Gestational Diabetes

Gestational diabetes is a metabolic disorder that occurs during pregnancy and is caused by hormonal changes leading to reduced insulin sensitivity.

The pancreas needs to produce more insulin to maintain normal glucose levels, but when it cannot compensate, glucose levels rise. The condition typically manifests in the middle of pregnancy, when placental hormones are most active. Causes include heredity, being overweight before pregnancy, reduced physical activity, and predisposition to insulin resistance.

Symptoms

For many women, gestational diabetes progresses without noticeable complaints. This is one reason why screening between 24–28 weeks of gestation is mandatory. Still, some expectant mothers may experience:

• increased thirst and more frequent urination;
• feelings of fatigue or weakness;
• increased appetite or episodes of hunger;
• blurred vision (rare and usually temporary).

These symptoms often overlap with normal changes during pregnancy, so they are not a reliable indicator and laboratory tests are primarily relied upon.

Risk Factors

Women with one or more of the following risk factors are more likely to develop gestational diabetes:

• previous gestational diabetes or delivering a baby over 4 kg;
• significant abdominal obesity or being overweight before pregnancy;
• family history of type 2 diabetes;
• age over 30–35 years;
• polycystic ovary syndrome (PCOS) or pronounced insulin resistance before conception.

Treatment and Monitoring

The treatment of gestational diabetes is individualized and aims to maintain normal blood sugar levels to reduce risks for both the mother and baby.

The first step is an individualized diet plan that provides essential nutrients without causing sharp fluctuations in blood sugar. More frequent, smaller meals rich in fiber, complex carbohydrates, and quality proteins are often recommended.

Moderate, pregnancy-adapted physical activity supports glucose metabolism and improves insulin sensitivity.

When these measures are not enough, insulin therapy is applied, which is completely safe for the fetus. During the treatment, frequent blood sugar measurements and ultrasound monitoring of the baby’s development are performed.

After childbirth, the condition usually disappears, but women who have been affected remain at an increased risk of type 2 diabetes. Therefore, a follow-up examination is recommended 6–12 weeks after delivery and periodic monitoring in the following years.

 Synonyms: Diabetes during pregnancy, High blood sugar in pregnant women, GDM