Gestational diabetes affects 16.4% of pregnant women, according to the 2021 national perinatal survey. Generally, pregnant women do not experience any symptoms. They sometimes report unusual tiredness, discomfort before or after meals, even increased urine volumes and recurrent urinary tract infections. But the signs mostly remain vague. However, some clues can put the doctor on the path to gestational diabetes: the child is fat, the amount of amniotic fluid is excessive, and the ultrasound shows the placental volume is too large.
“For every pregnant woman, it is scheduled to look for sugar in the urine during monthly consultations to monitor the pregnancy,” she says. The test is done using a urine swab during the first pregnancy consultation and during the monthly follow-up.
Targeted screening for at-risk pregnant women
Gestational diabetes screening targets pregnant women with risk factors: overweight, family history of diabetes or personal history in a previous pregnancy, over 35, complications in a previous pregnancy.
- In the presence of significant risk factors, a fasting blood test is recommended to calculate the blood sugar level (glycemia) from the first trimester of pregnancy .
- Otherwise, the test is done between the 24th and 28th weeks of amenorrhea. One of the most widely used tests , the OGTT (oral induced hyperglycemia) test, consists of evaluating the blood glucose level with three blood samples (on an empty stomach, one hour after glucose ingestion, the last two hours) after glucose has been absorbed. after hours).
What are the risks associated with gestational diabetes?
“During pregnancy, in these women who are prone to gestational diabetes, the movement of the placenta will impair the body’s ability to use insulin. Insulin is a hormone produced by the pancreas that allows blood sugar to be absorbed by cells . opens,” explains Dr. Gilbert Sarrot, gynecologist-obstetrician.
This blood sugar anomaly is not without consequences:
- Gestational diabetes increases the risk of premature rupture of the water bag due to premature birth or excess volume of the uterus. The expectant mother may also develop high blood pressure or preeclampsia ;
- diabetes also affects the baby: if left unchecked, it can cause nerve or heart defects or overweight (over 4kg baby). There is also a risk of hypoglycemia at birth, so the baby is fed immediately after birth;
Gestational diabetes: should I be treated?
Treatment of gestational diabetes aims to keep blood sugar levels within acceptable values to prevent complications. Dr. “In general, strict control of your diet associated with a healthy lifestyle (rest, sleep, and physical activity) will suffice, unless you have diabetes prior to pregnancy,” explains Sarrot reassuringly. The doctor determines the required calorie intake, the foods to be preferred and avoided, the number of snacks…
Thanks to a particular device, the expectant mother will need to strictly control her blood sugar before and after the three main meals of the day. If dietary guidelines are inadequate, treatment will be based on injection of insulin doses adapted to the blood glucose level. In any case, it is important to monitor the growth of the baby, as well as the volume of amniotic fluid. If the follow-up is serious and the mother increases the number of prenatal consultations as part of this follow-up, the pregnancy is uneventful.
What affects during childbirth?
Dr. As Sarrot points out, birth will be scheduled most frequently and to the extent possible:
- or vaginally if possible: in this case and depending on the baby’s position, delivery will be initiated and guided by taking all necessary precautions, especially when the water bag is broken.
- or by cesarean section.
Breastfeeding is generally recommended and even recommended if the mother wishes and can.
Will I remain diabetic after giving birth?
In 90% of cases, gestational diabetes disappears after pregnancy. However, you need to have your blood sugar levels checked in the months after giving birth because gestational diabetes is sometimes a precursor to a prediabetic condition and should be monitored and treated afterwards.
If another pregnancy is planned, earlier follow-up from the first months of pregnancy will be necessary. A diet is desirable before the conception of the child.