Gestational Diabetes: Screening, Diet and What It Means for Your Baby

Gestational diabetes mellitus (GDM) is a form of diabetes that develops during pregnancy. It occurs when the body cannot produce enough insulin to meet the increased demands of pregnancy, leading to higher-than-normal blood sugar levels. In Malaysia, gestational diabetes affects approximately 15 to 25 per cent of pregnancies — one of the highest rates in the region.

The condition usually develops in the second or third trimester and often has no noticeable symptoms. This is why universal screening is recommended in Malaysia. The standard test is the oral glucose tolerance test (OGTT), typically performed between 24 and 28 weeks. You fast overnight, then drink a glucose solution, and blood samples are taken at intervals to measure how your body processes sugar.

Certain factors increase the risk of developing GDM: being over 35, having a higher BMI, a family history of diabetes, previous GDM in an earlier pregnancy, and being of Asian ethnicity. Malaysian women of Indian ethnicity have a particularly elevated risk. However, GDM can occur in women with no risk factors at all, which is why screening is recommended for all pregnant women.

Managing gestational diabetes starts with diet and exercise. A dietitian will help you plan meals that control blood sugar while providing adequate nutrition for your baby. Regular moderate exercise, such as walking after meals, helps your body use insulin more effectively. You will also be asked to monitor your blood sugar levels at home using a glucose meter.

If diet and exercise do not keep blood sugar within target range, medication may be needed. Insulin is the most common treatment and is safe for the baby. Some doctors also use oral medications like metformin. The key is consistent monitoring and adjustment — an MFM specialist like Dr. Kartik has particular expertise in managing GDM, especially when it occurs alongside other pregnancy complications.

Poorly controlled gestational diabetes can lead to a larger-than-average baby (macrosomia), which increases the chance of a difficult delivery or C-section. It also raises the baby's risk of low blood sugar after birth and a higher likelihood of developing diabetes later in life. With good management, most women with GDM have healthy pregnancies and healthy babies.