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HEALTH&FITNESS
294
July14
By Amy Greenburg
You may be familiar with diabetes, a condition
in which there’s too much glucose (sugar) in the
blood, but did you know there’s a form of diabetes
that occurs only during pregnancy? While only five
percent of pregnant women develop gestational
diabetes mellitus (GDM), it’s important to be
conscious of the condition, as you and your baby
could be at risk without your even knowing it.
Gynaecologist and obstetrician DR KELLY LOI fills
us in on the facts.
What causes GDM?
The hormonal changes that occur during pregnancy can
make one’s body less responsive to insulin – a hormone
produced by the pancreas to help the body utilise glucose
for energy. For most women, this isn’t a problem. However,
if there’s an inability to meet the increased insulin demand
during pregnancy, glucose then remains in the blood and
causes levels to rise very high, resulting in GDM.
Does diet play a role?
To a certain extent, yes. Eating an excessive amount of sugary
foods will apply further stress on the insulin requirements.
You’re most at risk if…
you’re obese, with a BMI over 30
you test positive for sugar in your urine
you have a strong family history of diabetes
you’ve had gestational diabetes in a previous
pregnancy
you’ve previously delivered a baby over 4kg
you’ve had an unexplained stillbirth
you’ve had a baby with a birth defect
you have high blood pressure
you’re over 35 years old
What are the symptoms, and how is GDM detected?
Occasionally, high blood sugar levels can lead to symptoms
of thirst and frequent urination, and recurrent infections such
as thrush. However, GDM doesn’t generally cause symptoms;
it is detected through an oral glucose tolerance test (OGTT),
usually performed at around 28 weeks, or earlier if there are
high risk factors. During an OGTT, one’s fasting blood sugar
level is checked before a glucose drink is administered. Blood
sugar levels are then checked two hours later to assess the
body’s reaction to the sugar intake.
Health and Fertility Centre for Women
290 Orchard Road #18-06, Paragon Medical Suites
6235 5066 | healthfertility.com.sg
How are babies affected by GDM?
Most women with GDM will go on to have healthy babies.
However, poorly controlled diabetes can have serious short- and
long-term consequences. If blood sugar levels are too high,
for example, excess glucose will end up in the baby’s blood,
which can lead to macrosomia (an overweight baby, over 4kg).
A macrosomic baby may be too large to enter the birth canal,
or its shoulders may get stuck – a dangerous situation called
shoulder dystocia – which can result in birth trauma.
Other complications can include sudden perinatal death,
or neonatal hypoglycaemia, where the baby has low blood
sugar due to excess insulin. In the long run, there’s a higher
risk of the baby developing diabetes and obesity in later life.
How is GDM treated?
The first line of treatment involves dietary control through well-
planned, healthy meals. I’d recommend a balanced diet with
sufficient amounts of protein, fats and carbohydrates. To keep
glucose levels stable, it’s particularly important that meals are
eaten at regular times, and that sugary snacks are avoided.
You’ll also need to learn how to monitor your blood sugar
levels using a home blood glucose meter. If the blood
glucose levels remain in the unhealthy range despite good
dietary control, then medication or insulin injections may
be necessary.
Although most women with GDM don’t remain diabetic
after delivery, they have a higher risk of getting it again during
a future pregnancy, and of developing diabetes later in life.
Preventive measures include staying at a healthy weight,
making healthy food choices and exercising regularly.
However, screening is still recommended for those with
risk factors.
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