2023-07-18 12:56:10
High blood sugar levels that suddenly occur in expectant mothers indicate gestational diabetes. The long-term consequences are often underestimated.
Gestational diabetes, also known as gestational diabetes mellitus (GDM), is the most common metabolic disease during pregnancy. In the beginning there are no obvious complaints.
Early treatment is important to avoid long-term damage to mother and child. Aftercare also plays an important role. After childbirth, the risk of the mother developing permanent type 2 diabetes multiplies. The German Diabetes Society (DDG) warns that the risk of a heart attack or stroke also increases significantly.
About every tenth pregnant woman is affected
“Unfortunately, we are seeing an upward trend in the numbers,” says associate professor Dr. Katharina Laubner from the Department of Endocrinology and Diabetology at the University Hospital Freiburg. According to the Institute for Quality and Transparency in Health Care (IQTiG), 9.5 percent of expectant mothers had gestational diabetes in 2020. The year before it was 7.3 percent.
“Pregnancy is a kind of stress test for the organism,” says Laubner. The metabolism is exposed to an above-average load during this time. Since the suddenly released hormones increased the need for insulin, a pregnant woman needs more insulin than usual. In the case of gestational diabetes, this mechanism is disrupted. The result: the blood sugar level rises – both in the child and in the mother. In the beginning, however, those affected do not notice anything.
How is gestational diabetes diagnosed?
Gestational diabetes can be diagnosed using a so-called sugar load test. It is one of the check-ups recommended during pregnancy. The test is usually carried out between the 24th and 28th week of pregnancy.
First, the blood sugar level is determined in the fasting state. It should be below 92 mg/dl. Then the expectant mother drinks a glass of water in which 75 grams of sugar (glucose) are dissolved. After an hour, blood is drawn once more and the blood sugar level is determined. Now the value should be below 180 mg/dl and when you take it once more two hours following drinking below 153 mg/dl. If all three measurements are unremarkable, gestational diabetes can be ruled out.
How is gestational diabetes treated?
The most important measures for the treatment of gestational diabetes are a change in diet and exercise habits. In many cases, these measures are sufficient to normalize the blood sugar level. It also reduces the risk of developing type 2 diabetes later on. By regularly measuring blood sugar, affected women can check whether their blood sugar levels have normalized.
If blood sugar cannot be lowered enough through lifestyle measures or if it exceeds certain limits, drug treatment is necessary. It is usually done with insulin treatment. In special training courses, those affected receive the necessary knowledge regarding insulin and its administration via insulin pen.
Who is particularly at risk?
Women of older age and body weight have a high risk of developing GDM, says Lauber. But women of normal weight can also be affected by the metabolic disorder. If women have already had pregnancies with gestational diabetes or have given birth to a child that is larger than average (over 4,000 grams for girls and over 4,170 grams for boys), they have an increased risk of developing gestational diabetes once more.
Risk patients are also pregnant women in whose families there are cases of diabetes. Taking certain medications, hormone disorders such as polycystic ovarian syndrome or smoking can also promote gestational diabetes.
High sugar levels harm the child
Although the blood sugar level can only be elevated for days to weeks in gestational diabetes, the disorder is anything but harmless. “Since the blood sugar level of mother and child is connected via the placenta, too much sugar in the mother’s blood also affects the unborn child,” explains Lauber.
The consequences are serious: the child can become too big and too heavy for a normal delivery, so that a caesarean section is necessary. There is also a risk of serious developmental disorders and metabolic complications such as hypoglycaemia in the newborn following birth. Later, the child has an increased risk of metabolic disorders such as obesity, according to the expert.
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