Gestational Diabetes Demystified: Top 5 Myths and the Real Facts

Gestational diabetes mellitus (GDM) is a condition where blood sugar levels become elevated during pregnancy, primarily due to pancreatic dysfunction caused by placental hormones. These hormones can interfere with insulin production, leading to insulin resistance and high blood glucose levels. In India, it affects almost 30% of Indian women of reproductive age — a higher rate than the global average. This condition often arises after the 20^th week of gestation or sometimes even during early pregnancy. It can happen even in women who have never been detected with diabetes.

While many see GDM as a temporary concern limited to pregnancy, its impact extends far beyond childbirth. Here’s a look at some common myths and the scientific facts behind them:

Myth 1: Gestational Diabetes Only Occurs in Women with a History of Diabetes

Fact: Gestational diabetes can develop in any pregnant woman. However, there are certain factors that can increase the likelihood. These include:

• Family History: Those with a strong family history of type 2 diabetes.
• Ethnicity: Indian women are particularly at risk due to a genetic predisposition to insulin resistance and rising obesity rates.
• Weight: Being overweight or obese prior to pregnancy can increase the risk.
• High-risk Pregnancies: Factors like twin or multiple pregnancies, maternal age above 30 years, and history of fertility treatment can increase GDM risk.
• Previous Gestational Diabetes: If a woman had gestational diabetes in a previous pregnancy, she’s at a higher risk of developing it again.

Myth 2: After Delivery, Gestational Diabetes is Gone for Good

Fact: Although blood sugar levels typically return to normal post-pregnancy, the effects of gestational diabetes often linger. Women who have had GDM have a high chance of developing type 2 diabetes within the next 5 years. There is also an increased likelihood of gestational diabetes in future pregnancies and increased risk of other health conditions, including obesity, fatty liver and coronary artery disease. Monitoring and maintaining a healthy lifestyle are essential even after pregnancy.

Myth 3: Gestational Diabetes Doesn’t Affect the Baby’s Health

Fact: Constantly elevated sugar levels can lead to serious complications for the baby. They are often larger than average (macrosomia), have a higher risk of developing low blood sugar shortly after birth and may need special care. Studies also reveal that these children are more likely to become obese, develop insulin resistance, and even become candidates for type 2 diabetes early in life. All of this leaves a female child at a higher risk of developing gestational diabetes during pregnancy as an adult — triggering a never-ending cycle.

Myth 4: Managing Gestational Diabetes is Just a Matter of Taking Medication

Fact: Managing GDM often requires a comprehensive lifestyle approach, not just medication. Effective management of gestational diabetes can greatly reduce complications for both mother and child.

• Regular Glucose Monitoring: Regular monitoring is crucial to ensure that blood sugar levels remain within the target range. Women with GDM may have to check their levels as often as 6-7 times a day.
• Healthy Diet: A balanced diet rich in whole grains, lean proteins, and plenty of fibre-rich vegetables can help regulate blood sugar levels. Small, frequent meals are often recommended.
• Regular Exercise: Physical activity helps the body use insulin more effectively. Many pregnant women can safely engage in low-impact exercises like walking or swimming.
• Medication: If lifestyle changes are not enough to control blood sugar, insulin injections may be prescribed. The treatment is typically as per globally-recognised International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines.

Myth 5: Gestational Diabetes Can’t Be Prevented

Fact: While it isn’t always possible to prevent gestational diabetes, certain lifestyle modifications may help reduce the risk:

• Healthy Pre-Pregnancy Weight: Optimising a healthy weight before conception reduces the risk of GDM. Women planning for pregnancy are encouraged to work toward a healthy BMI of 18-24.
• Balanced Diet and Regular Exercise: Adopting a balanced diet and a routine of regular exercise pre-pregnancy can lower the chances of developing gestational diabetes.
• High-risk behaviours: Smoking, excessive alcohol consumption, high caffeine intake, chronic stress, poor sleep, and frequent junk food consumption can all contribute to insulin resistance and increase the likelihood of GDM. Manage these behaviours to reduce your chances of GDM.
• Routine Screening: Early and regular screening during pregnancy can help detect gestational diabetes promptly, allowing for early management and reducing potential risks.

Gestational diabetes is more than just a temporary pregnancy complication. Awareness, early detection, and proactive management can help mitigate these risks. For those at higher risk, maintaining a healthy lifestyle before and during pregnancy can make a significant difference in reducing the likelihood of gestational diabetes and ensuring a healthier future.