What Is Gestational Diabetes and How to Treat It

Gestational diabetes is a condition in which a woman develops high blood sugar during pregnancy. It can affect your pregnancy and the health of your baby, so it requires special care from your healthcare provider both during and after pregnancy. Although your healthcare provider will test for gestational diabetes at your prenatal visits, there are some steps you can take before and during pregnancy to lower the risk, or to control your blood sugar levels. These including eating healthily and exercising regularly. Read on to find out more this condition, what the risk factors are, and how it may affect your pregnancy.

What Is Gestational Diabetes?

Gestational diabetes is a form of diabetes that affects some moms-to-be during pregnancy. Here’s how: Pregnancy hormones make it harder for the body to process sugar (glucose), because they stop insulin from doing its job of keeping blood sugar levels more stable. Usually, the body produces more insulin to counteract this, but, for some pregnant women, not enough extra insulin is produced, resulting in blood sugar levels remaining high. As a result, too much glucose remains in the blood, instead of moving to cells where it’s used up as energy.

This condition usually occurs in the second half of pregnancy, sometimes as early as 20 weeks, but usually later. This is because as the baby grows, the placenta produces more of those hormones that stop insulin from working as it should. A modest spike in blood sugar levels after eating is normal, but if you have gestational diabetes the rise in blood sugar levels can impact the growth and development of your baby.

How Is Gestational Diabetes Diagnosed?

You may not notice any signs or symptoms of gestational diabetes. However, if you have any of the risk factors listed below, your healthcare provider will probably test for gestational diabetes at a prenatal checkup. If you’re at a lower risk of gestational diabetes, your doctor may wait and do a screening test during the second half of your pregnancy, usually between 24 weeks and 28 weeks. If you’re concerned, ask your doctor for advice on what’s right for your situation.

If you have gestational diabetes, your healthcare provider may want you to have more frequent prenatal visits, particularly during the last three months of pregnancy, to check that everything is going well for both you and your baby.

Risk Factors

It’s not known why some women develop this condition, but risk factors for gestational diabetes include if you

• are older than 25

• are physically inactive

• are overweight

• have high blood pressure

• have a history of heart disease

• have polycystic ovarian syndrome (PCOS)

• have prediabetes (a precursor to type 2 diabetes), or a close family member has type 2 diabetes

• had gestational diabetes during a previous pregnancy

• have previously delivered a baby who weighed more than 9 pounds

• have had an unexplained stillbirth in a past pregnancy

• are African American, Hispanic, Native American, a Pacific Islander, or Asian.

Your doctor might be aware that you have some of the risk factors, but make sure you mention whether any of these factors apply to you, either before trying to get pregnant, or at your first prenatal visit.

How Can Gestational Diabetes Affect My Pregnancy and My Baby?

Most moms-to-be with gestational diabetes will go on to have healthy babies. But gestational diabetes needs to be carefully controlled and monitored by your healthcare provider. These are some of the risks of gestational diabetes for your baby’s health:

• Excessive weight gain for your baby. The increased glucose in your blood means more sugar is passed on to your baby, leading to your baby becoming too large. This can cause complications or injuries at birth.

• Increased risk of preterm birth. Although most women with gestational diabetes take the pregnancy to full term, in some cases − due to the bigger size of the baby − the doctor may recommend inducing the birth before the due date.

• Increased risk of respiratory distress syndrome. This condition can make it more difficult for a baby to breathe, and so a baby may need assistance with breathing until his lungs develop.

• Low blood sugar level (hypoglycemia)

• Jaundice

• Developing type 2 diabetes later in life

• Being overweight or obese later in childhood.

Delivery of a large baby may often involve

• Labor difficulties

• Increased chance of cesarean section- this is because the size of the baby can make a vaginal delivery riskier

• Heavy bleeding after delivery

• Tears in the vagina or in the area between the vagina and the anus (perineum) in the case of a vaginal birth.

Gestational diabetes also increases your risk of

• High blood pressure and preeclampsia (a high blood pressure disorder) during pregnancy

• Type 2 diabetes. Blood sugar levels should return to normal soon after giving birth but there is a higher risk of developing type 2 diabetes later in life. Between 15 and 70 percent of women who had gestational diabetes will develop diabetes later in life. The good news is that getting to your ideal body weight after delivery lowers this risk. Of those women with gestational diabetes who lost the excess weight, less than 25 percent went on to develop type 2 diabetes later in life.

Some women may have had a mild form of diabetes before becoming pregnant without realizing it. For these women, diabetes may be a lifelong condition that may not go away after giving birth.

Can Gestational Diabetes When Pregnant Be Prevented or Treated?

There are some practical steps you can take to prevent gestational diabetes. Adopting healthy habits before becoming pregnant may help reduce the risk, but there are no guarantees. If you can, eat healthily, exercise regularly, and lose any excess weight well before you conceive.

If you have been diagnosed with gestational diabetes, here’s what you can do to control blood sugar levels and reduce the chance of complications:

• Follow a healthy diet. Although it’s not recommended that pregnant women lose weight, eating lots of fruit, vegetables, and whole grains may help control gestational diabetes. Eat regular meals throughout the day, but keep an eye on portion sizes. Your healthcare provider may recommend a diet designed to help control gestational diabetes and can give you information on the healthy amount of weight to gain throughout your pregnancy.

• Exercise. Exercise helps lower blood sugar levels and is also good for your general health. Speak to your doctor about what type of exercise is OK for you during pregnancy. Walking or prenatal yogamay be good options. If your healthcare provider gives you the OK, aim for about 30 minutes of moderate exercise a day, five days a week.

• Take medication. About 10 to 20 percent of women with gestational diabetes need insulin (usually in the form of injections) to help control their blood sugar levels. Your doctor will prescribe insulin if this is needed.

During the last three months of pregnancy, your healthcare provider may recommend more regular prenatal checkups and will test your blood sugar levels. In some cases, the healthcare provider may recommend that you check your own blood sugar on a daily basis (possibly even several times a day). If this is the case, your doctor will be able to walk you through exactly how and when to do this.

Your provider will also closely monitor your baby’s health to make sure everything’s progressing well.

Right after you give birth, your healthcare provider will typically check your blood sugar levels, and again 6 to 12 weeks later (sometimes more regularly). Your provider may recommend having your blood sugar levels checked every few years thereafter.

It can be stressful and upsetting to find out you have gestational diabetes, and you probably have many questions. But keep in mind your healthcare team will be able to give you the right medical care to ensure that your pregnancy goes smoothly, and your baby remains healthy.