Gestational Diabetes

Gestational diabetes develops in pregnancy, and like more traditional types of diabetes will affect how your cells process glucose. Developing a complication during pregnancy can be frightening, but there is good news for those that develop gestational diabetes. This condition can largely be managed with exercise, healthy diet and medication. Your blood sugar will usually return to normal following delivery. However, those that have experienced gestational diabetes may be at a higher risk for developing type 2 diabetes in the future. You will need to work with your health care provider to better manage and monitor your blood sugar in the future.

How to Know if I Have Gestational Diabetes

There are no symptoms to gestational diabetes in most cases. This is why most pregnant women are encouraged to have glucose screenings between 24-28 weeks. If you are at high risk of diabetes or you are showing signs of this condition such as sugar in the urine your doctor may recommend having a glucose screening at your first prenatal visit. You can then repeat the test at 24-28 weeks if your initial tests came back negative.

If you have a positive result on your glucose screening, this does not necessarily mean you have gestational diabetes. This just means that you will need to follow up with a glucose tolerance test (GTT) for more information.

Risk Factors of Gestational Diabetes

There are several factors that can increase the risk of developing gestational diabetes:

• Having sugar in the urine
• Being overweight prior to pregnancy (commonly defined as being 20 percent or more over the ideal body weight for your size)
• Being in a high risk group including Native American, Asian, Hispanic or Black
• A family history of diabetes
• Impaired fasting glucose or glucose tolerance
• Previously giving birth to a stillborn child
• Giving birth to a child over 9 pounds prior to your current pregnancy
• Having an excessive amount of amniotic fluid
• Experiencing gestational diabetes in a previous pregnancy

Many who develop gestational diabetes do not have any known risk factors. Watch a video to learn about gestational diabetes:

Complications of Gestational Diabetes

For the Mother

Those that have gestational diabetes are at a higher risk of developing this condition in future pregnancies or developing type 2 diabetes as they age. Making healthy lifestyle choices, including maintaining a healthy diet and getting plenty of exercise can help to reduce this risk. Working to maintain a healthy body weight after delivery can also help to reduce this risk. During pregnancy, gestational diabetes can increase your risk of high blood pressure, eclampsia or preeclampsia, conditions that cause high blood pressure and symptoms that are dangerous for both mother and the baby.

For the Baby

• Additional glucose in your bloodstream could enter the placenta which could cause your child’s pancreas to produce excess insulin. This can cause your child to grow to be too large, increasing the risk that they will become wedged in the birth canal requiring a C-section and increasing their risk of injury.
• High blood sugar in the mother can also increase the risk of early labor, which can cause the baby to be delivered early. Your doctor may also recommend early delivery if the child is too large. This increases the child’s risk of respiratory distress syndrome which can make it difficult for them to breathe. Your child may require breathing assistance until their lungs are strong enough for them to breathe on their own.
• Some babies may experience jaundice which causes the whites of the eyes and skin to appear yellow. This is caused when the liver is not capable of breaking down bilirubin, a substance that is created when your body breaks down damaged or old red blood cells.
• Babies exposed to gestational diabetes may develop low blood sugar because they have high insulin production. This could cause severe seizures in severe episodes. Prompt feeding or intravenous glucose solutions can help return a child’s insulin levels to the proper rate.
• Children born from mothers with gestational diabetes are also at a higher risk of developing type 2 diabetes later on in life.

What to Do with Gestational Diabetes

Your doctor will check your blood sugar every 6-12 weeks following your delivery to ensure that your glucose levels return to normal. If your tests are normal you will need to be assessed every three years for your diabetes risk. If you appear to be at risk for diabetes, your doctor will discuss a management plan for you.

How to Treat

• Check blood sugar level. While you are pregnant you will need to check your blood sugar around 4-5 times each day, including first thing in the morning and following meals to ensure it is in a healthy range. You will also need to monitor your blood sugar during labor and delivery to ensure your baby’s insulin level does not rise and cause low blood sugar following birth.
• Eat a healthy diet. Eating a healthy diet and avoiding excess weight gain during pregnancy can help to manage gestational diabetes. Focus on a diet of whole grains, fruits and vegetables while avoiding refined carbohydrates and sweets. A dietitian can help you to determine what diet is most appropriate for your unique needs.
• Keep Exercising. Exercise is also important for lowering blood sugar by moving glucose into the cells for use. Exercise also increases insulin sensitivity to ensure that your body is less likely to produce insulin to transport sugar through the body. In some cases exercise may also decrease discomfort during pregnancy and help to prepare you for delivery. Check with your doctor about what level of exercise is appropriate.
• Insulin Injections. If these methods are not sufficient, your doctor may prescribe insulin injections to help manage your blood sugar. Around 10-20 percent of women with this condition will require this treatment or oral blood sugar medication to maintain healthy blood sugar levels.
• Monitor Your Baby. Your baby will need to be monitored closely in order to ensure that they are developing at a healthy rate. If you do not go into labor by your prescribed due date, your doctor may opt to induce to reduce your risk of complications. If you are planning to breastfeed you will need to meet with your doctor to ensure you are not at risk for developing type 2 diabetes or increasing your child’s risk of this condition.

How to Prevent

Those at risk for gestational diabetes can take a few steps before attempting to become pregnant to further reduce their risk. Dropping unhealthy habits can also reduce your risk of developing type 2 diabetes later.

• Start by eating healthy foods that are low calorie and high in fiber such as whole grains, fruits and vegetables. Work to get a variety of foods into your diet to get plenty of nutrients.
• Staying active by getting at least 30 minutes of activities 4 days a week or more can greatly help reduce your risk of gestational diabetes. If you cannot manage a single 30 minute session due to your schedule, plot out smaller amounts of activity you can sprinkle throughout your day. You should be very cautious about losing weight while pregnant, but you can work to lose excess weight beforehand to improve the health of your pregnancy.