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Pregnancy demands some extra care and concern. If you are a diabetic pregnant woman, you have to be more cautious. Diabetes diagnosed during pregnancy is called gestational diabetes. This will put your pregnancy into the risk category due to chances of miscarriage, birth defect, stillbirth, premature birth and oversized baby  . Gestational diabetes is divided into two classes, Class A1 (which can be controlled through diet alone) and Class A2 (requires insulin or oral medications to control the condition).
When a woman conceives, her body goes through a lot of changes and also, she may be prone to certain disorders that are specific to pregnant women. When a woman undergoes gestational diabetes, the blood sugar levels may increase drastically and this can cause certain other issues both for the baby and the mother  .
Consequently, one of the issues that have been much heard of these days during pregnancy is the occurrence of gestational diabetes. The hormone levels can make the blood sugar level rise when you are pregnant, raising the odds of having a complicated and high-risk pregnancy. However, one is always advised to stay positive even if gestational diabetes has been diagnosed   .
Gestational diabetes only occurs during pregnancy. It indicates high levels of sugar during pregnancy which was normal before you conceived. The condition usually gets cured once you deliver the baby. At times, it increases the chances of you developing type 2 diabetes, although rare  .
Causes Of Gestational Diabetes
The exact cause behind the development of the condition is unknown. However, it has been asserted that hormones play a major role in the development of the condition.
During pregnancy, the hormones produced by the placenta cause the build-up of glucose in your bloodstream, which results in gestational diabetes  . Ideally, your pancreas can produce enough insulin to handle this. However, in some cases, when it does not, the blood glucose levels rise to lead to gestational diabetes.
Symptoms Of Gestational Diabetes
Normally, the condition does not cause any signs or symptoms. The symptoms caused can be mild and are as follows .
- Blurred vision
- Excessive thirst
- An excessive need to urinate
However, it is to be noted that most of the symptoms that are associated with gestational diabetes are very common and are seen in most pregnant women. These include symptoms like fatigue, increased thirst, nausea and vomiting. Because of the sheer nature of the symptoms, they may go unnoticed, putting both the mother as well as the child at risk  .
Risks For Gestational Diabetes
You are more likely to have gestational diabetes if you
- have a history of diabetes
- have had gestational diabetes during your earlier pregnancies
- were overweight before conceiving
- had high blood sugar levels
- have high blood pressure
- have given birth to a large baby before
- gained a lot of weight during pregnancy
- are over the age of 25
- are expecting multiple babies
- had a miscarriage or stillbirth
- have polycystic ovary syndrome (PCOS), acanthosis nigricans, or other conditions that are associated with insulin resistance  
Complications Of Gestational Diabetes
In the event of lack of care and attention, the condition can worsen and lead to complications that can affect the health of the child and the mother  .
The complications pertaining to the condition are as follows:
- Breathing difficulties
- A high birth weight
- Shoulder dystocia (causes the shoulder of the baby to get stuck in the birth canal during labour)
- Low blood sugar
- Premature delivery
- Increased chances of caesarean delivery
- Neonatal death
Diagnosis Of Gestational Diabetes
It usually occurs during the second half of your pregnancy. The symptoms of this could be a need to pee more often, feeling more thirsty than usual, feeling hungrier and tending to overeat. Although these symptoms could be associated with the symptoms of pregnancy alone, usually the diagnosis of gestational diabetes involves a test conducted during your routine pregnancy screening tests  .
Usually, between weeks 24 to 28, your doctor would prescribe a test to check for gestational diabetes.
Treatment For Gestational Diabetes
In the event of being diagnosed with the condition, the treatment plan will be dependent on the daily blood sugar levels.
You will be required to test your blood sugar before and after meals.
In some cases, insulin injections will be advised to help control blood sugar levels  .
Impact Of Gestational Diabetes On The Baby
As your baby gets nutrients from your blood, you having gestational diabetes would also affect the baby. The baby stores the additional sugar in the form of fat which makes him or her grow larger than normal. There could be certain pregnancy complications such as the following  :
- There could be injuries to the baby during labour due to the increased size of the baby.
- The baby could be born with low levels of blood sugar and minerals.
- There could be pre-term birth.
- The baby could be born with jaundice.
- There could be temporary breathing problems.
Apart from these, the child could also possess an increased chance of developing obesity and diabetes during the later stages of his life. Such children should be encouraged to maintain a healthy lifestyle right from the beginning  .
Managing Gestational Diabetes
If you have been diagnosed with gestational diabetes, your doctor would be closely monitoring you. You would also be asked to visit your doctor for check-ups frequently and would be required to do the following  
- Check your blood sugar levels at least four times a day. Keep an auto-digital blood glucose monitoring machine at home.
- Get a urine test done regularly to check for the presence of ketones. This is done to check if the diabetes is under control.
- Regular exercise. You can reach out to trainers who would be able to guide you best about the exercises that are suitable and healthy to perform during pregnancy.
- Seek your doctor's or dietician's recommendation to form a healthy diet chart. Your food should be such that it does not increase blood glucose levels.
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-  Bellamy, L., Casas, J. P., Hingorani, A. D., & Williams, D. (2009). Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis.The Lancet,373(9677), 1773-1779.
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-  Facts, G. D. F. (1986). What is Gestational Diabetes?.
-  Koivusalo, S. B., Rönö, K., Klemetti, M. M., Roine, R. P., Lindström, J., Erkkola, M., ... & Andersson, S. (2016). Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish Gestational Diabetes Prevention Study (RADIEL): a randomized controlled trial.Diabetes care,39(1), 24-30.
-  Kamana, K. C., Shakya, S., & Zhang, H. (2015). Gestational diabetes mellitus and macrosomia: a literature review.Annals of Nutrition and Metabolism,66(Suppl. 2), 14-20.
-  Aroda, V. R., Christophi, C. A., Edelstein, S. L., Zhang, P., Herman, W. H., Barrett-Connor, E., ... & Knowler, W. C. (2015). The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program outcomes study 10-year follow-up.The Journal of Clinical Endocrinology & Metabolism,100(4), 1646-1653.
-  Kampmann, U., Madsen, L. R., Skajaa, G. O., Iversen, D. S., Moeller, N., & Ovesen, P. (2015). Gestational diabetes: a clinical update.World journal of diabetes,6(8), 1065.
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