Gestational Diabetes Mellitus


Will the fetus have diabetes if the mother has gestational diabetes?
Gestational diabetes is a common complication during pregnancy, characterized by elevated levels during glucose tolerance tests conducted while a woman is pregnant. Gestational diabetes can significantly affect both the mother and fetus, but actively controlling blood sugar can generally minimize these impacts. If a baby is born to a mother with gestational diabetes, this baby has a higher likelihood of developing diabetes later in life compared to the general population, but it does not necessarily mean that they will. This is because such babies have a genetic predisposition and might experience insufficient pancreatic function as adults, which can lead to diabetes. Therefore, it is important for these newborns to undergo regular blood sugar monitoring as adults to determine if they have diabetes, and if so, to seek proactive treatment.


Gestational diabetes blood sugar standards
The diagnostic criteria for gestational diabetes involve a pregnant woman undergoing a 75-gram glucose test at any time during pregnancy to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. The thresholds are: fasting blood glucose equal to or greater than 5.1 mmol/L, blood glucose one hour after glucose intake equal to or greater than 10.0 mmol/L, and blood glucose two hours after glucose intake equal to or greater than 8.5 mmol/L. Diagnosis of gestational diabetes can be made if blood glucose levels exceed these standards at any of the three time points. In China, pregnant women typically undergo the 75-gram glucose test between the 24th to 28th week of pregnancy. Women at high risk for gestational diabetes are advised to undergo the 75-gram glucose test early.


Prevention of Gestational Diabetes
The prevention of gestational diabetes mainly focuses on diet and exercise. First, weigh yourself every morning to monitor weight changes during pregnancy, as excessive weight gain can increase the risk of gestational diabetes. Second, maintain a healthy and balanced diet that is low in fat and calories, and high in fiber and protein, avoiding excessive consumption of high-sugar foods. Third, regularly engage in exercises suitable for pregnancy. Fourth, keep a regular routine. Finally, closely monitor the fetus.


Gestational diabetes symptoms
Gestational diabetes refers to the abnormal glucose tolerance that occurs during pregnancy, typically characterized by mild, asymptomatic elevated blood sugar levels without obvious symptoms such as dry mouth, excessive thirst, and frequent urination. However, when blood sugar levels are high, symptoms typical of diabetes such as dry mouth, excessive thirst, and frequent urination may occur. If excessive amniotic fluid, a large fetus, or recurrent infections of the external genitalia occur during pregnancy, it is important to be vigilant for the presence of diabetes. It is generally recommended that patients undergo the OGTT (Oral Glucose Tolerance Test) during the mid-stage of pregnancy to confirm whether gestational diabetes is present. Women's blood sugar levels generally return to normal after childbirth, but the risk of developing diabetes later increases significantly. Therefore, patients with gestational diabetes should be screened for diabetes 6-12 weeks postpartum and monitored over the long term.


Gestational diabetes indicators
Gestational diabetes refers to the absence of a diabetes history before pregnancy, but during pregnancy screening (Tang screening), blood sugar abnormalities are discovered. At this point, the diagnosis of gestational diabetes is made. The criteria for diagnosing gestational diabetes are based on a diabetes screening test conducted at 24-28 weeks. If the fasting blood glucose is ≥5.1, one-hour blood glucose is ≥10.0, or two-hour blood glucose is ≥8.5, meeting any one of these criteria is sufficient for a gestational diabetes diagnosis.


What is gestational diabetes?
The group of people who were diagnosed with diabetes before pregnancy is called gestational concurrent diabetes. Those who were not diagnosed with diabetes before pregnancy, but were diagnosed after becoming pregnant, are referred to as having gestational diabetes. Eighty percent of women are diagnosed with gestational diabetes, while twenty percent have gestational concurrent diabetes.


Exercise for Gestational Diabetes
Exercise can increase insulin sensitivity and can lower blood sugar independently of insulin. Therefore, patients with gestational diabetes can also exercise appropriately, which is beneficial for the utilization of blood sugar and helps lower it. The exercise for gestational diabetes generally involves regular, rhythmic aerobic exercises, which can include upper body exercises, gymnastics, and previously mentioned activities. The duration of exercise should generally be around 20-30 minutes, and it is advisable to exercise about one hour after meals. The frequency of exercise should be three to five times per week. During exercise, the heart rate should not exceed 120 beats per minute to avoid intense physical activity.


Symptoms of gestational diabetes
Gestational diabetes refers to abnormal glucose tolerance that occurs during pregnancy. It usually involves only mild, asymptomatic hyperglycemia without the typical symptoms of diabetes such as dry mouth, excessive thirst, frequent urination, and weight loss. However, significant increases in blood sugar can lead to symptoms such as dry mouth, excessive thirst, frequent urination, and weight loss. It is important to be vigilant for gestational diabetes in patients who exhibit symptoms such as excessive amniotic fluid, a large fetus, or recurrent urinary tract infections. Therefore, it is generally recommended for pregnant patients to complete an OGTT (Oral Glucose Tolerance Test) by the 24th week of pregnancy to confirm whether they have gestational diabetes. After childbirth, blood sugar levels in women with gestational diabetes generally return to normal, but the risk of developing Type 2 diabetes in the future significantly increases. Therefore, patients with gestational diabetes should undergo diabetes screening 6 to 12 weeks postpartum and be monitored over the long term.


Gestational diabetes screening time
The screening time for gestational diabetes refers to all pregnant women undergoing a 75-gram glucose tolerance test between 24 to 28 weeks of pregnancy to measure blood sugar levels and determine the presence of gestational diabetes. However, for pregnant women at high risk, including those with a history of gestational diabetes, delivery of a large fetus, obesity, polycystic ovary syndrome, a family history of diabetes, positive urinary glucose in early pregnancy, or unexplained recurrent miscarriages, fetal malformations, stillbirths, or even a history of childbirth with neonatal respiratory distress syndrome, blood sugar should be monitored as early as possible to understand the situation.


How to reduce blood sugar in gestational diabetes
Gestational diabetes cannot be treated with oral medications, as they can affect the fetus. Currently, the main treatment for gestational diabetes in China is insulin, with options for short-acting or rapid-acting insulin. If fasting blood glucose is high, long-acting insulin can be used to control fasting blood glucose levels. If post-meal blood glucose is high, short-acting or rapid-acting insulin can be used to control post-meal blood glucose levels. The blood glucose control standards for gestational diabetes are fasting blood glucose between 4.0 and 5.3, and two hours post-meal blood glucose between 4.4 and 6.7.