Understanding Gestational Diabetes and its Management

Empowering women to take charge of their own health

 Most pregnancies are uneventful, with a healthy baby and a happy mother to show for it. Despite this, there are exceptions and statistically 8% of pregnancies present with complications1.

To ensure you remain empowered throughout your pregnancy, it is worth your while to be familiar with potential conditions that can, in rare cases, develop. One of these is Gestational Diabetes Mellitus (GDM).

The most important thing to understand about GDM is that it is a condition that can develop even if you’ve never had diabetes. However, there are ways to help reduce your chances of developing it, and there are factors that can influence who gets it. Also, even if you do get it, there are ways to manage it to ensure you continue to feel in control of your body and your pregnancy.

Knowledge is power

Like any health issue, the more you know about it and the sooner you have that knowledge, the more power you have over the outcome because there are more options to treat it or avoid it. According to a 2022 study published in the Pan African Medical Journal, in sub-Saharan Africa the prevalence of GDM is 9%3, estimated from a recent meta-analysis that had pooled data from 33 studies. What makes it significant though relatively rare, is it can lead to developing diabetes in later life for both mother and the child.

GDM is caused by a dysfunction in the body’s metabolic rate. During pregnancy nutrients are passed from mother to child through the placenta and this results in raised sugar levels in the mother. In the majority of pregnancies the mother’s body produces more insulin to deal with these raised levels. Where GDM develops, the mother’s body does not.

Health risks caused by GDM

Expectant mothers who have gestational diabetes need to be aware of the following:

    1. An overgrown baby – the baby can be ‘overfed’ meaning it is too large and this can create discomfort during the final trimester of pregnancy and can cause complications with vaginal birth, resulting in a C-section and other complications.

    2. High blood pressure (preeclampsia) – GDM can lead to high blood pressure, which is more common in women with diabetes generally. The dangers of this could be the baby coming too early or the mother suffering from seizures or a stroke during labour and delivery. Swelling in fingers and toes, as well as protein in the urine can be signs of preeclampsia.

    3. Low blood sugar – those with diabetes who take insulin or other medications can have blood sugar that drops too low. This can be serious, or fatal, if not treated quickly. Careful and regular monitoring of blood sugar avoids it as it can be identified early. Also, managing sugar levels during pregnancy helps ensure that the baby’s blood sugar isn’t at dangerous levels after birth.


How to prevent GDM

There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. If you've had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes in the future.

    1. Eat healthy foods. Choose foods high in fiber and low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition. Watch portion sizes.

    2. Keep active. Exercising before and during pregnancy can help protect you from developing gestational diabetes. Aim for 30 minutes of moderate activity on most days of the week. Take a brisk daily walk. Ride your bike. Swim laps. Short bursts of activity — such as parking further away from the store when you run errands or taking a short walk break — all add up.

    3. Start pregnancy at a healthy weight. If you're planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy. Focus on making lasting changes to your eating habits that can help you through pregnancy, such as eating more vegetables and fruits.

    - Don't gain more weight than recommended. Gaining some weight during pregnancy is typical and healthy. But gaining too much weight too quickly can increase your risk of gestational diabetes. Ask your health care provider what a reasonable amount of weight gain is for you.


Here’s who is most at risk:

    - Women with borderline high sugar levels before pregnancy

    - Overweight women

    - Women who eat a diet high in saturated fat

    - Women who don’t exercise before or during pregnancy

    - Those with a family history of diabetes


How to manage GDM

Where a pregnant woman develops GDM, a doctor might prescribe medication or changes in diet. Treatment for gestational diabetes includes:

    - Lifestyle changes - healthy diet and staying active. A healthy diet focuses on fruits, vegetables, whole grains and lean protein — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. Regular physical activity (30 mins per day) plays a key role in every wellness plan before, during and after pregnancy because exercise lowers your blood sugar.

    - Blood sugar monitoring - Your healthcare team may ask you to check your blood sugar four or more times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range; this can easily be done at home with a glucometer. It is important to maintain stable  levels as fluctuations can have a negative impact on the baby.

    - Medication, if necessary

Dr. Caterina Pesenti, MD, Cluster Medical Lead - India, Middle East and Africa, Roche Diabetes Care, explains,“At Roche, we are dedicated to ensure that people with diabetes across South Africa have best access to high quality and accurate diabetes management support driven by the latest technology in order to keep their diabetes in check. It should be easily accessible and accurate so that it empowers them to live life to the fullest. For pregnant women there’s an increased need to feel reassured and supported during this joyful time of life. Through our range of blood glucose monitoring systems under the brand name of Accu-Chek, Roche is committed to making this a stress-free experience to bring true relief and joy to expecting mothers.”


Pregnancy is a normal part of life and 92% of pregnancies present no challenges1. However, as an expectant mother it is always a good idea to be prepared for anything and do what you can to prevent complications. And, if you can’t prevent them, at least manage them the way you want to, so you are never forced to cede control of your body as it goes through incredible changes to bring new life into the world.

About Roche Diabetes Care

Roche Diabetes Care has been pioneering innovative diabetes technologies and services for more than 40 years. More than 4,500 employees in over 100 markets worldwide work every day to support people with diabetes and those at risk to achieve more time in their target ranges and experience true relief from the daily therapy routines.

Being a global leader in integrated Personalised Diabetes Management (iPDM), Roche Diabetes Care collaborates with thought leaders around the globe, including people with diabetes, caregivers, healthcare providers and payers. Roche Diabetes Care aims to transform and advance care provision and foster sustainable care structures. Under the brands RocheDiabetes, Accu-Chek and mySugr, comprising glucose monitoring, insulin delivery systems and digital solutions, Roche Diabetes Care unites with its partners to create patient-centred value. By building and collaborating in an open ecosystem, connecting devices and digital solutions as well as contextualising relevant data points, Roche Diabetes Care enables deeper insights and a better understanding of the disease, leading to personalised and effective therapy adjustments. For better outcomes and true relief.

Since 2017, mySugr, one of the most popular diabetes management apps, is part of Roche Diabetes Care.

For more information, please visit www.rochediabetes.com, www.accu-chek.com and www.mysugr.com.

 

About Roche

Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice.

In recognizing our endeavor to pursue a long-term perspective in all we do, Roche has been named one of the most sustainable companies in the pharmaceuticals industry by the Dow Jones Sustainability Indices for the thirteenth consecutive year. This distinction also reflects our efforts to improve access to healthcare together with local partners in every country we work.

Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan.

For more information, please visit www.roche.com.


References:

1. 4 Common Pregnancy Complications | Johns Hopkins Medicine

    

2. cdc.gov https://www.cdc.gov/pregnancy/diabetes-gestational.html

    

3. ncib.nlm.nih.gov https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011905/#:~:text=In%20sub%2DSaharan%20Africa%2C%20the,%2D12%25

    

4. hopkinsmedicine.org https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-pregnancy/4-common-pregnancy-complications

    

5. Gestational diabetes - Symptoms & causes - Mayo Clinic

 

Cassien Tribunal Aungane, Editor