Gestational Diabetes

Gestational diabetes mellitus or what we commonly known as gestational diabetes is a state where individuals without previously diagnosed diabetes display high blood glucose levels during pregnancy. This increase in blood glucose levels is exhibited during the second trimester of pregnancy.  During pregnancy, instances happen where women do not produce adequate insulin required during this stage. Babies born to mothers with gestational diabetes can have some complications after birth. Usually, babies are large for gestational age (weigh much more than normal) that can cause delivery difficulties, problems and complications; have low blood sugar level, exhibits jaundice, or your baby may. Even if gestational diabetes goes away after the child is born complications during perinatal stage may and can be very serious. Treatment of gestational diabetes is essential to not further aggravate the complications.

Types

The two types of gestational diabetes are:

  • Type A1
    • Reveals altered finding during oral glucose tolerance test (OGTT), but with normal blood glucose levels with fasting and after two hours with meals.
    • With this stage of gestational diabetes, diet modification is enough to manage the increased glucose levels.
  • Type A2
    • Reveals altered finding during oral glucose tolerance test (OGTT), it also has elevated glucose levels even during fasting and/ or during after meals.
    • Apart from modification of lifestyle and diet, adjunct therapy with insulin and other diabetes medications are indicated and necessary.

Risk Factors

Classical risk factors for developing gestational diabetes are:

  • Poor obstetric history
  • Genetics
    • Family history of diabetes
    • First-degree relative with type 2 diabetes
  • Maternal age
    • Women increase the risk of acquiring gestational diabetes as her age increases. For gestational diabetes, women at the age of 35 and above are prone to develop this condition.
  • Weight, pregnant women who are overweight, obese and those severely obese are at high risk for having gestational diabetes. a previous pregnancy which resulted in a child with a high birth weight.
  • Previous diagnosis of gestational diabetes
  • Previous episodes of impaired glucose tolerance
  • Previous episodes of impaired fasting glycemia
  • Ethnic background
    • South Asians
    • African-Americans
    • Hispanics
    • Pacific Islanders
    • Afro-Caribbeans
    • Native Americans

Assessment and Diagnosis

  • Regular blood tests to check blood sugar level
  • Glucose-screening test between 24 and 28 weeks

Management

  1. Exercise regularly as planned and prescribed, exercise can help keep the blood sugar level normal.
  2. Take frequent blood tests to check blood sugar level.
  3. Have insulin therapy as indicated and as ordered to control increased blood sugar level.
  4. Eat well-balanced meals, controlled as prescribed by the physician or nutritionist.
  5. Gestational diabetes goes away after the baby’s birth, however it increases the risk for diabetes onto the next pregnancy, it is essential therefore that the management listed above should be followed.
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Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

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