Gestational Diabetes

Gestational Diabetes

What is gestational diabetes?

Gestational diabetes is a type of diabetes that starts during pregnancy. If you have diabetes, your body isn’t able to use the sugar (glucose) in your blood as well as it should. This causes the level of sugar in your blood to become higher than normal.

Gestational diabetes affects 1% to 3% of all pregnant women. It usually develops in the second trimester (sometimes as early as the 20th week of pregnancy). Most often, gestational diabetes goes away after the baby is born.

How can gestational diabetes affect my baby and me?

High blood sugar levels can be unhealthy for both you and your baby. If the diabetes isn’t treated, your baby may be more likely to have problems at birth. For example, your baby may have a low blood sugar level or jaundice. Or your baby may weigh much more than normal.

Gestational diabetes can also affect your health. For instance, if your baby is very large, you may have a more difficult delivery. You may even need a cesarean section. Gestational diabetes also increases your risk of developing preeclampsia. Preeclampsia is a condition that can be serious if left untreated.

Need a link to a handout on preeclampsia or a better description of what this is.  Otherwise, sounds ominous and scary for a patient reading this

Symptoms of gestational diabetes

Many times, there are no noticeable symptoms for women who have gestational diabetes. This could be because some of the common symptoms of diabetes are also symptoms of pregnancy. These include:

  • frequent urination
  • fatigue (being tired)
  • nausea (feeling sick to your stomach).

Other symptoms can include:

  • unusual thirst
  • blurred vision
  • bladder infections.

What causes gestational diabetes?

Pregnant women sometimes develop gestational diabetes because of pregnancy hormones. These hormones interfere with insulin. They can make your body more resistant to insulin. When this happens, insulin cannot regulate the sugar (glucose) in your blood. So your sugar levels increase.

How is gestational diabetes diagnosed?

As part of you prenatal care, your doctor will recommend screening for gestational diabetes around 24 weeks of pregnancy. But this could happen sooner if there is reason to believe you are at risk for developing gestational diabetes. If you have elevated glucose levels in your urine (checked at each regular prenatal visit) or other risks, your doctor may recommend having the screening sooner.

During the glucose test, you’ll drink a syrupy-sweet bottle of glucose solution. One hour after drinking that, a lab technician will take a sample of your blood. He or she will measure the amount of sugar in your blood.

If your blood sugar is too high, your doctor will likely prescribe another glucose test. For this test, you will need to fast (not eat for 8-14 hours before the test). A lab technician will test your blood sugar while you are fasting. Then, you will again drink the syrupy-sweet bottle of glucose solution. The lab technician will test your blood once an hour for 3 hours.

Can gestational diabetes be prevented or avoided?

Gestational diabetes cannot always be prevented or avoided. According to the National Institutes of Health, you may be more likely to develop gestational diabetes if you:

  • Are older than 25 while you are pregnant.
  • Come from a higher-risk ethnic group, such as Hispanic American, African American, Native American, Southeast Asian, or Pacific Islander.
  • Have a family history of diabetes.
  • Gave birth to a baby that weighed more than 9 pounds or had a birth defect.
  • Have high blood pressure.
  • Have too much amniotic fluid.
  • Have had an unexplained miscarriage or stillbirth.
  • Were overweight before your pregnancy.
  • Gain too much weight during your pregnancy.
  • Have polycystic ovary syndrome (POS).

But there are things you can do to reduce your chances for developing gestational diabetes.

  • If you are overweight, try losing weight before you become pregnant. (Do not try to lose weight if you are already pregnant.)
  • Do not use pregnancy as an excuse to eat sugary foods, such as cakes, candy, and ice cream.
  • Talk to your doctor about safe exercises you can do while pregnant. Getting even a little exercise each day can do a lot to prevent diabetes.

Gestational diabetes treatment

If you are diagnosed with gestational diabetes, lifestyle changes can help you control it. You will need to follow a diet suggested by your doctor, exercise regularly, and have frequent blood tests to check your blood sugar level.

Doing these things may not be enough to keep your blood sugar at a normal level. You may also need to take a medicine to help. There are a number of oral medications that can help control diabetes. Your doctor may prescribe one of these. Or you may need to take insulin injections to lower your blood sugar.

Your doctor may ask you to see a specialist if you have to start taking insulin.

What changes should I make in my diet?

Your doctor may ask you to change some of the foods you eat and see a registered dietitian to help you plan your meals. It’s important to eat well-balanced meals. You may need to eat less at each meal, depending on how much weight you gain during your pregnancy. Your doctor or dietitian will talk to you about this.

Avoid eating foods that contain a lot of simple sugar, such as cake, cookies, candy, or ice cream. Instead, eat foods that contain natural sugars, such as fruits.

If you get hungry between meals, eat foods that are healthy for you, such as raisins, carrot sticks, or a piece of fruit. Whole-grain pasta, whole-grain breads, and rice are also good for both you and your baby.

Why is exercise important?

Your doctor will suggest that you exercise regularly at a level that is safe for you and the baby. Exercise will help keep your blood sugar level normal. It can also make you feel better. Walking is usually the easiest type of exercise when you are pregnant. But swimming or other exercises you enjoy are also beneficial during this time. Ask your doctor to recommend some activities that would be safe for you.

If you’re not used to exercising, begin by exercising for 5 or 10 minutes every day. As you get stronger, you can increase your exercise time to 30 minutes or more per session. The longer you exercise and the more often you exercise, the more in control you will be of your blood sugar.

You do need to be careful about how you exercise. Don’t exercise too hard or get too hot while exercising. Ask your doctor what activities are safe for you. Depending on your age, your pulse shouldn’t go higher than 140 to 160 beats per minute during exercise. If you become dizzy or have back pain or other pain while exercising, stop exercising immediately and call your doctor. If you have uterine contractions (labor pains), vaginal bleeding, or your water breaks, call your doctor right away.

What happens after my baby is born?

You may not need to have blood tests to check your blood sugar while you’re in the hospital after your baby is born. However, it may be several weeks after your baby’s birth before your gestational diabetes goes away. To make sure it has gone away, your doctor will ask you to have a special blood test 1 or 2 months after you have your baby.

Living with gestational diabetes

Gestational diabetes increases your risk for diabetes in your next pregnancy and also later in life. It is important that you continue to exercise, watch your weight, and eat a healthy diet after pregnancy. If you do these things, you may avoid diabetes when you’re older.

Questions to ask your doctor

  • I’m pregnant. Am I at risk for gestational diabetes?
  • Is screening for gestational diabetes a standard part of my prenatal care?
  • What tests do I need?
  • Does gestational diabetes put my baby at risk for any health problems?
  • Can I control gestational diabetes through lifestyle changes alone?
  • What changes should I make to my diet and exercise?
  • Will I need insulin? For how long?
  • What follow-up tests or care will I need after I deliver my baby?