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What You Need to Know About Gestational Diabetes



Kimberly Morris

MS, RD, LD
Seton Diabetes Education Center

Gestational Diabetes

Gestational Diabetes or diabetes that occurs during pregnancy is a controllable condition that affects 2-5% of pregnant women. If you are woman of childbearing age, you should know: What it is, if you are at risk, and treatment options. You’ll also want to know if there are any possible risks to you or your baby.

What is gestational diabetes?

Gestational diabetes is diabetes that occurs during pregnancy. Diabetes means the body has trouble processing sugar known as glucose. The hormone that processes glucose for energy is called insulin. Glucose can build up in the blood stream because: #1 the body cannot use its own insulin efficiently or #2 the body does not make enough insulin to process glucose. During pregnancy, hormones from the placenta interfere with insulin and affect how it processes glucose. As placental hormones increase during pregnancy, insulin has a harder time processing the glucose. If insulin cannot keep up, the glucose builds up beyond normal levels in the blood leading to gestational diabetes.

How do you know if you are at risk?

You are at risk for developing gestational diabetes if you are overweight or obese prior to becoming pregnant, 25 years or older when you conceive, have had gestational diabetes with a previous pregnancy, and/or are of Hispanic, African, Native American, South or East Asian, or Pacific Islander decent as these ethnic groups commonly carry the gene for diabetes. Your doctor will assess your risk factors and determine when to check for gestational diabetes during your pregnancy. Women with risk factors might be tested earlier in their pregnancy. Women without risk factors might not be tested at all. Most women are usually tested at 24-28 weeks gestation when the placental hormones are increasing.

How do you control it if you have it?

If you find out you have gestational diabetes, it is important to work with your health care provider to keep your blood sugar levels normal. All women with gestational diabetes need to follow a healthy eating plan to help stabilize blood sugars. Your doctor may provide you with some diet guidelines and/or refer you to a dietitian who can help you with a meal plan specifically designed for you. Your doctor may also recommend some physical activity unless this is not safe due to bed rest or another condition during pregnancy. It is very important to talk with your doctor before starting any type of physical activity to make sure it’s safe. Your doctor will most likely have you test your blood sugar several times a day. Testing your blood sugar will help you and your doctor to see if your treatment plan is working or if additional steps are needed to keep the blood sugar levels normal. Some women need medication in addition to the meal plan and physical activity. Your treatment plan should be individualized to promote the best outcome for you and your baby.

Are there any risks to the baby?

It is important for your baby to get the right amount of glucose. A baby that receives too much glucose will grow too large, too quickly. Having a large baby is one of the main concerns with gestational diabetes as this can make the labor and delivery process more difficult for both the mother and the baby. A large baby runs the risk of being injured if delivered through the birth canal. Therefore, having a large baby increases your chance of needing a cesarean section delivery. Also, a woman with uncontrolled blood sugars during pregnancy can have a baby born with twice as much body fat. Too much body fat at birth can lead to future weight problems and increase their chances of developing diabetes later in life. Another major concern is respiratory distress. The baby’s lungs are the last organs to develop, so if it’s necessary to have your baby delivered early, their lungs might not be fully ready to do their job. Your baby’s blood sugar will be tested after delivery as he or she run the risk of low blood sugar. Low blood sugar can occur because the baby was just separated from the placenta, which was very recently supplying them with abundant amounts of sugar. There are other conditions that could arise during and after delivery so it’s important to discuss these risks with your doctor.

With the right tools and knowledge, gestational diabetes can be controlled. Controlling blood sugar levels during pregnancy can help reduce the risk of possible complications for you and your baby. It is important to know if you are at risk or if you develop gestational diabetes so that you can receive proper treatment from your healthcare team. You may have several different members on your team, including your doctor, nurse, a certified diabetes educator and registered dietitian. But you are always the key member of the team. Whether it’s gestational diabetes or another condition during your pregnancy, it’s important to get the help you need to have a healthy and happy baby.

References:

Thomas AM, Gutierrez YM. American Dietetic Association Guide to Gestational Diabetes Mellitus. 2005; 3:19 & 4:29-31.
U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Child and Health and Human Development. Managing Gestational Diabetes: A Patient’s Guide to a Healthy Pregnancy. July 2004; 1-9.