Update | November 4, 2024 Author : Diana Coelho Gestational diabetes is diabetes that is diagnosed during pregnancy in women without previous diabetes . It is due to an inability to produce enough insulin to control blood glucose levels that result from increased requirements during pregnancy. It is more common in the second and third trimesters of pregnancy. In most cases it disappears after birth. The importance of diagnosing and treating gestational diabetes is related to maternal and fetal complications. Gestational diabetes occurs as a consequence of hormonal changes during pregnancy and can affect between 5% and 15% of pregnant women. Its prevalence has increased due to increasing maternal age and the increase in overweight and obesity in the general population. Risk factors Any pregnant woman can develop gestational diabetes, but the risk is higher in a pregnant woman: Over 35 years old; Overweight or obese; With excessive weight gain during pregnancy; With a history of diabetes in immediate family members (for example, parents or siblings); With gestational diabetes and/or babies with high birth weight (> 4000 g) in previous pregnancies; With African, South American or Asian origin. Symptoms and diagnosis of gestational diabetes Many pregnant women with gestational diabetes do not have specific symptoms. Diagnosis is made based on the results of tests carried out during pregnancy. When there are symptoms, the most common are: Dry mouth and increased thirst; Need to urinate more frequently; Tiredness; Changes in vision; Itching in the genital area. However, these symptoms are not specific to gestational diabetes and are common during pregnancy . There are different diagnostic criteria for gestational diabetes, according to different scientific societies. In Portugal, the diagnosis is made in two phases : In the first trimester of pregnancy, a fasting blood glucose test is carried out; Between 24 and 28 weeks of gestation, an oral glucose tolerance test is performed; One of these altered tests will diagnose possible gestational diabetes. Complications of gestational diabetes The main complications of gestational diabetes are: Overweight babies , which is associated with a higher risk of: Prolonged and difficult birth; Injuries to mother and baby; Need for instrumented delivery (forceps and suction cup); Need to induce labor; Need to perform a cesarean section; Premature birth. Polyhydramnios (excess amniotic fluid) , which is associated with a greater risk of premature birth and complications during childbirth. Pre-eclampsia , which can lead to hypertension during pregnancy and complications during childbirth. Neonatal jaundice , requiring hospital treatment; Newborn hypoglycemia ; Later development of type 2 diabetes in mothers ; More rarely, abortion . Large babies born to mothers with gestational diabetes also have a higher risk of developing diabetes and obesity later in life. Treatment and control of gestational diabetes When gestational diabetes is diagnosed, it is necessary to control blood glucose levels and thus reduce the likelihood of complications. The pregnant woman should have more frequent monitoring, ideally by a multidisciplinary team , namely, her obstetrician , an endocrinologist , a nutritionist and a nurse specializing in maternal health. She should start regular monitoring of glucose levels (before and 1 hour after meals) with specific devices, which can be of different types, from those that allow determining glucose levels from blood from a finger prick to those from continuous glucose monitoring, depending on the particularities of each case. The first measures to control glucose levels are interventions at two levels: Diet , with meals eaten at regular intervals, which include a greater proportion of foods with a lower glycemic index and more fiber (for example, pasta and rice and other whole grains, legumes, among others), vegetables and whole fruits, sources of lean protein (lean meats and fish) and exclude sugary, high-fat and high glycemic index foods and drinks; Physical activity , as exercise helps regulate blood sugar. Exercise must be properly planned taking into account the pregnancy, goals and particularities of the pregnant woman, especially when she has not previously exercised. When these interventions are not sufficient, treatment with oral antidiabetics or insulin may be necessary. In most cases, after birth, blood glucose stabilizes . All of these women will be required to have a reclassification test 6 to 8 weeks postpartum, which again consists of an oral glucose tolerance test. Due to the increased risk of this situation recurring in a future pregnancy, or of developing type 2 diabetes, these women must maintain healthy lifestyles and maintain more frequent medical surveillance. Meet the obstetrics-gynecology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
