PT Health Watch: Why some pregnant women develop gestational diabetes

Gestational diabetes is one of the common complications that can develop during pregnancy, even in women who did not have diabetes before becoming pregnant.

The condition occurs when the body cannot produce enough insulin to overcome the increased insulin resistance that naturally develops during pregnancy, leading to higher blood sugar levels.

It can affect pregnancy outcomes and increase health risks for both the mother and baby.

Qudus Lawal, an obstetrician and gynaecologist, told PT Health Watch that gestational diabetes can occur in up to eight per cent of pregnancies.

“It’s a condition we see frequently,” Mr Lawal said, noting that gestational diabetes differs from diabetes that existed before pregnancy.

How it develops

Mr Lawal explained that pregnancy naturally causes changes in the way the body responds to insulin.

“Normally, the body tries to adapt to the needs of the baby so that glucose is made available to the baby, while also controlling the glucose so that it’s not excessive,” he said.

He said that hormones produced during pregnancy can counteract the action of insulin, which normally helps regulate blood glucose.

“As pregnancy progresses, insulin resistance increases. The body therefore needs to produce more insulin to keep blood sugar levels within the normal range,” he said.

“When the pancreas cannot produce enough insulin to meet this increased demand, blood glucose levels rise, resulting in gestational diabetes.”

When to screen

Mr Lawal said gestational diabetes is typically screened for or diagnosed between the 24th and 28th week of pregnancy.

“We don’t want to screen for it too early so that we don’t miss the diagnosis,” he said.

Although some insulin resistance is normal later in pregnancy, women who already have insulin resistance before pregnancy may be at higher risk of developing the condition.

Gestational diabetes may not cause the typical symptoms associated with diabetes, Mr Lawal said.

This means that a pregnant woman may have the condition without knowing it, making routine antenatal screening important.

In some cases, however, the baby may grow larger than expected for its gestational age, a condition known as macrosomia.

Risk factors

Mr Lawal said the risk of gestational diabetes may be higher among women who are overweight or obese, are older than 35, have a family history of diabetes or have previously had a baby with a high birth weight.

Women who have experienced previous pregnancy loss may also have an increased risk.

He also noted that the condition is more common among some ethnic groups, including people of Southeast Asian and Black African descent.

Risks to mother, baby

Gestational diabetes can increase the risk of complications during pregnancy and childbirth.

Studies in Nigeria have linked the condition with higher risks of pre-eclampsia and caesarean delivery in mothers, while babies may face complications such as low blood sugar, excessive birth weight and jaundice.

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The effects can also extend beyond pregnancy. Women who develop gestational diabetes have a higher risk of developing type 2 diabetes later in life, while children born following pregnancies affected by the condition may have a higher risk of obesity and type 2 diabetes.

Managing the condition

Mr Lawal said treatment depends on the severity of the condition.

For mild cases, he said women may be advised to make changes to their diet, increase physical activity where appropriate and monitor their blood sugar levels.

Others may need medication or insulin therapy to control blood glucose, in addition to lifestyle changes.