By Dr Rut Gómez de Segura (Gynaecologist – Reg. No. 28/2908776).
Gestational diabetes mellitus (GDM) is a condition that affects approximately 1 in 10 pregnant women worldwide. It is a type of diabetes that is first diagnosed during pregnancy and is associated with risk factors such as being overweight or having a family history of diabetes.
In 2022, approximately 16,100 cases of gestational diabetes were recorded in Spain.
Often, gestational diabetes is asymptomatic, but when symptoms do appear, affected women may experience excessive thirst, blurred vision, frequent urination, weight loss, or urinary infections.
Therefore, if you are pregnant, even if you have never had diabetes problems before, you should consult a healthcare provider if you have any of these symptoms.
There are two strategies for diagnosis:
Screening/diagnosis will be carried out:
Gestational diabetes can pose risks for both the mother and the baby. For the mother, there is an increased risk of preeclampsia and a higher likelihood of developing type 2 diabetes in the future.
For the baby, severe gestational diabetes can cause structural malformations in the fetus (nervous, muscular, digestive system abnormalities, fetal cardiomyopathy) or more commonly, fetal macrosomia (larger size at birth, which can complicate delivery). After birth, the baby may experience hypoglycemia (low blood sugar levels) or respiratory problems.
When a pregnant woman is diagnosed with gestational diabetes, it is essential to carry out metabolic control (monitoring blood glucose levels several times a day to ensure they remain within the appropriate range), nutritional control (following a healthy eating plan, low in sugars and rich in fruits, vegetables, and proteins), and daily physical exercise with moderate physical activity. If this is not sufficient, the use of insulin may be necessary.
In most cases, this condition disappears once the woman has given birth. However, it is important to note that women who have had gestational diabetes may develop type 2 diabetes in the future.
For this reason, it is recommended to perform periodic blood glucose tests after pregnancy to detect any early signs of diabetes.
The most important thing is to follow a balanced diet that helps keep blood glucose levels within a healthy range. Your doctor will provide you with a diet plan and guidelines to follow (such as dividing your intake into 5 meals a day instead of 3 and engaging in daily physical exercise), as well as pre- and postprandial glucose monitoring. Pregnant women with GDM who have poor glycemic control, macrosomia, obesity, or other comorbidities are at risk of worse perinatal outcomes.
Obstetric control will be similar to that of a normal pregnancy, with some specific considerations. Follow-up in patients with GDM will include the recommendation to perform an additional ultrasound at 28-30 weeks to evaluate polyhydramnios (increased amniotic fluid) and fetal macrosomia (increased baby size).
An ultrasound around 36-38 weeks can provide useful information for planning the end of the pregnancy. The conclusion of the pregnancy in well-controlled GDM patients will be similar to the general population. In cases with risk factors, such as those requiring insulin or having very large fetuses, the decision will be individualized, although generally, it is not advised to prolong the pregnancy beyond 39-40 weeks.
Breastfeeding is recommended due to its beneficial effects on both the mother and the baby. Recommendations regarding contraception after childbirth are similar to those for the general population.
American Diabetes Association Professional Practice Committee.
Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2024.
American Diabetes Association (ADA).
2024;
S282-S294
Recommendations on managing diabetes during pregnancy:
https://diabetesjournals.org/care/article/47/Supplement_1/S282/153937/15-Management-of-Diabetes-in-Pregnancy-Standards
International Association of Diabetes and Pregnancy Study Groups Consensus Panel.
International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy.
International Association of Diabetes and Pregnancy Study Groups (IADPSG).
2010;
676-682
Recommendations on the diagnosis and classification of hyperglycemia in pregnancy:
https://doi.org/10.2337/dc09-1848
Mack LR., Tomich PG.
Gestational Diabetes: Diagnosis, Classification, and Clinical Care.
Obstetrics and Gynecology Clinics of North America.
2017;
207-217
Review on the diagnosis and management of gestational diabetes:
https://doi.org/10.1016/j.ogc.2017.02.002
American College of Obstetricians and Gynecologists.
Gestational Diabetes Mellitus: ACOG Practice Bulletin, Number 190.
American College of Obstetricians and Gynecologists (ACOG).
2018;
e49-e64
Clinical guide on gestational diabetes mellitus:
https://doi.org/10.1097/AOG.0000000000002501
Privacy Policy
IVF-LIFE, hereby informs you of its privacy policy applied to personal data. The use of the website does not imply that the user must provide any information regarding their identity, and cannot be associated with a specific user by the company. In the event that personal data is provided, this data will be collected and used in accordance with the limitations and rights set out in the aforementioned regulation.
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