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Why Self-Monitoring Gestational Diabetes Is A Lifelong Gift For Moms & Babies

Gestational diabetes is a condition where women develop high blood sugar levels during pregnancy. The risks can be curbed with regular self-monitoring among other lifestyle changes.

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Dr. Shalini Jaggi
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Image: Mila Zen, Shutterstock

Image: Mila Zen, Shutterstock

For a pregnant woman, nothing is more important than protecting the life growing inside her. Sumedha (35, name changed) smiled as she held her newborn. Looking at the joyful faces of her family members, she was reminded of the baby she lost last year. Sumedha was diagnosed with high blood sugar or gestational diabetes (GDM) during her first pregnancy and lost her baby at 20 weeks to complications.

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Her second pregnancy was filled with anxiety as she was diagnosed with GDM again, this time at 16 weeks. In addition to following a strict regimen involving insulin and dietary modification, she also self-monitored blood sugar levels intensively to keep them under control.

This time, she delivered a healthy girl. Though her blood sugar was back to normal post-delivery, doctors cautioned that she was at a high risk of developing diabetes later in life. They advised maintaining a healthy lifestyle, losing weight, exercising, and getting screened periodically for diabetes. 

How Is Gestational Diabetes Caused?

Many pregnant women remain unaware of the seriousness of GDM. This condition is becoming common across the world, with nearly 13% of pregnant women in India suffering from it.  Increasing age at pregnancy (above 25 years) and overweight or obesity increase the risk of GDM.  

Prediabetes, a sedentary lifestyle, stress, GDM in a previous pregnancy, polycystic ovary syndrome (PCOS), and delivery of a baby above 3.5 kg in an earlier pregnancy are other risk factors besides a strong family history of diabetes.  

GDM is different from type 1 or type 2 diabetes. Type 1 diabetes (T1D) is caused by the autoimmune destruction of insulin-producing cells leading to complete dependence on insulin. Type 2 diabetes (T2D)  is essentially due to a complex interplay of increasing insulin resistance and reducing insulin secretion and can be managed with weight loss, diet as well as medications.

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Meanwhile, GDM is associated with hormonal changes during pregnancy, leading to a massive increase in insulin resistance, thereby reducing insulin action and a transient rise in blood glucose levels during pregnancy. Most women see a normalisation of their glucose levels after delivery, however a few may continue to remain prediabetic and eventually convert to type 2 diabetes. 

Managing Gestational Diabetes

During pregnancy, the hormones produced by the placenta increase insulin resistance. To make up for this, the body produces more insulin. In women with GDM, the body is unable to keep up with this increased demand. GDM has many short-term and long-term consequences. It can cause several complications for the baby such as larger babies, severe breathing problems, preterm delivery, or even stillbirth.

GDM increases the risk of developing type 2 diabetes later in life for both the mother and the child. Nearly 70% of women with GDM eventually develop type 2 diabetes 

Self-monitoring of blood glucose is crucial for diabetes management. The same principle must be applied to women with GDM. By regularly checking their blood sugar levels, premeal as well as 2 hrs post-meal, with a home blood glucose monitoring device, women can track their glucose levels and alter their diet, exercise, and medication to manage this condition, in consultation with their doctor effectively. 

Even post-delivery, women need to continue monitoring their blood sugar levels. This and other preventive measures can help delay the onset of type 2 diabetes. Continuous monitoring thus empowers women to take charge of their health and prevent future complications.

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A study by Yeh PT et al. found that self-monitoring of blood glucose along with other interventions can prevent several complications. These include preeclampsia (a life-threatening complication that causes high blood pressure), low average birth weight infants, and babies too large for their age.  Most importantly, regular checkups are essential to facilitate early detection and timely intervention. 

GDM is not just a temporary condition confined to pregnancy; it is a significant warning bell for future metabolic diseases such as T2DM, heart disease, hypertension etc. For millions of women worldwide, GDM is a precursor to future health challenges, most importantly the increased diabetes risk.

Lifestyle adjustments alone may not be enough because the mind doesn’t believe what the eyes don’t see.  A woman needs to be empowered and educated to frequently check her glucose levels at home and make informed decisions about her health.

Self-monitoring of blood glucose is a powerful, proactive tool that gives women these much-needed real-time insights into their health. With self-monitoring, women can monitor how their daily choices affect their well-being, and build habits that can safeguard their long-term health.

For healthcare providers, prioritizing self-monitoring of blood glucose education and support for women who have had GDM can transform lives. Let us empower women to take control today, harness the power of knowledge, and make diabetes prevention and lasting health a priority.

This article was written by Dr Shalini Jaggi, Consultant & Director, Lifecare Diabetes Centre, Delhi.

Gestational Diabetes Diagnosis Gestational diabetes
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