One of the conditions that many pregnant women face is gestational diabetes. Health experts indicate that gestational diabetes happens during pregnancy. Unlike type 1 diabetes, gestational diabetes is not caused by having too little insulin. Rather, a hormone made by the placenta keeps the body from using the insulin as it should. This is called insulin resistance. Blood sugar (glucose), then builds up in the blood instead of being absorbed by the cells in the body. According to Dr Iba Mayele, an obstetrician-gynaecologist at Clinic Galien, Kimironko, gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes affects how your cells use sugar (glucose) and cause high blood sugar that can affect pregnancy and the baby’s health. He says, during pregnancy, the placenta makes hormones that can lead to a build-up of glucose in the blood, usually, the pancreas can make enough insulin to handle that if not, blood sugar levels will rise and cause gestational diabetes. He expresses that women with gestational diabetes don’t usually have symptoms; some even find out that they have it during a routine screening, they may even feel thirstier than usual, hungrier and eat or pee more than usual. Doctors say that some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy and doctors most often test for it between 24 and 28 weeks of pregnancy. “Gestational diabetes can cause complications for both the mother and the baby. If your blood glucose level is effectively controlled throughout your pregnancy, you will reduce the risk of these complications. Gestational diabetes may increase the risk of pre-eclampsia, placenta abruption, premature birth, neonatal hypoglycaemia, perinatal death (the death of the baby around the time of birth). RISK FACTORS Dr Michel Baingi, a Kigali-based general practitioner, says any woman can develop gestational diabetes, but some women are at greater risk. Some of the risk factors for gestational diabetes include women above 25 years of age. He also adds that one could be more likely to develop gestational diabetes if they are overweight with a body mass index (BMI) of 30 or higher. Baingi says that the risk of developing gestational diabetes rises if one has prediabetes, or if a close family member, for instance, a parent or sibling, has type 2 diabetes. He also states that one is more likely to develop gestational diabetes if they had it throughout a preceding pregnancy, if they delivered a baby who weighed more than 4.1 kilograms or if they had a mysterious stillbirth. “You are more likely to get gestational diabetes if you have blood sugar levels that are higher than they should be, but not high enough to be diabetes, this is called prediabetes, have high blood pressure or other medical complications or have given birth to a baby who was stillborn or had certain birth defects,” Baingi notes. COMPLICATIONS Mayele further says that if gestational diabetes is not sensibly managed, it can lead to unrepressed blood sugar levels and become dangerous to the baby and the mother, to an increased probability of having a C-section during delivery. “A mother’s high blood sugar may increase her risk of early labour and delivering her baby before the due date if she has gestational diabetes. The doctor may recommend early delivery as the baby is large,” he states. PREVENTION Mayele adds, eat healthy foods that are high in fibre and low in fat and calories. Focus should be put on fruits, vegetables and whole grains. He points out that working out before and during pregnancy can help protect you from developing gestational diabetes, for example, aim for 30 minutes of moderate activity on most days of the week. Several shorter sessions can also do well to the body. Mayele notes that doctors don’t recommend weight loss during pregnancy. But if you are planning to get pregnant, losing extra weight earlier may help you have a healthier pregnancy. He advises all pregnant women to get proper prenatal care, that is to say, screening for the condition, getting advice on food, activity and weight loss. Baingi urges pregnant women to check their blood sugar often, as directed by their doctor since pregnancy causes the body’s need for energy to change, blood sugar levels can change very rapidly. He explains that sometimes a woman with gestational diabetes must take insulin. If insulin is ordered by the doctor, they should take it as directed in order to help keep blood sugar under control. “Get tested for diabetes six to twelve weeks after the baby is born, and then every one to three years. For a great number of women with gestational diabetes. Diabetes disappears after delivery. When it does not go away, diabetes is referred to as type 2 diabetes. “Even if diabetes disappears after the baby is born, half of all women who had gestational diabetes develop type 2 diabetes later. It’s vital for a woman who has had gestational diabetes to continue to exercise and eat a healthy diet after pregnancy to avert or delay getting type 2 diabetes. Women should also remind their doctor to check their blood sugar every one to three years,” Mayele says. TREATMENT According to Baingi, in case a person is having gestational diabetes, the doctor will ask them to check the blood sugar levels four or more times a day, check their urine for ketones — chemicals that mean that diabetes isn’t under control. The doctor will keep track of the weight of the pregnant woman and the baby’s development, they might give insulin or any other medicine to keep the blood sugar under control.
