Questions and answers about Gestational Diabetes

Gestational Diabetes is a form of diabetes that occurs in pregnant women. Gestational Diabetes means that the mother has a high content of sugar in her blood, which can be caused by the inadequate production of insulin. Insulin is a hormone produced by the pancreas. Insulin’s primary role is to lower the blood sugar. The hormone “unlocks” the cells, so that they can take in sugar. Lack of insulin or reduced sensitivity to insulin will result in sugar not entering the cells. The sugar is then left in the blood, and the blood sugar level rises. During pregnancy, the woman’s system becomes more and more sensitive to insulin. It is partly due to the hormonal changes in placenta. In most cases, due to the pancreas insensitivity more insulin is produced, so that the blood glucose is kept at a normal level. But in some pregnant women the pancreas cannot be adapted to a higher production of insulin than is needed. Then Gestational Diabetes develops. Below you will find answers to the questions on Gestational Diabetes prevalence, why some mothers get it, who can be affected, the symptoms that can be recognized, how the diagnosis is formed, risks, influences on the unborn child, how it can be avoided and treated.

How common is Gestational Diabetes?

In Europe and the United States the results of numerous studies state that between three and five percent of all pregnant women develop Gestational Diabetes. In Sweden, the numbers are slightly lower, just under three percent, but new criteria for assessing Gestational Diabetes can cause the number of women diagnosed with it increase two to three times. As a result more people can get treatment that reduces the risk of negative effects of the elevated blood glucose levels in the mother and child.

What causes Gestational Diabetes?

The insulin hormone produced in the pancreas lowers the blood sugar level. If you cannot produce enough insulin, you are under the risk of developing Gestational Diabetes. During pregnancy, and especially in the second and third trimesters, there is a reduced sensitivity to insulin, which is primarily caused by the hormones produced in placenta. This means that the pancreas has to increase its insulin production to be able to compensate for the increased insulin need. If the pancreas cannot increase the production of insulin, blood sugar rises and a woman develops Gestational Diabetes.

Who is suffering from Gestational Diabetes?

There are a number of factors that contribute to some women being under a higher risk of developing Gestational Diabetes:

There is a family history of diabetes
The expectant mother had Gestational Diabetes before
Complications associated with previous pregnancy, such as the baby is big at delivery or Caesarean section was made
Obesity
Relatively high age of the mother, i.e., over 35 years
Mother had many pregnancies
Ethnicity
Hypertension
Vitamin D deficiency

There are various theories about why some women are under a higher risk of developing the disease than others, regardless of the risk factors.

How can I learn that I have Gestational Diabetes?

Usually, it is difficult to notice that you have Gestational Diabetes, because the disease rarely produces any obvious symptoms. The symptoms that occur are usually mild and not life threatening.
Some common symptoms are:

Increased thirst
Often peeing and in greater amounts
Increased appetite
Fatigue and weakness
Frequent infections
Nausea and vomiting

How is Gestational Diabetes diagnosed?

Since the disease rarely gives any clear symptoms, pregnancy diabetes is almost always detected through the samples taken at the Maternity Care Center (MVC). When you register at the clinic, they will take a sample to measure blood sugar. If the sample is within the norm, your blood sugar will be checked a few times during pregnancy. How many times it is checked depends on where you live. If the blood sample shows higher blood sugar levels, it is always named a glucose load.

A glucose load means that you cannot eat anything for eight hours before the next blood test is performed. The blood sugar level is measured about eight hours after meal and is named fasting blood glucose. Then you have to drink a sugar solution containing water and glucose. Blood glucose level is then measured twice during the next two hours. Sugar levels measured after meals are named in medical literature as postprandial blood sugar.

If blood sugar levels are above the limit according to the criteria used, Gestational Diabetes is diagnosed.

What are the risks of Gestational Diabetes?

There are several risks in pregnancy, both for you as the mother and the fetus, of having Gestational Diabetes.

For large fetuses. If you have higher blood sugar levels, it leads to the higher blood sugar levels in the fetus, because glucose is transported into the fetus through the placenta. The fetus then responds by increasing its own production of insulin to deal with the increased amount of sugar (glucose) in blood. One can say that the baby gets a too energetic nutrient solution. It can lead to the baby growing too fast and gaining too much weight. It can lead to complications when it is time for birth.
Preeclampsia. Gestational Diabetes can cause the mother to develop preeclampsia, a condition that can be threatening both mother and fetus lives.
Premature birth. Gestational Diabetes increases the risk of premature birth and the related complications, which include that the baby needs help with breathing until its lungs are able to function on their own.
For low blood sugar. Babies whose mothers have higher blood sugar levels can suffer from low blood sugar levels right after birth, since their insulin production may be abnormally high (in response to the mother’s high blood sugar, which is shared by the fetus). This condition, if not treated, can lead to seizures and other complications in the newly born baby.
Risk of diabetes. Mothers who had Gestational Diabetes before are at a greater risk of developing Diabetes Type 2 diabetes than those mothers who did not have Gestational Diabetes. Therefore, the baby has a higher risk of developing diabetes and becoming overweight later in life.

How does Gestational Diabetes affect my child in the belly?

Most fetuses are not seriously affected by their mother’s Gestational Diabetes. Higher blood sugar during the first trimester increases the risk of birth defects in the fetus. But it is rarely Gestational Diabetes, it is commonly caused by an expectant mother having diabetes before pregnancy. If blood sugar level increases during the last trimester, the baby can grow abnormally, which increases the risk of complications during childbirth.”

What if I had Gestational Diabetes already?

The risk grows significantly, and it means that you, already in the early pregnancy, should get help from a special maternity care center. You can get a referral to them via the regular prenatal care center.

How can I avoid getting Gestational Diabetes?

Most people avoid developing Gestational Diabetes. Some are more at risk than others of getting it, see the question about risk factors and who suffers from these factors. If you want to be extra careful, whether certain risk factors apply to you, or not, you should avoid obesity, eat healthy food and exercise regularly. One method that can help you control your blood sugar and thereby reduce the risk of Gestational Diabetes is medical nutrition therapy, which you can read more about here.

What is the treatment for Gestational Diabetes?

If you have passed a glucose tolerance test made by the midwife, and it shows that you have Gestational Diabetes, in the first stage the treatment consists of advising you to change your eating habits and to exercise, which would help bring your blood sugar down to a normal level.
The general advice is:

Eat smaller amounts, but have more frequent meals distributed evenly during the day.
Food should be rich in fiber and vegetables and low in fast carbohydrates.
Exercise daily, take long walks
Ask to talk to a dietitian.

Unless dietary management and exercises are enough to lower the blood sugar level, antidiabetic therapy, mostly with insulin, is required.
With the help of medical nutrition therapy blood sugar content can be reduced without insulin treatment. You can read more about Preload® Balance production here.

What to do after pregnancy?

For most people who had Gestational Diabetes blood sugar is naturally normalized soon after childbirth, which means that the problem of high blood sugar disappears after the baby is born. However, there is an increased risk of developing Type 2 Diabetes later in life. You can actively reduce the risk of developing Type 2 Diabetes by avoiding obesity, eating healthy food and exercising. Preload® Balance can also be eaten after pregnancy to achieve good saturation, long-lasting energy and to reduce craving for sweets.

Studies performed

The Indevex network now successfully includes a group of experts in medical nutrition therapy during pregnancy and GDM with the focus on gaining more knowledge through their own and others’ researches and participation in the public debate in order to raise the question of women’s and babies’ health.

Preload® Balance

Preload® Balance is based on medical nutrition therapy, and is a treatment designed to stabilize blood sugar in a simple way. This method is the basis of our first product, containing a combination of all-natural nutrients derived from peas, eggs, rose hips and sugar beet fibers.

Our product name is Preload® Balance and it should be drunk 30 minutes before meals (breakfast, lunch and dinner) in order to increase saturation and reduce craving for sweets.

It is sold in individual packs. Each pack contains 235 ml of drink and is available in five flavors: blueberry, rose hip, apple/cinnamon, tomato and coffee. Preload® Balance is developed by the Swedish biotechnical company Indevex.

About Indevex

Indevex is a Swedish biotechnical company founded in 2001. Since 2006, we have researched and developed products and treatment concepts for Type 2 Diabetes, and since 2014 our research and development teams have been focused on Gestational Diabetes Mellitus, GDM – pregnancy diabetes. We are trying to prevent the development of and to reverse the negative impact of GDM.

More about Indevex.