How to Treat Gestational Diabetes in Pregnant Women

Gestational Diabetes

Gestational diabetes is diabetes that appears during pregnancy, and only lasts until birth. This condition can occur at any gestational age, but usually occurs in the 24th to 28th week of pregnancy. Similar to normal diabetes, gestational diabetes occurs when the body does not produce enough insulin to control glucose (sugar) levels in the blood during pregnancy. This condition can harm the mother and fetus, but can be suppressed if treated quickly and appropriately.

Symptoms of Gestational Diabetes

Symptoms of diabetes during pregnancy appear when blood sugar levels rise high (hyperglycemia).
Some of the symptoms are:

1. Constantly feeling thirsty.
   Pregnant women who experience gestational diabetes may want to drink more than usual. They will feel thirsty even when they haven’t eaten something salty, done daily activities, or done anything else that would normally make someone want an extra glass of water.
2. The body gets tired easily, weak, lethargic.
   If pregnant women feel tired, even early in the day, it may be more than just the stress of being pregnant that’s causing them to be so tired. If you experience this condition, don’t hesitate to immediately ask a doctor whether pregnant women are at risk of developing gestational diabetes or not.
3. Dry mouth.
   Dry mouth can occur along with increased thirst experienced by pregnant women. Pregnant women may want to drink more water to relieve the dry feeling. Both could be signs of gestational diabetes.

Pregnant women who experience gestational diabetes may also show other signs or symptoms, such as:

1. Blurred vision.
2. Nauseous.
3. Bladder, vaginal or dry skin infections.
4. Frequent urination.
5. Sugar in urine.

Please note that not all of the symptoms above indicate gestational diabetes, because they can be experienced by pregnant women. Therefore, talk to a doctor if you experience the conditions above. The doctor may be able to determine whether they have gestational diabetes or another condition. If pregnant women are diagnosed with gestational diabetes, their doctor may have them checked more frequently during pregnancy, so they can monitor their health more closely. Pregnant women may also need to follow a strict diet and exercise plan, as well as monitor blood sugar levels or take medication to control gestational diabetes.

Causes of Gestational Diabetes

It is not yet known for certain what causes gestational diabetes. However, this condition is thought to be related to hormonal changes during pregnancy. During pregnancy, the placenta will produce more hormones, such as the hormone estrogen, HPL (human placental lactogen), including hormones that make the body resistant to insulin, which is a hormone that lowers blood sugar levels. As a result, blood sugar levels increase and cause gestational diabetes.

Risk Factors for Gestational Diabetes

All pregnant women are at risk of developing gestational diabetes, but it is more at risk for pregnant women with the following factors:

1. Having excess weight.
2. Bad lifestyle.
3. Have a history of high blood pressure (hypertension).
4. Have had gestational diabetes in a previous pregnancy.
5. Have had a miscarriage.
6. Have ever given birth to a child weighing 4.5 kg or more.
7. Have a family history of diabetes.
8. Experiencing PCOS (polycystic ovary syndrome) or acanthosis nigricans.
9. Has high cholesterol and heart disease.

Gestational Diabetes Diagnosis

Doctors can suspect that a patient has gestational diabetes if there are symptoms accompanied by the medical history described previously. However, to be sure, the doctor can carry out further examinations, such as:

1. Initial oral glucose tolerance test (OGTT).
   In the initial OGTT, the doctor will check the patient’s blood sugar levels one hour before and after being given the sugar liquid. If the initial OGTT results show blood sugar levels above 130–140 mg/dL, the doctor will perform a follow-up oral glucose tolerance test.
2. Follow-up oral glucose tolerance test (OGTT).
   In this test, the patient will be asked to fast overnight before undergoing a blood test in the morning. After the first blood is drawn, the doctor will give sugar water with a higher sugar content than the initial OGTT. Then, blood sugar levels will be checked 3 times every hour. If 2 out of 3 examinations show high blood sugar levels, the patient will be diagnosed with gestational diabetes.

For patients who have been diagnosed with gestational diabetes, the doctor will recommend more regular blood tests, especially in the last 3 months of pregnancy. If pregnancy complications occur, the doctor will check the function of the patient’s placenta to ensure the baby gets proper oxygen and nutrition in the womb. The doctor will also carry out blood tests again after the patient gives birth and 6-12 weeks afterward, to ensure that the patient’s blood sugar levels have returned to normal. Patients are also advised to undergo blood tests every 3 years, even if blood sugar levels have returned to normal.

Gestational Diabetes Treatment

Gestational diabetes treatment aims to control blood sugar levels and prevent complications during pregnancy and childbirth. Gestational diabetes treatment methods include:

1. Routine blood sugar level checks.
   Doctors will recommend that patients have their blood checked 4-5 times a day, especially in the morning and after every meal. Patients can check their blood independently, using a small needle, and placing the blood in a blood sugar checker.
2. Healthy diet.
   Doctors will advise patients to consume lots of high fiber foods, such as fruit, vegetables and whole grains. Patients are also advised to limit consumption of sweet foods, as well as foods with high fat and calorie content. Losing weight while pregnant is not recommended, because the body requires extra energy. Therefore, if you want to lose weight, do it before planning a pregnancy. Diet patterns are also not the same for every patient. Therefore, consult a doctor about the right diet pattern for the mother.
3. Sport.
   Exercise can stimulate the body to move sugar from the blood into cells to be converted into energy. Another benefit of regular exercise is that it helps reduce discomfort during pregnancy, such as back pain, muscle cramps, swelling, constipation and difficulty sleeping.
4. Medicine.
   If a healthy diet and exercise have not been able to reduce blood sugar levels, the doctor will prescribe metformin. If metformin is ineffective or causes severe side effects, the doctor will give you insulin injections. About 10-20 percent of gestational diabetes patients require medication to normalize blood sugar levels.

If a pregnant woman’s blood sugar levels remain uncontrolled or she has not given birth at a gestational age of more than 40 weeks, the doctor may choose to perform a caesarean section or induction to speed up labor. Gestational diabetes can increase the risk of a baby being born with complications. Therefore, it is important to have regular pregnancy consultations, so that the baby’s development is monitored.

Complications of Gestational Diabetes

Pregnant women who suffer from gestational diabetes can still give birth to healthy babies. However, if this condition is not treated properly, several complications can occur in the baby at birth, such as:

1. Excess weight at birth caused by high blood sugar levels (macrosomia).
2. Premature birth which causes the baby to have difficulty breathing (respiratory distress syndrome). This condition can also occur in babies born on time.
3. Born with low blood sugar (hypoglycemia) due to high insulin production. This condition can cause seizures in babies, but can be treated by giving them sugar.
4. Risk of obesity and type 2 diabetes as an adult.

Prevention of Gestational Diabetes

Until now, it is not known whether gestational diabetes can be prevented or not. However, there are several ways that can be done to reduce the risk of developing this disease, namely:

1. Increase your consumption of healthy foods with high fiber, such as vegetables and fruit. In addition, avoid foods that contain high fat or calories.
2. Exercise regularly to maintain body fitness before and during pregnancy. It is recommended to do light to moderate exercise, such as swimming, brisk walking or cycling for at least 30 minutes per day. If this is not possible, do short but regular exercise, such as walking frequently or doing housework.
3. Lose weight when planning a pregnancy by adopting a healthy diet permanently. This step will also provide long-term benefits, such as having a healthy heart.