Gestational Diabetes – Cause for Concern?

Gestational diabetes is characterized by high blood sugar levels first recognized during pregnancy in other non-diabetic women. Normally the disease appears around 24th week of pregnancy. Since the disease does not show any significant symptoms, it remains undiagnosed in a large percentage of women in India – so adding to a huge load of diabetics every year.

What causes Gestational Diabetes?

GD represents chronic β cell dysfunction of pancreas (gland that secretes insulin which metabolizes sugar in our blood). Almost all pregnant women exhibit some degree of impaired glucose metabolism under the influence of placental hormones, but extra insulin is secreted in response, to maintain the sugar balance. However, in some pregnancies insulin action is blocked, or cells develop resistance to process sugars into energy, thus raising sugar levels in blood.

Complications of Gestational Diabetes

Diabetes can affect the development fetus through the pregnancy. In early pregnancy, mother's diabetes can cause birth defects (skeletal, brain, heart) and miscarriages.

During the second and third trimester, as the blood with high sugar levels enter the foetal circulation, the foetal pancreas secret extra insulin to process the excess glucose and store it as fat. Thus, making large for date babies or Macrosomia, a grave complication of GD. Having a large baby increases risks during birthing for both mother and also the child. For example:

  • Large babies often require C-section delivery, and if delivered vaginally, there is increased risk of injury to perineum and excessive bleeding
  • Damage to the shoulders of baby during birth
  • Low sugar levels (hypoglycemia) at birth due to extra insulin produced by baby's pancreas – which can be fatal if delivery is not well attended at hospital
  • Higher risk of breathing problems at birth, and its associated complications
  • High risk of obesity as these babies grow
  • Very high risk for type-2 diabetes as adults.

Gestational Diabetes in India

India has approx. 62.4 million diabetics and these figures are expected to increase to 101 million by 2030. It is estimated that about 16% of women who get pregnant every year develop diabetes during their gestation period. So, about three to four million women suffer from Gestational Diabetes every year. Considering the deliveries per annual being twenty-seven million, of these three million women, 30% go on to develop type-2 diabetes in 5-10 years and more than 50% become diabeti c over a period of 20 years.

Women with Gestational Diabetes often do not show any noticeable symptoms. Doctors typically suggest going through a screening test for diagnosis of Gestational Diabetes. World Diabetes Association recommends the universal screening of all pregnant women, irrespective of risk factors during early and late pregnancy.