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Gestational Diabetes

This article was originally published by the BabyCenter, L.L.C. a Delaware limited liability company, with its principal offices in San Francisco, California.  To learn more about them and the services they provide please visit http://www.babycenter.com  Prior to publication on its website, the article was approved by the Society for Maternal-Fetal Medicine  No substantive changes have been made to the article posted on our site; however, minor changes have been made in regard to some hyperlinks and the image associated with the post.

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What is gestational diabetes?

Gestational diabetes is the type of diabetes that’s first diagnosed during pregnancy. Like the other types, gestational diabetes causes blood sugar levels to become too high.

When you eat, your digestive system breaks down most of the food into a type of sugar called glucose. The glucose enters your bloodstream so your cells can use the glucose as fuel, with the help of insulin (a hormone made by your pancreas). Insulin helps muscle, fat, and other cells absorb glucose from your blood.

However, if the body doesn’t produce enough insulin, or if the cells have a problem responding to it, too much glucose remains in the blood instead of moving into cells and getting converted to energy.

When you’re pregnant, your body naturally becomes more resistant to insulin so that more glucose is available to nourish your baby. For most moms-to-be, this isn’t a problem: When the body needs additional insulin to process excess glucose in blood, the pancreas just secretes more.

But if the pancreas can’t keep up with the increased demand for insulin during pregnancy, blood glucose levels rise too high because the cells aren’t using the glucose. This results in gestational diabetes.

Gestational diabetes needs to be recognized and treated quickly because it can cause health problems for mother and baby, now and in the future.

Unlike other types of diabetes, gestational diabetes isn’t permanent. Once a baby is born, blood sugar will most likely return to normal quickly. However, having gestational diabetes does make developing diabetes in the future more likely.

Am I at risk of developing gestational diabetes?

Anyone can develop gestational diabetes, and not all women who develop the condition have known risk factors. About 5 to 10 percent of all pregnant women get gestational diabetes. However, you’re more likely to develop gestational diabetes if you:

  • are age 25 or older
  • have a close relative who has diabetes
  • are overweight, especially if your body mass index (BMI) is 30 or higher
  • have polycystic ovarian syndrome (PCOS)
  • have a medical condition that makes diabetes more likely, such as glucose intolerance
  • take certain medications like glucocorticoids (for asthma or an autoimmune disease), beta-blockers (for high blood pressure or a rapid heart rate), or anti-psychotic drugs (for mental health problems)
  • have had gestational diabetes before
  • have had a big baby before (macrosomia)
  • are African American, Native American, Asian American, Hispanic, or Pacific Islander

Unfortunately, there’s no way to guarantee that you won’t get gestational diabetes. But there are ways to lower your risk. Adopting a healthy lifestyle – eating a balanced diet and getting regular exercise – can make it less likely that you’ll develop the condition.

What are the symptoms of gestational diabetes?

Most women who are diagnosed with gestational diabetes don’t have any symptoms. That’s why your healthcare provider will offer you a screening test for gestational diabetes when you’re between 24 and 28 weeks pregnant.

If you have any risk factors for gestational diabetes, your provider may suggest doing the test earlier. Most women who have gestational diabetes find out that they have it after taking this test.

The most common test for gestational diabetes is the oral glucose screening test. This test measures how efficiently your body produces insulin. On the day of the test, your provider will give you a sweet liquid to drink. An hour later, you’ll have a blood test to check your glucose levels.

If your test shows that your blood sugar is too high, you’ll have to take a longer test called the oral glucose tolerance test. For this test, you’ll need to fast before being given a sweet liquid to drink. Your blood will be tested at fasting, then again after one, two, and three hours. If the result of two tests shows your blood sugar is too high, you’ll be diagnosed with gestational diabetes.

Both of these tests are safe for you and your baby and don’t have any major side effects. But drinking the liquid may taste unpleasant and make you feel nauseated afterward.

What’s the treatment for gestational diabetes?

Many women can manage their gestational diabetes by following an exercise plan and eating a balanced, healthy diet based on whole grains, lean proteins, vegetables, and other foods that release sugar slowly. However, about 15 percent of women with gestational diabetes need to take medication to balance their blood sugar (anti-hyperglycemic medication).

Insulin injections are the most common medical treatment for gestational diabetes. If you need insulin, you’ll have up to three injections daily, and your provider will teach you to inject yourself.

Monitoring your own blood sugar is a vital part of your treatment plan. Your provider will show you how to test yourself with a special device. This involves pricking your finger with a small needle first thing in the morning and then again an hour or two after you’ve eaten a meal. Many women find this uncomfortable procedure to be the worst part of the treatment for gestational diabetes.

How does gestational diabetes affect pregnancy?

Most women with gestational diabetes who can keep their glucose levels in check go on to have a successful pregnancy and a healthy baby. But having gestational diabetes makes you and your baby more likely to develop certain complications.

If you have gestational diabetes, you’re more likely to go into labor early (preterm labor). Babies who are born early are more likely to have health problems and may also need extra care after birth. You may also have a higher risk of high blood pressure or preeclampsia. These conditions make preterm labor more likely and can cause health problems for you and your baby.

Babies of women with gestational diabetes are more likely to be bigger than average (macrosomia). Large babies can get stuck in the birth canal while being born (shoulder dystocia), which can injure nerves in the neck and shoulder (brachial plexus injury). Large babies are more likely to be delivered by c-section.

Your baby may also have low blood sugar (hypoglycemia) after birth and trouble breathing (respiratory distress).

How can I have a healthy pregnancy with gestational diabetes?

The most important thing you can do to ensure a healthy pregnancy is follow the treatment plan recommended by your provider. This includes sticking to your meal plan, monitoring your blood sugar, exercising regularly, and going to all your prenatal appointments.

Although a diagnosis of gestational diabetes may make you feel upset and anxious, with the right treatment and careful management, it’s possible to have an uncomplicated pregnancy and healthy baby.

It’s natural to find a diagnosis of gestational diabetes difficult to cope with at first. You may feel deprived when you can’t treat yourself to foods you love. You may also find it hard to motivate yourself to exercise, especially if you’re feeling tired and sluggish.

You’re not alone in struggling with these changes. But by changing your lifestyle and the foods you eat, you’re giving your baby the best chance to have a healthy start in life.

Even if you do find it hard to stick to your treatment plan, it’s important to try your best. Your provider can offer advice and extra support if you’re having a hard time.

When should I call the doctor if I have gestational diabetes?

If you have gestational diabetes, you’ll probably see your healthcare provider frequently. But if you don’t feel well between visits or notice any unusual symptoms, contact your provider right away.

These symptoms could indicate that your blood sugar is too high:

  • feeling very thirsty
  • peeing more often than usual
  • feeling very tired
  • feeling nauseous
  • having blurred vision

Your provider may have you come in for an exam and additional tests to make sure that you and your baby are doing well. If you’re having trouble keeping your blood sugar at a healthy level, your provider can refer you to a specialist.

Visit the Society for Maternal-Fetal Medicine’s website for more information and to find an MFM specialist near you.

  1. Annabelle H.

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