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Pregnancy Problems

Gestational Diabetes

Every mom-to-be gets tested for gestational diabetes — could you be at risk? And if you do have it, how can you keep you and baby healthy? We've got answers.

What is gestational diabetes?

Some women develop diabetes only during pregnancy; it’s called gestational diabetes. Gestational diabetes is defined as glucose intolerance that is first diagnosed in pregnancy, and it occurs when pregnancy hormones affect how the body makes or uses insulin, which is a hormone that converts sugar in food into energy the body uses.
If your body doesn't make enough insulin or if it doesn't use the insulin appropriately, the level of sugar in the blood rises to an unacceptable level. This is called hyperglycemia and means you have too much sugar in your blood. Occasionally, hormones made by the placenta can also hamper the actions of insulin, and gestational diabetes can occur. Several other factors can affect your glucose levels, including stress, the time of day (glucose values are often higher in the morning), the amount of exercise you do and the amount of carbohydrates in your diet.

What are the signs of gestational diabetes?

Symptoms of gestational diabetes include the following:
[   ] Blurred vision
[   ] Tingling or numbness in the hands and/or feet
[   ] Excessive thirst
[   ] Frequent urination
[   ] Sores that heal slowly
[   ] Excess fatigue

Are there any tests for gestational diabetes?

Yup! The glucose challenge screening test and glucose tolerance test involve testing your blood-glucose levels after you drink a sweet drink to see how well your body processes the sugar.

How common is gestational diabetes?

Gestational diabetes affects about 10 percent of all pregnancies. After pregnancy is over, nearly all women who experience this problem return to normal, and the problem disappears. However, if gestational diabetes occurs with one pregnancy, there’s almost a 90 percent chance it will recur in subsequent pregnancies. In addition, studies show that 20 to 50 percent of those women who develop gestational diabetes may develop type 2 diabetes within 10 years.

How did I get gestational diabetes?
Gestational diabetes occurs for two reasons. One is the mother's body produces less insulin during pregnancy. The second is the mother's body can't use insulin effectively. Both situations result in high blood-sugar levels. Risk factors for developing gestational diabetes include:

[   ] Over 30 years old
[   ] Obesity
[   ] Family history of diabetes
[   ] Gestational diabetes in previous pregnancy
[   ] Previously gave birth to a baby who weighed over 9.5 pounds
[   ] Previously had a stillborn baby
[   ] Black/African-American, Latina/Hispanic, Asian, Native American/Pacific Islander

A woman's weight when she was born may also be an indicator of her chances of developing gestational diabetes. One study showed that women who were in the bottom 10th percentile of weight when they were born were three to four times more likely to develop gestational diabetes during pregnancy.

How will my gestational diabetes affect my baby?
If left untreated, gestational diabetes can be serious health concern for you and your baby. You’ll both be exposed to a high concentration of sugar, which isn’t healthy for either of you. You might experience polyhydramnios (excessive amounts of amniotic fluid). This may cause premature labor if the uterus becomes overdistended.

A woman with gestational diabetes may have a long labor because the excess sugar can cause baby to become quite large. Sometimes a baby can’t fit through the birth canal, and a cesarean delivery is required.

If your blood-sugar levels are high, you may experience more infections during pregnancy. The most common infections include those in the kidneys, bladder, cervix and uterus.

What’s the best way to treat gestational diabetes?

Good control of gestational diabetes is important during pregnancy. Treatment of gestational diabetes includes regular exercise and increased fluid intake. Diet is essential in handling this problem. Your doctor will probably recommend a six-meal, 2,000- to 2,500-calorie-per-day eating plan. You may also be referred to a dietitian. Research shows that women who receive dietary counseling, blood-sugar monitoring and insulin therapy (when needed) do better during pregnancy than women who receive routine care. Many experts believe that glyburide, an oral hypoglycemic agent used to treat type 2 diabetes, is a good alternative to insulin, and just as effective, in treating women with gestational diabetes.

In a 2014 study, researchers at the Division of Research at Kaiser Permanente Northern California found that women with a history of gestational diabetes were at higher risk of developing early heart disease after pregnancy. So speak to your doctor about how your condition may affect your future health, and what lifestyle and treatment choices you should be making longterm.

What can I do to prevent gestational diabetes?

Maybe nothing. It’s unknown exactly what causes gestational diabetes, but it might be a result of hormones blocking the insulin in your body. Maintaining a healthy weight before your pregnancy can help lower your risk.

What do other pregnant moms do when they have gestational diabetes?

“I had [GD] with my first, who was 6 pounds, 12 ounces, at birth, and now I have it again with my second. I was terrified the first time around. If you eat healthy and keep your blood-glucose levels where they need to be, you and your baby should be fine.”

“The worst part is remembering to prick your finger after you eat...and when you get major cravings, you can’t indulge. But you can still snack healthily — PB&J and peanut butter and apples became staples for me!”

“I thought the diagnosis was going to stop me from having the type of birth experience I wanted, but it didn’t. I was able to have a natural birth.”

Are there any other resources for gestational diabetes?

American Diabetes Association

Plus, more from The Bump:

Prenatal Tests and Checkups

Glucose Tolerance Test

Nutrition During Pregnancy

Some info from Your Pregnancy Week By Week, 6th edition, by Glade Curtis, MD, and Judith Schuler, MS. Reprinted by arrangement with Da Capo Lifelong, a member of the Perseus Books Group. Copyright © 2007.

By The Bump Editors