Gestational Diabetes

WHAT IS GESTATIONAL DIABETES?

Gestational diabetes is diabetes that is diagnosed during pregnancy. Hormones that originate in the placenta can interfere with insulin function, making this a common condition. In Quebec, some 7 to 9% of pregnant patients will be diagnosed with it. There are many known risk factors for developing gestational diabetes, including obesity, a maternal age of over 35 years, a family history of diabetes, non-Caucasion origin, diabetes or delivery of a large baby during a previous pregnancy. However, screening pregnant women for diabetes between the 24th and 28th week is recommended if these factors are not present.

Gestational diabetes increases the mother's risk of hypertension during pregnancy, and this may be associated with the growth of larger-size babies, the possibility of a more difficult delivery and a higher risk of cesarean section. The greatest risk for such women is developing non-pregnancy-related diabetes over the mid or long term (diabetes type 2). The risk of this happening is 50% on average, although it varies greatly depending on the populations studied. It is therefore important for such patients to be screened for diabetes again following their pregnancy and on a regular basis thereafter.

Gestional diabetes does not cause any fetal abnormality. If the fetus is large, delivery of the shoulders may be more difficult. However, a large baby does not necessarily mean diabetes is present and, conversely, diabetes can occur when the baby is not large. Sugar, calcium and bilirubin levels can be disrupted following childbirth and must be checked. The treatment of gestational diabetes reduces the incidence of neonatal complications.

The main feature of the treatment is a diet containing no complex sugars. It is not a question of losing weight, but of eating better and avoiding major changes in blood sugar levels. Blood sugar (glycemia) is monitored by frequent fingertip tests using a small, specially designed device. Target reference values are desirable. If they cannot be achieved by dieting alone, a hormone (insulin) is prescribed to help improve control. This will happen with approximately 30% of patients. The hormone is not dangerous to the baby, as it does not cross the placenta. In fact, the baby will already be making its own insulin. The addition of regular physical exercise is strongly recommended and helps control the diabetes. Maintaining good eating habits after pregnancy reduces the risk of developing diabetes later on. Another point is that these good habits will be passed on to your children and partner, too!