Gestational Diabetes

Gestational diabetes is diabetes diagnosed for the first time during pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health. All expectant mothers will be tested for gestational diabetes at some point during their pregnancy. Expecting mothers who are over the age of 35, overweight, or have a family history of diabetes may be tested earlier and more frequently.

Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery. The free My Fetal Life app: iOS, Android.  It features meal recommendations, kicks counter, blood glucose tracking, and more.

What is gestational diabetes?

Gestational diabetes is a temporary (in most cases) form of diabetes in which the body does not produce adequate amounts of insulin to regulate sugar during pregnancy. It may also be called glucose intolerance or carbohydrate intolerance.In women with gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you’ve had gestational diabetes, you have a higher risk of getting type 2 diabetes. You’ll need to be tested for changes in blood sugar more often.

Symptoms

For most women, gestational diabetes doesn’t cause noticeable signs or symptoms. But symptoms include:

  • Sugar in urine (revealed in a test done in your doctor’s office)
  • Unusual thirst
  • Frequent urination
  • Fatigue
  • Nausea
  • Frequent vaginal, bladder, and skin infections
  • Blurred vision

Who gets gestational diabetes, and why do I have to be tested?

Approximately 2-5% of pregnant women develop gestational diabetes; this number may increase to 7-9% of mothers who are more likely to have risk factors. The screening for this disease usually takes place between your 24th and 28th week of pregnancy.

Doctors test for gestational diabetes during this time because the placenta is producing large amounts of hormones that may cause insulin resistance. If the results indicate elevated levels, further testing would be done to confirm a gestational diabetes diagnosis.

What should I expect during my test?

During your prenatal visit, your doctor will give you a sweet (but not necessarily tasty) liquid to drink one hour before your blood is drawn. It may cause you to feel a bit nauseous. The results will indicate if you are producing enough insulin or not.

What are the risk factors?

  • Overweight and obesity
  • A lack of physical activity
  • Previous gestational diabetes or prediabetes
  • Polycystic ovary syndrome
  • Diabetes in an immediate family member
  • Previously delivering a baby weighing more than 9 pounds
  • Race — Women who are Black, Hispanic, American Indian and Asian American have a higher risk of developing gestational diabetes

What is the treatment?

The primary means of treating gestational diabetes is controlling your blood sugar levels.

  • Self-monitoring of blood glucose levels
  • Insulin therapy, if necessary
  • Diet and exercise management

How can I prevent gestational diabetes?

There are no guarantees when it comes to prevention, but the more healthy habits you can adopt before pregnancy, the better. If you’ve had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes in the future.

  • Eat healthy foods – Choose foods high in fiber and low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition. Watch portion sizes.
  • Keep active – exercising before and during pregnancy can help protect you from developing gestational diabetes. Aim for 30 minutes of moderate activity on most days of the week. Take a brisk daily walk. Ride your bike. Swim laps. Short bursts of activity — such as parking further away from the store when you run errands or taking a short walk break — all add up too.
  • Start pregnancy at a healthy weight – if you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy. Focus on making lasting changes to your eating habits that can help you through pregnancy, such as eating more vegetables and fruits.
  • Don’t gain more weight than recommended – gaining some weight during pregnancy is normal and healthy. But gaining too much weight too quickly can up your risk of gestational diabetes. Ask your doctor what a reasonable amount of weight gain is for you.

Is there anything I should be afraid of?

If gestational diabetes is diagnosed and treated effectively, there is little risk of complications. In such cases, women with gestational diabetes can have healthy babies, and diabetes should disappear after delivery.

However, if it is not treated, effects on the mother and baby can include:

  • Large birth weight -those who weigh 9 pounds or more are more likely to become wedged in the birth canal, have birth injuries or need a cesarean delivery.
  • Premature delivery – an early delivery may be recommended because the baby is large.
  • Respiratory distress syndrome – babies born early to mothers with gestational diabetes may experience Serious breathing difficulties.
  • Low blood sugar –  sometimes babies of mothers with gestational diabetes have low blood sugar (hypoglycemia) shortly after birth. Severe episodes of hypoglycemia may cause seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby’s blood sugar level to normal.
  • Obesity and type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth. Untreated gestational diabetes can result in a baby’s death either before or shortly after birth.

Complications that may affect you

If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older. Testing may be done a few months after the delivery to make sure your blood sugar levels have returned back to normal. Talk to your doctor if you experience symptoms of Type II diabetes.

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Compiled using information from the following sources:

  • Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 52.
  • MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US). Gestational Diabetes.
  • Mayo Clinic, Diseases and Conditions, Diabetes.