The body needs to absorb more sugar from the blood when you are pregnant than when you are not. Your blood sugar levels can therefore get too high if there is not enough insulin, and you can then be diagnosed with gestational diabetes. In this article, we go through what that means!

Not all pregnant women are able to meet the increased demand for insulin production that pregnancy entails and develop gestational diabetes. Insulin is a hormone that is formed in the pancreas and helps to break down the blood sugar level in your blood (glucose). During pregnancy (especially the latter part), there is a reduced sensitivity to insulin, which is mainly due to hormones secreted from the placenta. This means that the pancreas must produce more insulin to compensate. If the pancreas is unable to produce enough, the pregnant person will develop gestational diabetes mellitus, also known as GDM.

Who is at risk of developing gestational diabetes?

All pregnant people can get gestational diabetes. Those who are at greater risk of developing GDM are elder pregnant people, those who have a genetic predisposition to diabetes, are overweight, have previously had pregnancies with GDM or gave birth to an oversized baby.

Why is gestational diabetes an issue?

If the pregnant person has elevated blood sugar levels in their blood, this in turn also leads to elevated blood sugar levels in the foetus (because high blood sugar in the pregnant person passes through the placenta).
The foetus then begins to produce more insulin to handle the increased blood sugar level. Insulin is a growth hormone for the foetus and the risk is that the foetus will gain a lot of weight and become too big. This, in turn, can lead to complications during childbirth.

How gestational diabetes is detected?

Some regions screen all pregnant people for gestational diabetes through a so-called glucose tolerance test. In other regions, a glucose tolerance test is offered if you have risk factors or get a random high blood sugar reading when the midwife tests you during pregnancy. In rare cases, diabetes is diagnosed directly by taking a sample from the finger, if it is too high. In the vast majority of cases, the diagnosis of GDM is made after the pregnant person has had a glucose tolerance test. During a glucose tolerance test, the pregnant person must first fast the night before, and then take a blood sugar test before consuming the sugar solution, and then again 60 minutes and 120 minutes after consuming the sugar solution. The result will then give a diagnosis of potential gestational diabetes.

GDM is treated through your diet and exercise as well as tablets and/or insulin, depending on the result of your glucose tolerance test but also how your blood sugar levels look later on in the pregnancy. If a GDM diagnosis is made, the pregnant person will need to have their blood tested regularly.

If you have a history of GDM, you run a greater risk of developing type II diabetes later in life. Follow-up normally takes place through your health centre when the pregnancy is over – and it is important to do this follow up!