Symptoms of Gestational Diabetes and Treatment

Gestational diabetes is a health condition characterized by high blood sugar that develops during pregnancy in women with no previous history of diabetes. Although it often does not cause obvious complaints, it can manifest with symptoms such as excessive thirst, frequent urination, and constant fatigue. With early diagnosis and an appropriate gestational diabetes diet planned alongside a specialist, the health of both the expectant mother and the baby can be safely protected.

• It typically appears between the 24th and 28th weeks of pregnancy.
• Blood sugar levels usually return to normal after birth.
• Excessive thirst and frequent urination are among the most common symptoms.
• The oral glucose tolerance test (OGTT) is the gold standard for diagnosis.
• Treatment is primarily based on a healthy diet, regular walking, and insulin if necessary.

What is Gestational Diabetes?

While November 14th, World Diabetes Day, aims to raise awareness about all types of diabetes, one of the most frequently asked questions by expectant mothers is what gestational diabetes actually means. Pregnancy is a period of immense hormonal changes in a woman's body. To support the baby's growth and development, the placenta secretes numerous hormones. However, these hormones can suppress the function of the mother's insulin. This condition, known as insulin resistance, leads to the accumulation of sugar (glucose) in the blood if the pancreas cannot produce enough insulin.

This clinical picture is called gestational diabetes. It usually becomes apparent in the second half of pregnancy, especially after the 24th week. Its incidence in the community is quite high; elevated blood sugar is detected in approximately one in ten pregnancies. Regular monitoring of blood sugar during your week-by-week pregnancy follow-up is the most important step in keeping this temporary but critical condition under control. For most women, blood sugar returns to its previous levels shortly after birth as hormones normalize.

Causes and Risk Factors

The main reason for elevated blood sugar during pregnancy is that hormones secreted by the placenta make it difficult for cells to use insulin. To counter this resistance, the body tries to produce up to three times more insulin than normal. When the pancreas cannot meet this demand, blood glucose levels rise rapidly, leading to the disease.

Although every expectant mother has the potential to experience this condition, certain factors significantly increase the risk. The risk is particularly higher for mothers aged 35 and older. For more detailed information on this topic, you can review our article on advanced maternal age pregnancy risks and perinatology follow-up.

Risk factors include:

• Being overweight or obese before pregnancy (Body Mass Index of 25 and above).
• Having a family history of Type 2 diabetes in first-degree relatives (mother, father, sibling).
• Having been diagnosed with gestational diabetes in previous pregnancies.
• Having previously delivered a large baby weighing over 4 kilograms (macrosomia).
• Having health issues that increase insulin resistance, such as polycystic ovary syndrome (PCOS).
• Leading a sedentary lifestyle.

What Are the Symptoms of Gestational Diabetes?

One of the most challenging aspects of gestational diabetes is that it often causes no noticeable complaints. Many expectant mothers do not realize their blood sugar has risen until routine screening tests are performed. The mild complaints that do arise are often confused with the normal fatigue or physiological discomforts of pregnancy.

However, when blood sugar levels rise significantly, some typical symptoms of gestational diabetes begin to emerge. These symptoms can vary from person to person, and their severity depends on how high the blood sugar is.

The most common symptoms are:

• Feeling much thirstier than usual and experiencing constant dry mouth.
• A need to urinate much more frequently than before, independent of the pressure pregnancy puts on the bladder.
• Extreme fatigue and weakness that do not resolve despite adequate rest, making daily tasks difficult.
• Feeling hungry again shortly after meals and having sugar cravings.
• Experiencing blurred vision or difficulty focusing.
• Vaginal yeast infections or urinary tract infections that recur more frequently and are harder to heal than before.

Diagnosis: How is the Glucose Screening Test Done During Pregnancy?

Because symptoms can remain hidden, screening all expectant mothers at specific weeks is a medical standard. The most reliable method used for diagnosis is the Oral Glucose Tolerance Test (OGTT), commonly known as the glucose screening test. This test is usually administered between the 24th and 28th weeks of pregnancy.

The glucose loading test is performed simply and safely in the hospital. In the first stage, the expectant mother gives blood after fasting for at least eight hours to check her fasting blood sugar. Then, she drinks a sugary liquid prepared by the laboratory containing a specific amount of glucose (usually 50 or 75 grams). Blood is drawn again one and two hours after drinking this liquid to measure how the body processes sugar.

If the blood sugar values exceed the determined threshold levels, the diagnosis of gestational diabetes is confirmed. Unfounded beliefs sometimes circulate in the community that the glucose screening test harms the baby. However, the amount of sugar in the liquid consumed is no different from a few slices of dessert eaten in daily life, and the test poses no harm to either the mother or the baby. On the contrary, it is of vital importance for diagnosing the disease and protecting the baby's health.

Treatment: Gestational Diabetes Diet and Medical Approaches

There is no need to panic once a diagnosis is made; with proper planning, blood sugar levels can be completely brought under control. The first and most important step of treatment is lifestyle modifications. At this point, a personalized gestational diabetes diet is planned with the guidance of a specialist dietitian. During the treatment, the expectant mother is asked to regularly measure and record her own blood sugar at home using a finger-prick test.

This diet aims to provide the calories the mother and baby need while avoiding simple carbohydrates (white bread, sweets, sugary drinks) that rapidly spike blood sugar. Whole grains, fresh vegetables, healthy protein sources, and fiber-rich foods form the foundation of this nutrition plan. Dividing meals into three main meals and three snacks helps prevent sudden fluctuations in blood sugar.

In addition to a healthy diet, light exercises approved by your doctor, such as brisk walking, swimming, or prenatal yoga, help the muscles use the glucose in the blood, thereby breaking insulin resistance. Exercise is much more effective at lowering blood sugar when done about thirty minutes after meals.

If the target blood sugar values cannot be reached with diet and exercise, medical treatment comes into play. Oral blood sugar-lowering pills are generally not preferred during pregnancy. Instead, highly safe insulin injections, which do not cross the placenta to the baby, are used. Insulin therapy is a temporary support that will most likely be discontinued after birth and is not addictive.

Complications and Risk Groups

When gestational diabetes is not taken seriously and blood sugar remains high, serious risks arise for both the mother and the baby. Excess sugar in the mother passes directly to the baby through the placenta. The baby's pancreas produces more insulin to process this excess sugar. This causes the baby to grow larger than normal and accumulate fat (macrosomia). A large baby makes vaginal delivery difficult, increases the likelihood of a C-section, and can pave the way for birth traumas such as shoulder dystocia.

For the mother, one of the biggest risks is an increased likelihood of developing preeclampsia (high blood pressure and protein leakage in the urine), also known as pregnancy toxemia. Additionally, having an abnormally high amount of amniotic fluid (polyhydramnios) can trigger the risk of premature birth.

Immediately after birth, the baby, who is accustomed to producing high levels of insulin in the womb, may experience a sudden drop in blood sugar (neonatal hypoglycemia). Furthermore, respiratory distress syndrome after birth can be seen more frequently in babies of diabetic mothers. For this reason, the blood sugar of newborns is closely monitored by pediatricians. In the long term, women who have had gestational diabetes have an increased risk of developing Type 2 diabetes in the future; therefore, regular postpartum health check-ups should not be neglected.

When to See a Doctor?

Listening to the signals your body gives during pregnancy is very valuable. It is essential not to skip your routine check-ups, but in some situations, you need to seek medical support without waiting.

If you experience any of the following symptoms, you should consult your obstetrician and gynecologist without delay:

• Severe thirst and dry mouth that do not go away despite your daily water intake.
• Blurred vision, double vision, or the appearance of floating spots before your eyes.
• Frequently recurring urinary tract or vaginal yeast infections.
• Finger-prick blood sugar measurements done at home consistently exceeding the limits set by your doctor.

Some situations require immediate medical intervention. If you experience shortness of breath, chest pain, a severe headache, sudden severe abdominal pain, or if you feel a noticeable decrease in your baby's movements, you should immediately go to the nearest emergency room or call the 112 Emergency Call Center.

The Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, we provide services with a multidisciplinary approach to protect maternal and infant health at the highest level. The follow-up of our patients with suspected or diagnosed gestational diabetes is meticulously carried out by our experienced physicians in the Gynecology and Obstetrics department.

During the diagnosis phase, high-standard glucose screening tests are performed in our laboratories, while our expert dietitians prepare personalized nutrition programs during the treatment process. When necessary, insulin therapy is planned in coordination with our endocrinology department, and the baby's development is periodically monitored with four-dimensional ultrasound devices.

With our emergency department providing uninterrupted service 24/7 and our fully equipped neonatal intensive care unit, you are safe at every stage of birth. Bringing your previous test results and pregnancy follow-up file with you when you come to our hospital will speed up the process. To get detailed information and book an appointment, you can visit our appointment page or contact us through our call center at 0850 811 34 00.

Frequently Asked Questions

Does gestational diabetes harm the baby?

Uncontrolled gestational diabetes can cause the baby to be born large, lead to premature birth, cause a drop in blood sugar after birth, and increase the risk of obesity in later years. However, when blood sugar is kept at normal levels with diet and medical follow-up, your baby will be born completely healthy.

Does gestational diabetes go away after birth?

Yes, in the vast majority of cases, blood sugar levels normalize immediately after birth as the placenta separates from the body and hormones return to normal. However, since there is a risk of developing Type 2 diabetes in later years, it is recommended to have another blood sugar test 6 to 12 weeks after delivery.

Is the glucose screening test during pregnancy harmful?

No, the glucose screening test causes no harm to the mother or the baby. The amount of sugar in the liquid consumed during the test is about the same as a standard portion of dessert eaten in daily life. On the contrary, skipping the test can lead to hidden diabetes being overlooked and cause serious complications.

What should a gestational diabetes diet look like?

The diet should be free from simple sugars and refined carbohydrates, and include fiber-rich vegetables, whole grains, and high-quality proteins. Dividing your meals into three main meals and three snacks helps keep your blood sugar balanced throughout the day. This process should definitely be planned with the guidance of a dietitian.

Can women with gestational diabetes have a normal vaginal delivery?

Expectant mothers whose blood sugar is well-controlled and whose baby's estimated birth weight is within normal limits can safely have a normal vaginal delivery. However, if the baby is very large (macrosomia) or if the mother has other medical reasons such as preeclampsia, your doctor may recommend a cesarean delivery.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.