A Guide To Gestational Diabetes

Learn how gestational diabetes may affect your pregnancy.

Gestational diabetes is the development of diabetes during pregnancy. Diabetes occurs when the body is unable to produce enough insulin to regulate blood glucose, resulting in high blood sugar levels. Similarly, gestational diabetes develops when the body does not provide enough insulin to handle the increase in glucose produced during pregnancy.

Gestational diabetes usually develops during the middle or end of pregnancy. Therefore, the test to diagnose gestational diabetes, which is known as the Oral Glucose Tolerance Test (OGTT), is conducted at between 24 and 28 weeks of pregnancy. It is a simple blood test that is taken about 60 minutes after the mother has consumed a sugar load (a drink with high sugar content).

What are the warning signs of gestational diabetes?

Most women with gestational diabetes do not experience any symptoms. Thus it is highly recommended that they undergo OGTT even though there are no symptoms of the disease.

However, if sugar levels are very high, some symptoms include:

  • Being unusually thirsty all the time.
  • Frequent urination.
  • Feeling tired or nauseous (which can be similar to early pregnancy symptoms).
  • Sugar detected in urine tests (conducted during each prenatal visit with the gynaecologist).

What factors will increase the risk of gestational diabetes?

An unhealthy diet can increase the risk of gestational diabetes. Excess intake of foods that are high in sugar or carbohydrates also increases risks.

Other risk factors include:

  • A family member (parent or sibling) who has diabetes.
  • A high Body Mass Index (BMI) of over 30kg/m2.
  • Had gestational diabetes in previous pregnancies.
  • Had a baby weighing over 4kg in previous pregnancies.
  • A history of polycystic ovarian syndrome.
  • Aged 40 years or older.
  • Family origin with a high prevalence of diabetes (South Asian, Chinese, Middle-Eastern, or African-Caribbean).

Asians have a higher chance of developing gestational diabetes. Which is why it’s recommended that all women in Singapore test for gestational diabetes at 24 to 28 weeks of pregnancy. Mothers-to-be with any risk factors will have an additional test earlier in the first trimester, and again at 24 to 28 weeks of pregnancy if the initial test result was normal.

How does gestational diabetes affect a pregnancy?

With proper diagnosis and treatment, most women with gestational diabetes can have healthy pregnancies and babies. However, poorly controlled gestational diabetes can result in complications that affect both mother and baby.

Risks for the baby:

  • High birth weight.
  • Early birth.
  • Low blood sugar.
  • Breathing difficulties after birth.
  • Jaundice (yellowing of the skin).
  • Obesity or Type 2 diabetes later in life.

Risks for the mother:

  • Induced labour and Caesarean section.
  • Wound infections after delivery.
  • High blood pressure (preeclampsia).
  • Low blood sugar (hypoglycemia).
  • Gestational diabetes in future pregnancies.
  • Type 2 diabetes later in life.

How is gestational diabetes treated?

Adopting a healthy diet and exercising regularly are crucial to managing gestational diabetes. Women with gestational diabetes will also have to monitor their blood glucose levels at home using a glucometer. Some patients may require additional medication, such as oral tablets and insulin injections, for the rest of the pregnancy.

Are there any long-term effects of gestational diabetes?

Most women who have gestational diabetes will return to normal after delivery. However, they do have a higher risk of developing diabetes during future pregnancies and later in life. All women with gestational diabetes are required to undergo an OGTT at least six weeks after delivery, to ensure that their blood glucose levels are back to normal. It is essential to test for diabetes or pre-diabetes every one to three years.

Can women lower the risk of developing gestational diabetes?

A healthy lifestyle, proper diet, and regular exercise is key to preventing gestational diabetes.

  • Maintain a balanced diet rich in whole grains, complex carbohydrates, lean meats and plenty of fruits and vegetables. Cut down on sugary drinks, snacks and desserts.
  • Mothers-to-be should have an exercise regimen. Safe and easy workouts include spinning and swimming.
  • Before getting pregnant, women should aim to be of a healthy weight or BMI of less than 30kg/m2 as obesity increases the risk of gestational diabetes.
  • During pregnancy, target a healthy total weight gain of 11kg to 16kg over the nine months. Excessive weight gain can also increase risks.