What is Gestational Diabetes

Gestational diabetes (also referred to as gestational diabetes mellitus, or GDM), is a form of diabetes occurring during pregnancy. The condition usually goes away after the pregnancy. Gestational diabetes is diagnosed when blood glucose levels appear higher than normal during the pregnancy.

Cause

During pregnancy, the placenta produces hormones to help the baby develop. These hormones can block the action of the mother’s insulin, resulting in insulin resistance. Consequently, the mother’s insulin requirements are 2 – 3 times greater than usual1.

Women who have insulin resistance before falling pregnant, may not be able to cope with an increased demand for insulin production. As a result, blood glucose (sugar) levels increase and gestational diabetes will be diagnosed. The diabetes should disappear when the pregnancy has finished. However, the insulin resistance increases the risk of experiencing Type 2 diabetes later1.

Risk Factors

There are several factors that can increase your risk of developing gestational diabetes. These include being over 25 years old, having a family history of Type 2 diabetes or gestational diabetes, being overweight, previously having gestational diabetes or giving birth to a large baby, or previously having Polycystic Ovary Syndrome1. Additionally, certain ethnicities are at greater risk of developing gestational diabetes, including people from a Vietnamese, Chinese, middle eastern, Polynesian, Melanesian or Asian Indian background 1,2.

Initially, gestational diabetes can be managed with lifestyle changes: healthy eating and physical activity. However, some women will require additional insulin to manage their gestational diabetes. This insulin may be administered via insulin injections or an insulin pump.

Women who require insulin, may choose to use an insulin pump. A MiniMed® insulin pump might be right for you if you experience any of the following:

• Three or more insulin injections per day
• Difficulty in managing high and low glucose values
• Fear of hypoglycaemia (lows), especially at night
• HbA1c outside the target range
• Difficulty following your prescribed insulin regimen for diabetes management
• Fear of needles
• Seeking more flexibility in your diabetes management

If you’ve tried managing your gestational diabetes using insulin injections, yet experience repeated episodes of hypoglycaemia, insulin pump therapy might be especially beneficial for you3.

The advantages of insulin pump therapy for gestational diabetes

Research indicates that the major advantages of using insulin pump therapy include:

• decreased variability in insulin4
• decreased risk of hypoglycaemia4
• improved control of the dawn phenomenon4
• Using CGM with an insulin pump during pregnancy can improve glycaemic control4

Research indicates insulin pump therapy is a safe and effective treatment to improve glycaemic control in women with gestational diabetes5

Works Cited

1. American Diabetes Association. (2021). Gestational Diabetes. Retrieved from https://www.diabetes.org/diabetes/gestational-diabetes
2. Centers for Disease Control and Prevention. (2021). Gestational Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/gestational.html
3. Medtronic Diabetes. (n.d.). Insulin Pump Therapy. Retrieved from https://www.medtronicdiabetes.com/treatments/insulin-pump-therapy
4. DeVries, J. H., & Snoek, F. J. (2015). Insulin therapy for pregnant women with diabetes. Diabetes Research and Clinical Practice, 108(2), 184-191. doi:10.1016/j.diabres.2015.02.025
5. Kumari, P., Gorthi, R. S., & Gangadhara, P. (2018). Insulin pump therapy in gestational diabetes: A review. International Journal of Medical Science and Clinical Inventions, 5(5), 3921-3925.
6. Moses, R. G., Wong, V. C., Lambert, K., Morris, G. J., & San Gil, F. (2017). The impact of gestational diabetes mellitus on postpartum practices and glycemic control in Australian women with type 1 diabetes. Diabetes Care, 40(2), e15-e16. doi:10.2337/dc16-1765
7. Rayanagoudar, G., Hashi, A. A., Zamora, J., Khan, K. S., & Hitman, G. A. (2016). Effect of dietary and lifestyle interventions on weight loss during pregnancy and gestational diabetes mellitus: A systematic review and meta-analysis. BMJ Open, 6(6), e010665. doi:10.1136/bmjopen-2015-010665
8. Retnakaran, R., Ye, C., Hanley, A. J., & Connelly, P. W. (2018). Prospective association between lactation and insulin resistance and type 2 diabetes in women with prior gestational diabetes mellitus. Diabetologia, 61(5), 972-979. doi:10.1007/s00125-018-4562-y
9. Yogev, Y., & Hod, M. (2019). Gestational diabetes mellitus: Treating the patient, not just the numbers. Diabetes Care, 42(3), 442-444. doi:10.2337/dci19-0004
10. Ziegler, R., & Heidtmann, B. (2019). Individualized treatment targets for pregnant women with diabetes. Current Diabetes Reports, 19(5), 20. doi:10.1007/s11892-019-1134-5