Pregnancy & Blood Sugar: The Silent Risks!
Gestational diabetes mellitus (GDM) is a type of glucose intolerance that arises during pregnancy. Although it is often seen as a temporary condition that resolves after delivery, GDM poses serious health risks for both the mother and the baby. In an interview with HT Lifestyle, Dr Rajesh Jain, diabetologist and physician at Diabetes & Wellness Clinic in Mumbai, emphasised, “Often undiagnosed or underdiagnosed, GDM is a silent threat that can lead to complications such as high blood pressure, infections and cardiac problems – sometimes with fatal consequences. It is important to recognise this connection to raise awareness, enhance maternal healthcare protocols, and support safe pregnancy outcomes.”…
Risk factors for gestational diabetes:
According to the doctor, several factors can increase the risk of developing gestational diabetes. These include becoming a mother at an older age, obesity or significant weight gain during pregnancy, family history of diabetes, previous history of GDM or giving birth to a baby with macrosomia (higher than average birth weight), and polycystic ovarian syndrome (PCOS).
Pathophysiological effects of gestational diabetes:
“Gestational diabetes develops as a result of insulin resistance caused by placental hormones, which is further intensified by the metabolic stress of pregnancy,” the doctor explained. “If not managed properly, this can lead to increased blood sugar levels (hyperglycemia), which in turn contributes to endothelial dysfunction, hypertension, and increased inflammatory responses.”
How Gestational Diabetes Mellitus (GDM) Is Linked to Maternal Mortality:
GDM significantly heightens the risk of serious pregnancy complications. It can lead to conditions such as pre-eclampsia and eclampsia, and often results in cesarean deliveries, which carry a greater risk of postoperative complications. Poor glycemic control also increases the likelihood of postpartum hemorrhage and infections. In more severe cases, GDM can contribute to cardiovascular issues that may ultimately result in maternal death.
Research indicates that women with unmanaged GDM face up to three times higher risk of pregnancy-related mortality compared to those without the condition.
Prevention Tips for Expectant Mothers:
- Early screening in high-risk women, ideally during the first trimester
- Lifestyle modifications, including proper dietary guidance and regular physical activity
- Medical management with oral hypoglycemics or insulin when necessary
- Close monitoring throughout labor and the postpartum period
- Long-term follow-up to reduce the risk of developing type 2 diabetes after pregnancy
“Although gestational diabetes is often silent and temporary, its impact can be life-threatening,” emphasized Dr.Rajesh Jain. “Early detection, timely intervention, and consistent postnatal care are crucial in reducing the maternal mortality associated with this preventable condition.”
How Diabetes Can Affect Your Baby:
During the first 8 weeks of pregnancy, your baby’s vital organs—such as the brain, heart, kidneys, and lungs—begin to develop. If your blood glucose levels are too high during this critical period, it can interfere with normal development and increase the risk of birth defects affecting these organs.
Uncontrolled blood sugar throughout pregnancy can also raise the chances that your baby may:
- Be born prematurely
- Be larger than average (a condition known as macrosomia)
- Experience breathing difficulties after birth
- Have low blood glucose (hypoglycemia) shortly after delivery
In cases where there is a risk of complications like hypoglycemia or other health concerns, a healthcare provider may recommend that your baby be cared for in a neonatal intensive care unit (NICU) after birth. Babies who are born too early, are very small, or have significant health issues may also require specialized care.
Additionally, high maternal blood sugar levels can increase the risk of miscarriage or stillbirth—the loss of the baby in the womb during the second half of pregnancy.
Long-term, babies born to mothers with poorly controlled diabetes may be more likely to develop health problems such as obesity or type 2 diabetes later in life.
Managing blood glucose levels before and during pregnancy is essential for reducing these risks and supporting your baby’s health from the very beginning.
How Diabetes Can Affect You During Pregnancy:
Pregnancy causes hormonal and physical changes that can significantly impact your blood glucose levels. Even if you’ve been managing diabetes for years, you may need to make adjustments to your diet, exercise routine, or medications during pregnancy. If you weren’t using insulin before, it may be necessary to start using it. As your pregnancy progresses—especially in the third trimester—your insulin needs often increase. Blood sugar levels can also fluctuate rapidly during labor and after delivery, so your healthcare team will likely monitor them closely and adjust your treatment as needed.
Potential Health Risks During Pregnancy:
Diabetes can worsen certain existing health conditions during pregnancy, particularly if blood sugar levels are not well controlled. Complications may include:
- Worsening of diabetic eye (retinopathy), kidney (nephropathy), or heart disease
- Increased risk of preeclampsia, a serious condition marked by high blood pressure and excess protein in the urine during the second half of pregnancy
- A higher likelihood of delivering a baby who is larger than average, which may lead your doctor to recommend a cesarean delivery (C-section)
Managing Diabetes During Pregnancy:
To protect your health and support your baby’s development:
- Stick to your diabetes care plan, including regular blood glucose monitoring
- Attend all prenatal checkups
- Take prenatal vitamins as prescribed
- Avoid smoking to reduce the risk of pregnancy complications
Careful monitoring and consistent management of diabetes throughout pregnancy can help ensure a healthier outcome for both you and your baby.
Stay Physically Active During Pregnancy:
Regular physical activity can help lower your blood glucose, blood pressure, and cholesterol levels. It may also promote better sleep and boost your mood, both important for a healthy pregnancy.
Before starting or continuing any exercise routine, talk to your healthcare team about which activities are safe for you during pregnancy. According to the Physical Activity Guidelines for Americans (2nd Edition), most people should aim for at least 150 minutes of moderate-intensity physical activity per week, along with strength-training exercises twice a week.
Your activity level may need to be adjusted based on how active you were before becoming pregnant. The key is to stay active in a way that supports both your safety and well-being during this time.
What You Should Know About Blood Glucose Testing During Pregnancy:
During pregnancy, your target blood glucose levels—and how often you need to check them—may change. Regular monitoring helps you track your blood sugar levels and manage highs and lows more effectively. Be sure to ask your healthcare team how frequently and at what times you should test your blood glucose.
At home, you can check your levels using a blood glucose meter, which measures glucose in a small drop of blood, typically from a fingertip prick. If you’re using insulin, your doctor may recommend a continuous glucose monitor (CGM) for more consistent and real-time tracking.
Your healthcare provider may also ask you to test your urine for ketones. High ketone levels can indicate that your diabetes management needs adjustment. If left unaddressed, elevated ketones can lead to diabetic ketoacidosis (DKA)—a serious and potentially life-threatening condition. Always work closely with your healthcare team to adjust your care plan if needed and keep both you and your baby safe.
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