Gestational diabetes (gestational diabetes) affects around eight percent of pregnant women. Many women do not notice any symptoms, so it is important to measure blood levels regularly during pregnancy. With a timely diagnosis, serious complications can be prevented.
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Quick Overview: Gestational Diabetes
Definition: Gestational diabetes is elevated blood sugar levels during pregnancy. In most cases, the metabolic disorder resolves after delivery.
Symptoms: Symptoms are rather atypical, but possible symptoms include fatigue, increased thirst and increased urine output
Therapy: Diabetes during pregnancy is treated by changing your diet. In some cases this is not enough and those affected have to inject insulin-
Consequences: One consequence can be preeclampsia, a pregnancy complication associated with high blood pressure and edema. In addition, the risk of premature births and miscarriages increases. In addition, the child may gain increased weight at birth.
At a glance:
Diabetes: These foods ensure stable blood sugar levels
What is gestational diabetes?
Gestational diabetes is elevated blood sugar levels during pregnancy. Technically, the pregnancy-related metabolic disorder is also known as gestational diabetes.
In most cases it resolves after birth, but the disease increases the risk of birth complications.
Many sufferers worry when they receive the diagnosis. However, diabetes during pregnancy is not a reason to panic. If detected early, it can often be treated well and most women give birth to a healthy child.
Common complication of pregnancy
Gestational diabetes is relatively common. Statistics also show that there is an increase in the disease. In 2018, for example, 6.8 percent of pregnant women in Germany were affected, and in 2021 8.5 percent. It turns out that the risk increases as the woman gets older.
Gestational diabetes: symptoms and complications
The symptoms of gestational diabetes are often only mild or go unnoticed: the majority of women with gestational diabetes are symptom-free. That’s why a sugar test is carried out as standard between the 24th and 28th weeks of pregnancy, and earlier for women with risk factors.
Possible signs and symptoms of gestational diabetes:
increased feeling of thirst (polydipsia)
frequent urination (polyuria)
vaginal inflammation
Sugar in the urine (glucosuria)
increased blood pressure (hypertension)
increased amount of amniotic fluid
Tiredness and exhaustion
The disease can cause unusually strong growth in the fetus and, as a result, an increased birth weight. Experts also speak of fetal macrosomia, which can make natural birth difficult.
Consequences and complications of gestational diabetes
To prevent serious health problems for mother and child, gestational diabetes must be treated quickly. Otherwise, the mother is at risk of pregnancy-related high blood pressure, increased excretion of proteins in the urine (proteinuria) and, as a result, water retention in the tissue (edema). Experts then also speak of the so-called (preeclampsia). If this worsens and progresses to eclampsia, it can be life-threatening.
Other possible complications include:
increased urinary tract infections in the mother
Hypoglycaemia in the child at birth
increased risk of miscarriage or premature birth
Immature organs of the child at delivery
Heart defect
high bilirubin levels (newborn jaundice)
Respiratory distress syndrome in babies
Gestational diabetes: causes and risk factors
During pregnancy, more hormones are produced – some act as antagonists to the hormone insulin, which is responsible for lowering blood sugar levels. Especially in the last third of pregnancy, the placenta produces increased levels of progesterone, prolactin and estrogen, which increase blood sugar. The pancreas must therefore intensify insulin production in order to keep blood sugar levels within the target range. If this does not work, gestational diabetes develops.
There are also risk factors that promote the development of diabetes during pregnancy. Without at least one of these risk factors, it is unlikely that glucose metabolism will be derailed during pregnancy.
Risk factors for gestational diabetes include:
How is the diagnosis made?
In order to detect gestational diabetes, doctors carry out a test (sugar load test, oral glucose tolerance test, OGTT). To do this, blood is first taken in the morning on an empty stomach in order to measure the blood sugar concentration while fasting.
The pregnant woman must then quickly drink 250 to 300 ml of water with 75 g of dissolved glucose. One and two hours later, another blood sample is taken and the blood sugar level is determined. In women with gestational diabetes, glucose is broken down more slowly. Therefore, blood sugar levels after one and two hours are higher than in non-pregnant women.
If the respective limit value is reached or exceeded in at least one of the three measurements, experts speak of gestational diabetes. If the metabolic disease is present, this will be documented in the maternity record.
Gestational diabetes: blood sugar values
The table provides information about the limit values (according to IADPSG and WHO) for blood sugar levels in diabetes during pregnancy:
| measurement time | Values in mg/dl | Values in mmol/l |
| sober | ≥ 92 | ≥ 5.1 |
| after one hour | ≥ 180 | ≥ 10 |
| after two hours | ≥ 153 | ≥ 8.5 |
Diet plan for gestational diabetes
Blood sugar levels can usually be easily controlled by changing your diet. Ideally, the diet should be discussed with a diabetologist. Nutritional advice may also be useful if necessary.
Diets to lower blood sugar levels are not recommended: regular meals are important to keep blood sugar levels constant and to ensure the health of mother and child. Three meals that are not too large and two to three smaller meals or snacks are recommended.
These foods help:
Vegetables of all kinds
legumes
whole grain products
Pseudocereal products: quinoa, amaranth, buckwheat
Low-sugar fruit in small quantities such as berries, watermelon, citrus fruits or apples
Water, unsweetened fruit or herbal tea: about 2.5 liters per day
Foods that have a negative effect:
Sugar in any form: granulated, cane, brown sugar, honey, fructose or maple syrup
Products made from white flour such as white bread, toast, white rice or pasta
sweets
Ready-made muesli mixes that contain a lot of sugar
cornflakes
Fruits that contain a lot of sugar, such as grapes, pears, pineapples or bananas
sweetened drinks such as lemonade and iced tea
fruit juices
Sugary spreads: jam, nut nougat cream
sugary ready-made sauces, for example ketchup and salad dressing
Pastries, cakes, tarts
Treatment: What helps keep sugar levels low?
In the treatment of gestational diabetes, the mother’s own initiative is primarily required. Because blood sugar should be normalized as gently as possible for the child. Therapy with tablets is often not possible because they can harm the unborn child via the placenta. Therefore, the first attempt is to normalize blood sugar by changing your diet and increasing physical activity. With this basic therapy, the problem can be easily managed in 80 percent of women with gestational diabetes.
If this does not work, insulin therapy must be started for gestational diabetes. Depending on your blood sugar profile, it may be enough to inject a quick-acting insulin before the main meal or you may also need to inject a long-acting, so-called basal insulin before going to bed. In some cases an insulin pump is required. In any case, the pregnant woman must measure her blood sugar regularly using test strips to monitor the values.
Course: Does diabetes go away after pregnancy?
In the majority of cases, blood sugar levels can be brought under control by changing your diet and increasing physical activity. After childbirth, sugar metabolism also returns to normal in most women.
However, there are secondary risks: women who have had to deal with this health problem in one pregnancy are very likely to be affected again in the next pregnancy. In addition, almost one in ten of these women will develop type 2 diabetes later in life.
There is also an increased risk for the child to be born with a higher weight, to later suffer from obesity and to develop type 2 diabetes.
Prevent gestational diabetes
Women should make sure to exercise regularly, eat a balanced diet and aim for a normal weight, especially before and during pregnancy. If diabetes mellitus runs in the family, the risk of gestational diabetes is increased. To prevent this, a healthy lifestyle is even more important.
Aftercare: Blood sugar check after birth
Even if the blood sugar level returns to the normal range shortly after giving birth, women who have already suffered from gestational diabetes should have their blood sugar levels checked regularly by their doctor. The risk of developing type 2 diabetes mellitus after the birth of their child is significantly increased.
It makes sense to have your first blood sugar test six to twelve weeks after birth. If nothing unusual is found, it is best for women to have their blood sugar levels checked every second or third year so that impending diabetes can be detected and treated as early as possible.
To ensure that gestational diabetes does not develop into a permanent and serious illness after childbirth, experts recommend that mothers breastfeed their babies for at least three months. The following also applies after birth: If you live a healthy lifestyle with enough physical activity and a fresh, balanced diet, you will reduce your risk of diabetes.
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