Gestational Diabetes

What is gestational diabetes?

Gestational diabetes is a type of diabetes, or high blood sugar, that only pregnant women get. In fact, the work gestational means pregnant. If a woman gets high blood sugar when she is pregnant, but she never had high blood sugar before, she has gestational diabetes. Nearly 200,000 pregnant women get the condition each year, making it one of the top health concerns related to pregnancy. If not treated, gestational diabetes can cause problems for the mothers and the babies. Some of these problems can be serious.

There is some encouraging news:

Most of the time, gestational diabetes goes away after the baby is born. The changes in your body that cause gestational diabetes normally occur only when you are pregnant. After the baby is born, your body goes back to normal and the condition goes away.
Gestational diabetes is treatable, especially if you find out about it early in your pregnancy. The best way to control gestational diabetes is to have it diagnosed early in your pregnancy and start treatment right away.
Treating the gestational diabetes greatly lowers the baby’s chances of having related problems.

Should I get tested for gestational diabetes?

If you are at high risk your physician will test you as soon as you know you are pregnant. If the first test is negative, you will likely get tested again when you are between 24 and 28 weeks along.

If you are average risk, a test may be given at 24 to 28 weeks.

If you are low risk, you will probably not be tested at all unless you start to display some symptoms.

Keep in mind that every pregnancy can be different. Even if you didn’t have gestational diabetes in a previous pregnancy, you might get it in a following pregnancy. Or, if you have it before, you may not get it during the following pregnancies. Follow your physician’s advice about getting tested.

What does gestational diabetes testing involve?

Health care providers may use one of two approaches for testing for gestational diabetes.

One step approach: After fasting (not eating or drinking anything except water) for 4 to 8 hours, a woman’s blood sugar level is measured (by a draw of blood) before and 2 hours after drinking a measured amount of a syrupy drink. This type of test is called an oral glucose tolerance test.
Two step approach: A measure of a woman’s blood sugar is taken (through a blood draw) 1 hour after she drinks a measured amount of a syrupy drink. Women whose blood sugar level is normal after 1 hour probably do not have gestational diabetes. Those whose blood sugar level is high after 1 hour then get an oral glucose tolerance test to see if they have the diabetes.

What if I don’t get treated?

Most women with gestational diabetes have healthy pregnancies and healthy babies because they controlled their condition. Without treatment, women are at risk for high blood pressure, preeclampsia (a sudden and dangerous increase in blood pressure), and fetal death during the last 4 to 8 weeks of pregnancy. Women with untreated gestational diabetes usually have very high birth weight babies which can increase the risk of infection and prolong recovery time.

As babies, children whose mothers had gestational diabetes are at higher risk for breathing problems. As they get older, these children are at higher risk for obesity, abnormal glucose tolerance, and diabetes.

Untreated women and their babies also have a higher lifetime risk for type 2 diabetes. It may be possible to prevent type 2 diabetes through lifestyle changes, mainly dietary. Always talk to your physician about any concerns and questions you may have.

Causes of Gestational Diabetes

Usually your body breaks down much of the food you eat into a type of sugar called glucose. Because glucose moves from the stomach into the blood, sometimes the term blood sugar is used instead of glucose. Your body makes a hormone called insulin that moves glucose out of the blood and into the cells of the body. In women with gestational diabetes, the glucose cannot get into the cells, so the amount of glucose in the blood rises higher and higher. This is called high blood sugar or diabetes.

Will the baby be affected?

Most women who have gestational diabetes give birth to healthy babies, especially when they control their blood sugar, eat healthy, exercise and control their weight. In some cases however, gestational diabetes can affect the pregnancy and the baby. Some potential risks include:

Macrosomia – The baby’s body is larger than normal. In this case, a c-section may be called for.
Hypoglycemia – The baby’s blood sugar is too low. Breasting feeding can help, but if not, tube feeding glucose into the baby’s blood may be needed.
Jaundice – This is an increase of bilirubin in the blood. The condition is easily treated.
Respiratory Distress Syndrome – The baby may have trouble breathing and require oxygen or other help.
The baby may have low minerals in the blood. This can cause muscle twitching or cramping. It can be treated by giving the baby extra minerals.

What is the treatment for gestational diabetes?

Following a treatment plan laid out by your physician can nearly assure a healthy pregnancy and a healthy baby. Here are some general ways to stay healthy with gestational diabetes:

Know your blood sugar level and keep it under control
Eat a healthy diet
Do regular, moderate exercise
Keep a healthy weight
Keep daily records to help track how well treatment is working

In some instances, the mother will need to take insulin to help manage the gestational diabetes. The extra insulin can help lower the blood sugar level. In some cases, the woman may have to test their urine to see if they are getting enough glucose.

What happens after birth?

For most women, blood sugar levels return to normal after the baby is born. Six weeks after giving birth, you should have a blood test to access where your blood sugar has leveled. The test also assesses your risk of getting diabetes in the future. If you know you plan on getting pregnant again, have a blood sugar test up to 3 months before becoming pregnant to make sure your blood sugar level is normal.