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When a woman is diagnosed with diabetes during her pregnancy, it is known as Gestational diabetes. Such patients have no history of diabetes before the pregnancy. It is usually diagnosed late, in the late second or third trimester of pregnancy. Gestational diabetes can be dangerous for the mother as well as for the child.

The baby can get high blood glucose levels from the mother, through the placenta. To regulate the extra sugar, more insulin is required for which baby’s pancreas starts working at an abnormal rate. More energy is produced which leads to “macrosomia” or a huge baby. This can cause problems during delivery, other than that the baby can also suffer from respiratory and heart problems.

Risk factors: It is therefore important to know about gestational diabetes especially when you are pregnant and have a family history of diabetes. Are you at risk for this disease? Well you are if you fall into any of these categories:
• Family history of diabetes
• Above 30 years of age
• Obese
• Having a previous birth of an overweight baby (4 kg/8.8 lbs or more)
• Presence of vaginal candidiasis or polyhydroamnios in the present pregnancy

Screening/Diagnosis: Prenatal care includes screening for gestational diabetes. A glucose challenge test is performed usually between 24th-28th weeks of pregnancy. The test can also be done earlier if the patient is at high risk for having gestational diabetes mellitus.
Oral glucose (50 gm usually) is given to the mother and blood sugar levels are then recorded.

Management: The blood glucose level is maintained by diet restriction, exercise and with medicines and insulin (if required). Diet with 2000-2500 Kcal/day for normal weight woman and restriction to 1200-1800 Kcal/day for over weight woman is recommended. Simple and safe exercise routines can also de done like aerobics and brisk walking. Such patients usually do end up with caesarean section.

The good thing with gestational diabetes is that sugar levels come back to normal after the delivery. But once you have had gestational diabetes, chances are that it will occur again in the subsequent pregnancies. Such women may go on to develop diabetes mellitus type 2 after few years. Therefore if you have had gestational diabetes, you need to watch out for your sugar levels even after the delivery.