gestasjonsdiabetes

Gestational diabetes, called gestasjonsdiabetes in Norwegian, is glucose intolerance that is first recognized during pregnancy. It arises from hormonal changes that increase insulin resistance, leading to higher blood glucose levels in the second or third trimester. Most cases resolve after delivery, but GDM identifies a higher risk for complications during pregnancy and a greater likelihood of developing type 2 diabetes later in life.

Risk factors include prepregnancy overweight or obesity, a previous history of gestational diabetes, a family history of diabetes, advanced maternal age, and belonging to certain ethnic groups. Screening for gestational diabetes is commonly performed between 24 and 28 weeks of gestation using an oral glucose tolerance test. Different diagnostic criteria exist (for example IADPSG or Carpenter-Collstaff), which may influence who is diagnosed.

Management focuses on maintaining maternal blood glucose within target ranges through diet and physical activity, with regular glucose monitoring. If lifestyle measures are insufficient, pharmacotherapy such as insulin or metformin may be used. Careful fetal monitoring and planning for delivery are important, as GDM is associated with increased risks of preeclampsia, cesarean delivery, macrosomia, shoulder dystocia, neonatal hypoglycemia, jaundice, and respiratory problems.

Delivery planning is individualized and may involve earlier delivery in certain circumstances. Most pregnancies with well-controlled GDM have favorable outcomes, but postpartum follow-up is essential. Blood glucose levels should be re-evaluated several weeks after birth, as most women return to normal, while those with GDM remain at higher risk for developing type 2 diabetes and should have ongoing lifestyle counseling and periodic testing.

Prevention and long-term health strategies include maintaining a healthy weight, regular physical activity, and routine glucose testing for women with prior GDM.