WHAT YOU NEED TO KNOW ABOUT GESTATIONAL DIABETES

• Type 1 Diabetes (T1DM)

A lack of insulin resulting from the destruction of insulin-producing β-cells in the pancreas.

• Type 2 Diabetes (T2DM)

Despite insulin production, insulin resistance develops in the body. Genetic predisposition, sedentary lifestyle, and obesity are contributing factors to the development of type 2 diabetes.

• Gestational Diabetes (GDM)

Commonly referred to as pregnancy diabetes, gestational diabetes (GDM) is defined as hyperglycemia that occurs in the second and third trimesters of pregnancy, in women who did not have diabetes prior to pregnancy. The hormonal changes during pregnancy contribute to insulin resistance. With the increase in fast food consumption and the prevalence of obesity, the number of pregnant women diagnosed with gestational diabetes is rising. This condition can lead to various pregnancy complications.

• Being overweight or obese,
• A history of impaired glucose tolerance, gestational diabetes, or delivering a baby weighing more than 9 lbs (4,080 grams),
• Family history of diabetes (especially first-degree relatives),
• Polycystic ovary syndrome (PCOS),
• Hypertension, 
• Use of glucocorticoids,
• A history of poor obstetric outcomes,
• Age (>25 years),
• High-risk ethnic background,
• Multiple pregnancies (twins, triplets, etc.)

• High consumption of red meat, 
• Processed meat products, 
• Refined grain products, 
• Sweets,
• French fries, 
• Sugary beverages

These foods can increase insulin resistance and raise blood glucose levels.

The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommends that all women who have not been previously diagnosed with diabetes undergo a 75-gram, 2-hour Oral Glucose Tolerance Test (OGTT) between the 24th and 28th weeks of pregnancy.

There are two current approaches to testing for Gestational Diabetes (GDM):

1. Single-stage approach: A single 75g Oral Glucose Test (OGTT) is performed.
2. Two-stage approach: First, a screening is performed using a 50g OGTT; if the results show a glucose value of 7.7 mmol/L (130-140 mg/dL) or higher, the pregnant woman should undergo a confirmatory 100g OGTT a few days later.

 For women with gestational diabetes (GDM) who do not achieve glycemic targets through diet and physical activity, a pharmacological agent should be added within one week after diagnosis, in addition to nutritional regulation and physical activity. Insulin remains the gold standard treatment for gestational diabetes (GDM). Additionally, some international organizations have approved the use of oral antidiabetic agents, such as metformin and gliburide, during pregnancy.

Insulin therapy is safe during pregnancy because it passes through the placenta in minimal amounts. The U.S. Food and Drug Administration (FDA) classifies fast-acting insulin analogs such as Lispro and Aspart, intermediate-acting insulin analogs such as NPH, and long-acting insulin analogs like Detemir as Pregnancy Category B.