Pregnancy is a special period where the expectant mother's metabolism undergoes changes, and hormonal balance shifts. During this process, some women may experience elevated blood sugar levels even if they have no prior history of diabetes. Gestational diabetes (pregnancy diabetes) is a type of diabetes that occurs during pregnancy and may resolve after childbirth, with blood sugar levels being higher than normal. Pregnancy diabetes may not cause any symptoms but can lead to conditions such as constant thirst, fatigue, and frequent urination.
What is Gestational Diabetes (Pregnancy Diabetes)?
Gestational diabetes refers to higher-than-normal blood sugar levels during pregnancy. Hormones produced during pregnancy can make it difficult for the mother to use insulin. When the pancreas does not produce sufficient insulin to maintain balance, blood sugar levels rise, leading to gestational diabetes.
Gestational diabetes can be diagnosed with a glucose tolerance test performed in the second trimester of pregnancy. Some women may not show any symptoms; therefore, screening tests should be a part of pregnancy monitoring.
What are the Symptoms of Pregnancy Diabetes (Gestational Diabetes)?
Gestational diabetes may not cause notable complaints in some women. Therefore, diagnosis can be made during routine pregnancy screenings. When symptoms are present, the following complaints may be observed:
-
Feeling more thirst than usual
-
Frequent urination
-
Dry mouth
-
Constant feeling of hunger
-
Fatigue
-
Blurred vision
-
Recurrent skin fungal infections
-
Increased urinary tract infections
-
Getting up frequently at night to urinate
What Causes Pregnancy Diabetes?
Pregnancy diabetes arises due to insulin resistance caused by hormones secreted from the placenta during pregnancy. Under normal circumstances, insulin is a hormone that helps in transporting blood sugar into cells. However, estrogen, progesterone, and placental hormones secreted during pregnancy can reduce the efficacy of insulin. This situation causes the insulin produced by the body to be insufficient in balancing blood sugar.
Factors such as genetic predisposition, starting pregnancy with excess weight, polycystic ovary syndrome (PCOS), a family history of diabetes, and having previously delivered a large baby may contribute to the development of pregnancy diabetes. However, gestational diabetes can develop in women without any risk factors, making screening tests an important part of pregnancy monitoring.
Who is at Higher Risk of Developing Gestational Diabetes?
Although it can occur in any pregnancy, some women are at a higher risk of developing gestational diabetes. The following situations are associated with increased risk:
-
Being overweight or having a high body mass index prior to pregnancy
-
Having a family history of diabetes
-
Having been diagnosed with gestational diabetes in a previous pregnancy
-
Previous births resulting in a baby weighing 4 kg or more
-
A diagnosis of polycystic ovary syndrome (PCOS)
-
Pregnancy at an advanced age
-
Excessive weight gain during the course of pregnancy
-
Having pre-pregnancy insulin resistance or a prediabetes diagnosis
Even if one or more of these risk factors are present, regular monitoring and proper nutritional management can keep blood sugar levels under control from the start of pregnancy.
What are the Diagnosis Criteria for Gestational Diabetes?
Gestational diabetes can be diagnosed with the Oral Glucose Tolerance Test (OGTT). This test is also known as a glucose loading test. First, a fasting blood sugar measurement is taken from the expectant mother, then a liquid containing a specific amount of glucose is consumed, and blood sugar measurements are taken again at the 1st and 2nd hours.
The aim of the test is to evaluate whether the expectant mother's blood sugar levels rise during the day. Measurements are taken during the test, and results are evaluated against internationally valid reference values. In mothers with risk factors, the test can be done at earlier weeks.
What are the Treatment Methods for Pregnancy Diabetes?
The aim of gestational diabetes treatment is to keep the expectant mother's blood sugar levels within a safe range and prevent possible complications for both mother and baby. The basic approach in treatment is lifestyle changes that will ensure blood sugar control and insulin therapy if necessary.
Methods applied in the treatment of gestational diabetes include:
-
Diet Regulation
Meal planning is done to maintain blood sugar balance. Carbohydrates are evenly distributed throughout the day; foods high in fiber, whole grains, vegetables, and protein are preferred.
-
Blood Sugar Monitoring
The expectant mother performs fasting and postprandial blood sugar measurements during the day, and the values are monitored by the doctor. Blood sugar results are decisive in guiding the treatment.
-
Exercise Plan
Regular and light-paced walks recommended by the doctor are suggested. Physical activity is effective in controlling blood sugar by increasing the muscles' glucose use.
-
Insulin Therapy
If blood sugar does not reach target values despite dietary regulation and physical activity, insulin therapy may be applied.
How Does Pregnancy Diabetes Affect Mother and Baby?
If gestational diabetes is not controlled, it can affect the health of both mother and baby. High blood sugar causes the baby to receive excessive glucose through the placenta, turning it into fat in the baby's body. This can impact both the pregnancy process and decisions regarding the mode of delivery. However, these risks can be significantly reduced with proper nutrition, regular monitoring, and necessary insulin therapy.
Possible effects of gestational diabetes on the mother include:
-
Increased risk of high blood pressure and preeclampsia during pregnancy
-
Development of a large baby (macrosomia), making normal delivery difficult
-
Increased likelihood of cesarean delivery
-
Risk of premature birth in the later stages of pregnancy if blood sugar is not controlled
-
Increased risk of developing type 2 diabetes in the years following childbirth
Possible effects of gestational diabetes on the baby include:
-
The baby developing larger than needed
-
Increased risk of physical complications during delivery, such as shoulder dystocia
-
Developing low blood sugar (hypoglycemia) after birth
-
Increased risk of breathing problems or respiratory distress
-
Increased likelihood of developing obesity and type 2 diabetes in later stages
How Should the Expectant Mother Eat During Pregnancy?
The diet of an expectant mother diagnosed with gestational diabetes is one of the most crucial steps during the pregnancy process. The goal is to keep blood sugar levels balanced, prevent sudden increases, and meet the nutritional needs of both the mother and baby consistently.
Skipping meals during pregnancy can prevent blood sugar fluctuations. Regular nutrition can be recommended with three main meals and snacks throughout the day. Staying hungry for long periods can cause sudden drops in blood sugar, while consuming foods with high and rapid carbohydrates in a single sitting can cause sudden increases in blood sugar.
Instead of foods containing refined sugar, opting for low glycemic index, high fiber, and slowly absorbed foods is advisable. Whole grains, rye bread, bulgur, oats, legumes, and vegetables are valuable in this regard.
Including protein sources in every main meal is essential. Eggs, yogurt, ayran, kefir, fish, chicken, and red meat can help balance blood sugar. Protein slows the rate at which carbohydrates are absorbed into the bloodstream, aiding in keeping glucose levels under control. Fat consumption should be moderate, and methods like frying should be avoided.
While fruits are considered healthy, fruit consumption must be controlled in pregnancy diabetes. Fruits can be consumed as snacks, together with a protein source.
Water consumption also plays a role in maintaining blood sugar balance. Drinking an adequate amount of water throughout the day is necessary for body functions and blood sugar control. Daily fluid intake should be planned according to the doctor's recommendation.
Frequently Asked Questions
Is gestational diabetes seen in every pregnancy?
No, it is not seen in every pregnancy; however, some expectant mothers may be at risk. Excess weight, a family history of diabetes, and a history of giving birth to a large baby are among the risk factors.
Is there a risk of developing diabetes again after pregnancy?
Women who experience gestational diabetes may be at risk of developing type 2 diabetes in the future. Therefore, maintaining healthy lifestyle habits after childbirth is important.
Does gestational diabetes cause the baby to gain weight?
Yes, uncontrolled gestational diabetes can increase the baby's blood sugar and consequently insulin secretion. Since insulin increases fat storage, the baby may gain more weight than normal.
Does gestational diabetes cause weight gain in the expectant mother?
High blood sugar can lead to increased appetite and rapid weight gain. However, with the right diet plan and meal arrangement, weight control can be achieved.