby being born.

Early detection of gestational diabetes is very important to reduce the risks or complications that may occur in mothers and babies.

In addition to early detection, maternal prophylaxis and intervention are also needed to reduce the incidence of gestational diabetes.

WHO and the American Diabetes Association have developed guidelines for the treatment and intervention of pregnant women with a history of diabetes or gestational diabetes.

It is expected to reduce the incidence of diabetes in pregnant women and the prevalence of mothers and children.

If you are still unaware of diabetes that sometimes happens to pregnant women, it is called Gestational diabetes. This diabetes occurs during pregnancy and lasts until childbirth. 

This type of diabetes is different from diabetes type 1 or diabetes type 2. You can read here for more information about diabetes type 1 and diabetes type 2. Gestational diabetes can occur at any pregnancy stage but usually occurs between the 24th and 28th weeks of gestation.

Gestational diabetes can cause hyperglycemia and can affect pregnancy and fetal health. Gestational diabetes can adversely affect the health of both the mother and the child. This condition can increase the risk of birth defects, premature and stillbirth.

Similar to diabetes type 1 and diabetes type 2, gestational diabetes occurs when the body does not produce enough insulin to control the level of glucose or sugar in the blood during pregnancy.

These conditions can be dangerous to the mother and the child but can be controlled with prompt and appropriate treatment.

Risk factors for gestational diabetes

All pregnant women are at risk for gestational diabetes, but the following factors increase the risk for pregnant women:
  • History of hypertension (hypertension).
  • Has experience with gestational diabetes during a previous pregnancy
  • Ever had a miscarriage.
  • Getting overweight or experiencing drastic weight gain during pregnancy
  • Deliver a baby with a weight of more than 4.5 kg.
  • Have a family with a history of diabetes.
  • Has PCOS (Polycystic Ovary Syndrome)

Gestational Diabetes diagnosis

Early diagnoses by doctors usually are associated with the above medical history. However, the doctors will still perform other tests, such as:

1. Initial Oral Glucose Tolerance Test (OGTT).

For the first OGTT, the doctor will check the patient's blood glucose levels 1 hour before and 1 hour after the doctor gives glucose syrup. 

If the initial OGTT results show blood glucose levels above 130-140 mg / dL, the doctor will issue an order for an oral glucose tolerance test as the next step.

2. Advanced Oral Glucose Tolerance Test (OGTT).

This test requires the patient to fast overnight before having a blood test in the morning. After the first blood draw, the doctor will provide water with a higher sugar content than the first OGTT.

After giving water with high sugar content, doctors will continue to check the blood sugar conditions three times for an hour. 

A patient will be diagnosed with gestational diabetes if two of the three tests show high blood sugar levels.

Once patients are diagnosed with gestational diabetes, doctors recommend regular blood tests, especially during the last 3 months of pregnancy. 

If pregnancy complications occur, the doctor will check the patient's placental function to ensure the baby receives enough oxygen and nutrients in the womb.

The doctor will also perform another blood test at least 6 to 12 month after the patient safely deliver the baby. The doctor will ensure the patient's blood glucose levels have returned to normal. 

Patients are also advised to have a blood test every three years, even after their blood sugar levels have returned to normal.

Gestational Diabetes treatment

Treatment of gestational diabetes is important because it is aimed at controlling blood sugar levels to prevent any further complications during pregnancy and childbirth.

Below are some treatments for gestational diabetes:

1. Regular blood glucose tests.

Doctors recommend that patients regularly check their blood 4 to 5 times daily, especially in the morning and after each meal. Patients can perform blood tests independently, using needles and glucose test strips.

2. Maintain healthy eating habits. 

Doctors will advise patients to eat plenty of high-fiber foods such as fruits, vegetables, and whole grains. 

Patients are also advised to limit their intake of sweet foods and foods high in fat and calories. It is not recommended to lose weight during pregnancy as bodies require extra energy. 

Therefore, to lose weight, it is advisable to do it before planning your pregnancy. Dietary patterns are different for all patients. Therefore, talk to your doctor about the right diet for you.

3. Do exercise regularly. 

Regular exercise will help the body to fasten the sugar in the blood to convert it into energy.  Another benefit of doing exercise regularly is that it helps to reduce some pregnancy symptoms such as back pain, muscle cramps, swelling, constipation, and sleep disorders.

4. Metformin medicine. 

The doctor will usually prescribe metformin if a healthy diet and regular exercise fail to lower blood sugar.

If metformin does not work or causes serious side effects, the doctor will give you an insulin injection. About 10 to 20% of people with gestational diabetes need medication to normalize their blood sugar levels. 

Even though Metformin can be used as a pharmacological treatment for diabetes during pregnancy, insulin is still the best option if blood sugar levels roam uncontrolled. 

5. Aspirin for Pregnant Women

Low-dose aspirin is also recommended for pregnant women with diabetes to reduce the risk of pre-eclampsia.

Suppose the blood glucose level of a pregnant woman remains uncontrolled or does not give birth after 40 weeks of gestation. 

In that case, the doctor can perform a cesarean section or give an injection to stimulate the baby's delivery.

Gestational diabetes can increase the risk of having a baby with more complications. Therefore, it is important to have regular pregnancy counseling sessions to monitor your baby's development.

Unlike other types, gestational diabetes is curable. This diabetes can be cured, and blood sugar levels return to normal after the mother is born.

There are several ways that can be done to prevent the risk of getting gestational diabetes that can be applied during pre-pregnancy:
  • Increase the consumption of healthy foods that contain high fiber, vegetables, and fruits.
  • Avoid foods that contain fat or high calories.
  • Avoid junk food, sugary drink, and sweets.
  • Doing light or moderate exercises. Doing some household chores are considered light exercise.
  • Walk more.
The above step also brings long-term benefits to the body, like a healthy heart, ideal body weight, and better internal organ function.

How to prevent gestational diabetes

Gestational diabetes can be prevented by doing some interventions either before or during pregnancy,

1. Doing regular counseling with the Obstetrician.

Doing regular counseling with the obstetrician will help to diagnose if there are any potential issues with your pregnancy, including gestational diabetes.

2. Build and practice healthy eating habits

Building and practicing healthy eating habits will help to prevent gestational diabetes to occurs. You can try to practice healthy eating habits with the target as below: 
  • Blood sugar level before eating < 95mg/ dL
  • Blood sugar level 1 hour after eating< 140mg/ dL
  • Blood sugar level 2 hours after eating< 120mg/ dL
Special for pregnant women who ever had a preliminary history of diabetes, either type 1 or 2, the blood sugar should be:
  • Blood sugar level before eating 60 to 99mg/ dL
  • Blood sugar level after eating 100 to 129mg/ dL
  • HbA1C< 6

3. Maintain blood pressure 110 to 129/ 65 to 79mmHg.

If the pregnancy is accompanied by hypertension, then further medication is needed. Some safe medicines to treat hypertension are antihypertensive medicines other than ACE impediments, and ARBs can be used.

3. Pregnancy gap minimum of 5 years

For A mother with a history of diabetes, either diabetes type 1, diabetes type 2, or gestational diabetes, it is advisable to keep the pregnancy gap minimum of 5 years from the previous pregnancy. 

The use of contraception to prevent pregnancy is highly recommended during this period. In addition, the number of baby delivery that can be carried out will also be limited to a maximum of 3 births due to the risk of macrosomia and other complications that can be fatal to the mother's life.

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