Will gestational diabetes get better?

Written by Chen Li Ping
Endocrinology
Updated on December 03, 2024
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Gestational diabetes refers to diabetes that appears or is diagnosed during pregnancy and is a distinct type of diabetes. Many women with gestational diabetes may see their blood sugar levels return to normal after delivery as insulin resistance diminishes. It is recommended to conduct an OGTT (oral glucose tolerance test) screening six weeks after childbirth, as the majority of women with gestational diabetes will have normal fasting blood glucose or OGTT values at six weeks postpartum. Approximately 25% to 70% of women with gestational diabetes may develop diabetes again within 16 to 25 years after delivery. Therefore, it is essential to continue monitoring the patient's blood glucose postpartum and to screen early for diabetes.

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How to treat gestational diabetes?

The treatment principle for gestational diabetes is to control blood sugar and then ensure the normal development of the child. There are many methods to control blood sugar. First, it involves diet management guided by a doctor, adjusting the diet's structure and quantity, followed by post-meal exercise. If after a week of adjusted diet and post-meal exercise, blood sugar levels still do not meet the standards, insulin injections can be used to keep the pregnant woman's blood sugar within the prescribed range. This can help reduce the impact of diabetes on the fetus and the pregnant woman.

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How to self-test for gestational diabetes

Gestational diabetes refers to conditions where there was no diabetes before pregnancy, and during the course of the pregnancy, specifically between the 24th to 28th weeks, a standard glucose tolerance test is conducted to screen for glucose metabolism. The specific procedure involves not eating after 8 p.m. the night before, though drinking water is allowed, followed by fasting for more than ten hours. The first blood sample is taken on an empty stomach. Then, 75 grams of anhydrous glucose, as prescribed by the doctor, is dissolved in 250 to 350 milliliters of water and consumed within 3 to 5 minutes. Starting from the first sip of this glucose solution, blood samples are taken again one hour and two hours later. The results from these three blood samples are used to determine the possibility of gestational diabetes.

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How is gestational diabetes treated?

The treatment of gestational diabetes includes dietary therapy, exercise therapy, and insulin therapy. For dietary therapy, we mainly control the total calorie intake and supplement with elements such as calcium, iron, folic acid, and various vitamins; in exercise therapy, we aim to control the speed of weight gain, improve the peripheral tissues' utilization of glucose, and improve the lipid profile. For patients whose blood glucose levels do not meet the standards after two weeks of diet and exercise therapy, we initiate insulin therapy. The goal of insulin therapy is to control fasting blood glucose below 5.3 and postprandial blood glucose below 6.7. The methods of insulin therapy include twice daily injections, multiple daily injections, or the use of an insulin pump.

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Does gestational diabetes require early delivery?

Patients with gestational diabetes primarily have higher blood sugar levels compared to normal pregnant women. For such individuals, strict blood sugar control is generally required. Poor control of blood sugar can significantly impact the baby and pose dangers during childbirth. However, for those patients with well-controlled gestational diabetes, it is possible to carry the pregnancy to full term without the need for early delivery. Early delivery, leading to a premature birth, can have a greater detrimental effect on the infant than the effects caused by high blood sugar. Therefore, patients with gestational diabetes do not need to deliver early. They can manage their condition through strict dietary control, including fetal monitoring and close monitoring of the baby’s vital signs, considering delivery only after reaching full term.

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What are the symptoms of a baby born to a mother with gestational diabetes?

During pregnancy, if a pregnant woman suffers from high blood glucose, it can potentially impact the fetus's growth and development. After the baby is born, this may result in a larger size of the fetus, and a decrease in the baby's immune system, making them more susceptible to infectious diseases. If high blood glucose occurs during pregnancy, it is important to control the diet promptly, eat less sugary food, and also control the portion of food. If necessary, medical treatment under the guidance of a doctor can also be conducted to maintain blood glucose at a stable level. If blood glucose is well-controlled during pregnancy, the baby will be just like other healthy babies after birth.