Gestational diabetes is diabetes that lasts during pregnancy until delivery. This condition generally occurs in the second or third trimester. Diabetes Gestational diabetes occurs when the body does not produce enough insulin to control blood glucose (sugar) levels during pregnancy. This condition is a complication of pregnancy that is dangerous for the health of the mother and baby.
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| Gestational Diabetes, Causes, Diagnosis, Treatment, Prevention, Complications |
Causes of Gestational Diabetes
The cause of gestational diabetes is not known with certainty. However, this condition is thought to occur because the body produces more estrogen, HPL (human placental lactogen), growth hormone, and cortisol during pregnancy.
The increased amount of these hormones makes it more difficult for the body to process blood sugar. This condition is called insulin resistance. As a result, blood sugar levels increase and cause complaints of gestational diabetes.
Risk factors for gestational diabetes
There are several factors that can increase the risk of pregnant women developing gestational diabetes, namely:
- Are overweight or obese
- Had gestational diabetes in a previous pregnancy
- Have a family with diabetes
- Suffering from polycystic ovary syndrome (PCOS)
- Have a history of high blood pressure or hypertension
- Giving birth to a baby weighing more than 4.5 kg in a previous pregnancy
Symptoms of Gestational Diabetes
Symptoms of gestational diabetes appear when blood sugar levels are too high (hyperglycemia). These signs and symptoms include:
- Often feel thirsty
- The frequency of urination increases
- Dry mouth
- Easily tired
- Blurred vision
It should be noted that some of these symptoms are also common in pregnant women. Therefore, pregnant women are advised to consult a doctor and check themselves regularly.
When to see a doctor
Immediately consult a doctor if you are pregnant and experience the symptoms above. The doctor will provide care and monitor blood sugar levels and overall health of the mother and fetus.
It is important to know, pregnancy checks should have been carried out since you are positively pregnant and carried out periodically according to the doctor's recommendations. This will make it easier for your doctor to screen and control your blood sugar levels during pregnancy.
Diagnosis of Gestational Diabetes
To diagnose gestational diabetes, the doctor will ask questions about the symptoms experienced, as well as the patient's and family's medical history. After that, the doctor will carry out screening and diagnostic tests.
Screening tests for gestational diabetes are performed at 24 weeks of gestation and above. This examination can also be done on pregnant women who are asymptomatic and have a history of type 1 or 2 diabetes. These tests include:
- Initial oral glucose tolerance test (OGTT).
- In this test, the doctor will check the patient's blood sugar level 1 hour before and after drinking the glucose solution. If the initial OGTT results show blood sugar levels above 130–140 mg/dL, the patient will be advised to undergo further OGTT.
- Advanced oral glucose tolerance test (OGTT).
- Follow-up OGTT is performed by giving a glucose solution with a higher sugar content than the initial test. After that, the patient's blood sugar level was checked three times in 3 hours. A patient is declared to have gestational diabetes if two tests show high blood sugar levels.
In addition to the oral glucose tolerance test, the doctor will also perform other tests, including:
- HbA1c test, to find out the average blood sugar level in the last 3 months
- Urine test, to determine the levels of protein, ketones, and creatinine in the urine
- Gynecological ultrasound, to measure the approximate length and weight of the fetus
- Cardiac record, to detect heart abnormalities that can indicate complications of hyperglycemia
Gestational Diabetes Treatment
Management of gestational diabetes aims to control blood sugar levels and prevent complications of pregnancy and childbirth. Treatment methods can be diet, exercise, or drugs. Here is the explanation:
Diet
The doctor will suggest dietary changes to control blood sugar levels. Patients will be advised to eat lots of fruits, vegetables, nuts, and whole grains. Doctors will also advise patients to limit consumption of foods and drinks that contain saturated fat and high sugar.
Sport
Regular exercise during pregnancy can help lower blood sugar levels. Therefore, pregnant women are advised to consult a doctor regarding the type of exercise that suits their health conditions.
Besides being able to lower blood sugar, regular exercise can also relieve various complaints related to pregnancy, such as back pain, cramps, swollen feet, constipation, and difficulty sleeping.
Drugs
If diet and exercise are not effective in managing gestational diabetes, doctors can prescribe drugs to lower blood sugar levels. The oral drug prescribed by the doctor is metformin. If needed, the doctor can also give injectable insulin.
Gestational Diabetes Complications
Untreated gestational diabetes can cause a number of health complications for both mother and baby. Gestational diabetes complications that can occur in pregnant women include:
- Preeclampsia
- Caesarean delivery
- Type 2 diabetes
- Risk of gestational diabetes in subsequent pregnancies
Meanwhile, complications of gestational diabetes that can occur in infants, namely:
- Born with excess weight
- Premature birth
- Jaundice or jaundice
- Died in the womb or shortly after birth
- Respiratory disorders
- Low blood sugar or hypoglycemia
- Type 2 diabetes later in life
Prevention of Gestational Diabetes
Not yet known exactly how to prevent gestational diabetes. However, there are several efforts that can be made to reduce the risk of developing gestational diabetes, namely:
- Eat a complete and balanced nutritious diet, especially vegetables, fruits and whole grains
- Limit consumption of fast food and food or drinks that contain high sugar
- Eat small portions, but more often
- Eat on a regular schedule
- Exercise regularly either before or during pregnancy according to health conditions
- Starting pregnancy with ideal weight
- Avoid excessive weight gain during pregnancy
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