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Gestational Diabetes Mellitus
Reviewed by the PMC Medical Team · Promise Medical Centre
Overview
Gestational diabetes mellitus (GDM) is a form of high blood sugar that develops during pregnancy in women who did not have diabetes before, typically diagnosed through screening between 24 and 28 weeks. It occurs because pregnancy hormones make the body more resistant to insulin. GDM is increasingly recognised in Nigeria as more women are screened, and while it usually resolves after delivery, it carries real risks for both mother and baby if not properly managed, and significantly raises the mother's future risk of type 2 diabetes.
Symptoms
Gestational diabetes often causes no noticeable symptoms, which is why routine screening during pregnancy is essential. When symptoms do occur, they may include:
• Increased thirst
• Frequent urination, beyond what is typical in pregnancy
• Fatigue
• Blurred vision
• Recurrent infections, such as thrush or urinary tract infections
When to See a Doctor
Attend routine antenatal screening for gestational diabetes, usually offered between 24 and 28 weeks of pregnancy, or earlier if you have risk factors. See a doctor sooner if you notice unusual thirst, frequent urination, or recurrent infections.
Seek prompt medical attention if you experience:
• Reduced fetal movements
• Signs of very high blood sugar: extreme thirst, confusion, rapid breathing, or a fruity-smelling breath
• Signs of very low blood sugar if on insulin/medication: shakiness, sweating, confusion, or fainting
• Any symptoms of pre-eclampsia, which is more common with GDM
Causes
During pregnancy, the placenta produces hormones that help the baby grow but also make the mother's cells more resistant to insulin, the hormone that regulates blood sugar. Normally, the pancreas produces extra insulin to compensate. In gestational diabetes, the pancreas cannot keep up with this increased demand, so blood sugar levels rise.
Risk Factors
• Overweight or obesity before pregnancy
• Previous gestational diabetes in an earlier pregnancy
• Family history of type 2 diabetes
• Previous delivery of a large baby (over 4kg)
• Polycystic ovary syndrome
• Age over 35
• History of unexplained stillbirth
• Multiple pregnancy
Complications
If poorly controlled, gestational diabetes can lead to:
• A larger-than-average baby (macrosomia), increasing the risk of difficult delivery
• Premature birth
• Low blood sugar in the newborn shortly after birth
• Increased risk of pre-eclampsia
• Higher chance of needing a caesarean section
• Increased risk of type 2 diabetes for the mother later in life
• Increased risk of the child developing obesity or type 2 diabetes in later life
Prevention
• Maintain a healthy weight before pregnancy where possible
• Eat a balanced diet rich in vegetables, whole grains, and lean protein, and limit sugary foods and drinks
• Stay physically active, as advised by your antenatal care provider
• Attend all antenatal appointments and screening tests
• Monitor blood sugar levels closely and follow treatment advice if diagnosed with GDM
• Breastfeed after delivery, which can help reduce future diabetes risk for both mother and baby