Wellness & Fitness

Diabetes during Pregnancy poses more disease risks

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Motherhood is a pleasure and blessing for most women. FILE PHOTO | NMG

Motherhood is a pleasure and blessing for most women. Many of them usually embrace their pregnancies with joy as they await the arrival of babies.

But this significant period in women’s lives also makes them vulnerable to certain health conditions that can end up jeopardising their future.

One such ailment is gestational diabetes (diabetes occurring during pregnancy only) which happens as a result of increased insulin demands due to hormonal changes that occur during pregnancy.

New research published in the Plos Medicine Journal shows that expectant women who develop the condition have a higher than normal risk of suffering from type 2 diabetes, hypertension and heart disease later in life. The study, conducted by researchers from the universities of Birmingham, Auckland and Warwick in the United Kingdom, involved more than 9,000 women diagnosed with gestational diabetes between 1990 and 2016.

The results showed that the women were 20 times more likely to be diagnosed with type 2 diabetes later in life compared to expectant women who did not get the disease.

Whereas gestational diabetes occurs only during pregnancy and disappears afterwards, type 2 diabetes is chronic and requires lifelong treatment to forestall its health impacts. It should thus be avoided by all means. The Plos study also found that women with the condition were about three (2.8) times more likely to develop ischemic heart disease.

They also had a double chance of suffering from hypertension or high blood pressure later in life. Young women are considered less vulnerable to such non-communicable diseases (NCDs). The study recommends that those who suffer from gestational diabetes should be targeted for regular check-ups and advise on how to reduce their vulnerability to the above three ailments.

“Clinical guidelines need to include after birth screening and management of all cardiovascular risk factors in women diagnosed with diabetes and not restrict it to diabetes as is currently the case,” said Krish Nirantharakumar, senior author of the study, from the University of Birmingham’s Institute of Applied Health Research.

Although it is well documented that women diagnosed with gestational diabetes have a higher risk of developing type 2 diabetes, its link to cardiovascular diseases such as hypertension and heart disease has not been studied much. This study therefore sought to assesses the association.

Aside from future health effects on the mother, Nancy Ngugi, a consultant endocrinologist at Kenyatta National Hospital, said that undiagnosed gestational diabetes can adversely affect the health of the mother and baby during pregnancy.

She said that the disease occurs in the last trimester of pregnancy and most women may not even be aware of it as it presents no symptoms. However, if the blood sugar rises out of control then affected women will begin complaining of thirst, feeling hungry and having frequent urges to urinate.

Women with gestational diabetes who receive proper care end up having successful pregnancies and delivering healthy babies.

Diet and exercise

The condition can be managed using diet and exercise alone since the disease disappears after the baby is born. But if this approach does not work, then insulin should be administered to help expectant mothers maintain their body sugar levels within the recommended healthy range.

According to Dr Ngugi, unmanaged gestational diabetes can cause the baby to be born larger than normal hence causing birth difficulties which can be fatal for the mother. Such women need to deliver through surgery but this may not be possible if they seek care in health facilities without skilled health workers. In such instances, the mother can end up bleeding to death.

Gestational diabetes may also increase the risk of preeclampsia, a condition characterised by high blood pressure and protein in urine.

It can cause kidney failure, brain damage or liver problems. It is for this reason that affected mothers should deliver before the recommended due date. Other serious complications of poorly controlled gestational diabetes that affect newborns include a greater risk of jaundice, increased risk of breathing difficulties, as well as higher chances of dying before, or just after, birth.

These babies are also at a greater risk of becoming overweight and developing type 2 diabetes later in life.

Risk factors for gestational diabetes include obesity, delivery of high birth weight babies (over four kilogrammes), and suffering from polycystic ovary syndrome (PCOS). Women can reduce their vulnerability to the ailment by maintaining a healthy weight before pregnancy, sticking to the right diet and staying active.