What is Gestational Diabetes And How Does It Affect Pregnancy?

What is Gestational Diabetes And How Does It Affect Pregnancy?

This mum was diagnosed with gestational diabetes in Singapore when she was 28 weeks pregnant. She tells us more about the condition and how it affected her.

Mummy Tan Poh Hong was diagnosed with gestational diabetes in Singapore when she was 28 weeks pregnant. She gave birth to her little one in April 2019. 

Here, she tells us more about the condition and how it affected her.

Gestational diabetes in Singapore: Mum shares her story

"I was diagnosed with gestational diabetes at 28 weeks - prior to that there were no symptoms. This is my second pregnancy and my baby was delivered in April 2019," says Mdm Tan, who is also mummy to a 9-year-old.

"The diagnosis was done through glucose tolerance test.  My mum has diabetes too (which was discovered at age 52)."

"After the diagnosis, I was referred to a diabetes specialist. Initially, I was given a tracking device to scan for my sugar levels every day for 2 weeks."

"I was advised to watch my diet by cutting down on carbohydrates, and was asked to avoid sugary food or drinks."

"I felt giddy initially when I adjusted my diet. But after the second check up, when the sugar levels seemed to be under control, I didn't have to track them strictly anymore as my doctor felt that I was independent enough to watch my diet well. My appointment was adjusted to a monthly visit."

"As to whether the gestational diabetes affected my health, I did experience some weight loss."

Mdm Tan, however, did not have to take insulin or medication, only diet control was required. Her baby’s weight at birth was 2.5kg. The baby was not abnormally big and was delivered by elective C-section. Her doctor has advised her to continue to watch her diet and sugar intake. 

She has this advice, "Gestational diabetes can actually happen to anyone, however, being watchful of your diet and exercising regularly can help in the overall well-being of mummy and baby."

What exactly is gestational diabetes: Expert opinion

Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means, your blood glucose, also called blood sugar, is too high. Your body uses glucose for energy. Too much glucose in your blood is not good for you or your baby.

According to Dr Christopher Chong, Obstetrician, Gynaecologist and Urogynaecologist, Gleneagles Hospital, "The real reason for gestational diabetes (GD) is not known."

"The term gestational means during pregnancy and most patients are not diabetic to start with and even if they have GD, this reverts to normal naturally in 6 - 8 weeks post delivery."

gestational diabetes in Singapore

"Common postulate is that the body, for that patient, could not handle the sugar load as well as before pregnancy due to the fact that the placenta produces hormones during pregnancy and these hormones counteract or reduce the action of insulin."

"In the 3rd trimester, there is a higher rise of these placenta hormones and typically, GD is assessed or discovered in the 3rd trimester. This phenomenon is different for different individuals and most patients will not have GD."

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Signs and symptoms of gestational diabetes

Dr Chong tells us that, "There are no known symptoms of gestational diabetes. Symptoms such as thirst and frequency of urination are very non-specific."

"Signs to suggest a need to check for GD include excessive weight gain in pregnancy, excessive water ( called liquor ) in the water-bag, a big foetus on ultrasound scan and recurrent sugar-positive on routine urine dipstick test which is usually done on every antenatal visit."

What gestational diabetes does to you

  • When a pregnant woman has gestational diabetes, her blood sugar crosses over to high levels. Hence, her body produces more insulin to cope up with this high level of blood sugar or glucose.
  • The insulin does not cross the placenta, but the glucose does, giving the baby high blood glucose levels.
  • The extra energy from the glucose becomes fat, sometimes resulting in a big baby. A big baby could mean complications for a mother during childbirth.
  • The baby’s pancreas will produce more insulin to counter this high level of glucose.
  • Excess insulin will put the baby at risk of being obese or diabetic in future.
  • According to a local study, around 10% of women who suffer from gestational diabetes develop type 2 diabetes within five years, compared with 1% of women without the condition.

gestational diabetes in Singapore

Am I at risk of getting gestational diabetes?

Your chances of getting gestational diabetes are higher if you

  • Are overweight.
  • Have had gestational diabetes before.
  • Have given birth to a big baby (weighing more than 9 pounds).
  • Have a parent, brother, or sister with type 2 diabetes.
  • Have pre-diabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetes.
  • Have a hormonal disorder called polycystic ovary syndrome, also known as PCOS.

Can I lower my chances of getting gestational diabetes?

This is what Dr Chong has to say, "Gestational diabetes is not easy to prevent as the anti-insulin extent from the placenta cannot be measured or predicted."

"Preventive measures include being healthy before pregnancy, losing excess weight before conceiving (obesity is linked to increased risk of GD ), exercising and eating healthy food and not overeating."

gestational diabetes in Singapore

How does gestational diabetes affect me?

Gestational diabetes may increase your chances of:

  • having high blood pressure and too much protein in the urine.
  • having surgery—called a cesarean section or c-section—to deliver your baby because your baby may be large.
  • becoming depressed.
  • developing type 2 diabetes and the problems that can come with this disease later on in life.

Dr Chong adds, "Often GD is not severe and often asymptomatic. If not controlled well, the patient may develop high blood pressure in pregnancy and it may affect the growth of the foetus."

"Long term risks include the increased risk of GD in subsequent pregnancies and that of diabetes mellitus later in life."

How is gestational diabetes diagnosed?

Doctors use blood tests to diagnose gestational diabetes.You will probably be tested for gestational diabetes between weeks 24 and 28 of your pregnancy.  

The most accurate blood test is the Oral Glucose Tolerance Test. You will need to fast for at least 8 hours before the test. Your fasting blood glucose level will be checked before the test begins. Then you will drink a sugary beverage. Your blood glucose levels will be checked 1 hour, 2 hours, and possibly 3 hours later. Your doctor will use your test results to find out whether you have gestational diabetes.

gestational diabetes in Singapore

Is there a cure for gestational diabetes?

The cure for gestational diabetes involves keeping your blood sugar levels under control. You can do this by:

  • Healthy eating – Your doctor or dietitian will help you with your dietary plan. The plan will help you know which foods to eat, how much to eat, and when to eat. Try not to skip breakfast. Avoid sugary drinks.
  • Physical activity – Be as physically active as you can. Aim for at least 30 minutes most days of the week.
  • Insulin shots, if needed – Again, your doctor will be the best person to advise you on whether you would require insulin shots. Note, insulin will not harm the baby.

How can I prevent or delay type 2 diabetes later in life?

  • Maintain a healthy weight.
  • Be physically active for at least 30 minutes most days of the week.
  • Follow a healthy eating plan. Eat more grains, fruits, and vegetables. Cut down on fat and calories.

Also READ: Pregnant mummies, sleep more to prevent gestational diabetes mellitus!

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