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What is gestational diabetes?

With the rise in obesity and type 2 diabetes, South Africa is experiencing an increased number of women diagnosed with gestational diabetes. Those who develop gestational diabetes mellitus (GDM) are at a higher risk of developing type 2 diabetes later in life.

During pregnancy, the increased focus on health and wellbeing is important for many reasons – it’s key to providing the best, most nourishing environment for the developing baby, as well as avoiding or reducing the risk of pregnancy-related complications. One such complication is GDM, which is on the rise in South Africa.

What is GDM?

The official definition of GDM is hyperglycemia (high blood sugar), recognised or diagnosed for the first time during pregnancy. ‘Globally there is an alarming increase in the incidence of type 2 diabetes mellitus and obesity,’ says Dr Liz Radloff, gynaecologist at Life Wilgers Hospital. ‘Similarly, the incidence of GDM is increasing worldwide and according to numerous studies, about 18 to 25% of South African women are affected.’ It’s important to note that diabetes may often present for the first time in pregnancy, but may resolve spontaneously after delivery. 

Symptoms and risk

GDM requires a medical diagnosis since, in many cases, there are no symptoms. According to Dr Radloff, the symptoms (such as increased thirst, a dry mouth, needing to urinate more often than usual and tiredness) are usual manifestations of pregnancy and therefore unreliable, so the universal screening of all pregnant women is recommended.

‘Women who develop GDM are at an increased risk of complications during pregnancy,’ says Dr Radloff. ‘There is a higher rate of Caesarean sections and assisted deliveries, shoulder dystocia, birth trauma, hypertensive disorders such as pre-eclampsia and an increased risk of developing postpartum haemorrhage (bleeding immediately after the birth of the baby).’

How to manage GDM

The primary tool for managing this condition is early diagnosis and good control of blood glucose levels. Blood sugar levels can be reduced through a change in diet and getting adequate exercise. ‘However, if that fails to achieve glucose control, other options such as oral medication or insulin injections are recommended,’ says Dr Radloff.

After giving birth, mothers are encouraged to continue with the same healthy lifestyle to reduce the risk of future complications. ‘Six to 13 weeks after giving birth, the mother should have a blood test to check for diabetes, which needs to be repeated every two to three years.’

Am I at risk?

The following questions can provide more insight into your risk of GDM:

  • Are you overweight?
  • Are you related to anyone who has or had diabetes?
  • Are you 35 years or older?
  • Have you had a baby who weighed more than 4.2kg at birth?
  • Have you experienced a previous stillbirth or miscarriage?
  • If you are currently pregnant, has your doctor told informed you that you have polyhydramnios (excessive amniotic fluid)?
  • Have you ever had problems with insulin or blood sugar?
  • Do you have high blood pressure, high cholesterol or heart disease?

NB: Early diagnosis and good control of blood glucose concentration will prevent most of the pregnancy and labour complications caused by diabetes mellitus. 

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.