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Diabetes

Updated 06 June 2018

The Cinderella of diabetes

There is a third, lesser known kind of diabetes we tend to forget about.

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When we think about diabetes, types 1 and 2 readily spring to mind.

There is, however, a third kind of diabetes that is not as common or as well-known as the other two. It is called gestational diabetes mellitus (GDM) and occurs during pregnancy when the body struggles to properly regulate blood glucose levels.

The big difference, however, is that gestational diabetes isn't permanent and blood sugar tends to return to normal soon after delivery. 

Some clues

According to the American Diabetes Association (ADA), gestational diabetes occurs when an expectant mother's body isn’t able to make or use all the insulin it needs. If the body cannot produce enough insulin, or if it cannot be used properly, blood glucose cannot be turned into energy and builds up in the blood (hyperglycaemia).

In other words, your pancreas may work overtime to produce insulin, which doesn't effectively lower blood glucose levels. This is called insulin resistance. 

The ADA adds that is not yet known exactly what causes gestational diabetes, but there are some clues: Hormones from the placenta help the baby develop, but these may also block the action of the mother's insulin, causing the resistance to insulin. 

A 2014 study by the Centers for Disease Control and Prevention found the prevalence of GDM to be 9.4% in the USA. Figures for South Africa are unreliable as, according to the South African Medical Journal (SAMJ), there is a current lack of consensus on the diagnostic criteria for GDM used in South Africa. 

Who is at risk?

Women are more likely to develop gestational diabetes if they:

  • Have a close relative with diabetes
  • Are overweight
  • Have polycystic ovarian syndrome
  • Have glucose intolerance
  • Take medications like glucoccorticoids, beta-blockers or antipsychotic drugs
  • Have had gestational diabetes before

Dangers of gestational diabetes

  • Infant macrosomia (an abnormally large baby)
  • Neonatal (newborn) hypoglycaemia
  • Caesarean delivery 
  • An increased risk of the mother developing type 2 diabetes five to 10 years after delivery 
  • Children more likely to develop impaired glucose tolerance

How does one treat gestational diabetes?

According to Baby Center, once diagnosed by a blood glucose tolerance test, GDM can be managed by an exercise plan and a healthy, balanced diet based on lean proteins, whole grains, vegetables and other foods that release sugar slowly. About 15% of women with GDM will need medication to balance their blood sugar, mostly in the form of daily insulin injections. 

Image credit: iStock

 

Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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