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Gestational Diabetes Overview

pregnant woman with man's arms around her tummy Gestational diabetes is a possible complication of pregnancy that causes high blood sugar and can lead to problems for the baby. Screening for this condition is typically conducted between 24 and 28 weeks gestation. (Photo: Unsplash, John Looy)

What Is Gestational Diabetes?

Gestational diabetes (also called GDM) is a possible complication of pregnancy. It develops when the mother’s blood sugar level (blood sugar level) goes too high during pregnancy.

According to the National Diabetes Information Clearinghouse, 2% to 10% of pregnant women will develop gestational diabetes. In addition, as many as 400,000 women develop gestational hyperglycemia (high blood sugar), which equals about 10% of expectant mothers.

Healthcare providers (HCPs) consider it standard of care to screen for gestational diabetes between 24 and 28 weeks because unchecked blood sugar levels increased risk of problems for the baby. Hyperglycemia during pregnancy may have many of the same harmful long-term health effects as untreated gestational diabetes.

If you are diagnosed with gestational diabetes, your HCP will work with you to manage your blood sugar levels so that you can have an uneventful pregnancy and protect the health of your baby.

Symptoms of Gestational Diabetes

Since there are few noticeable symptoms, most mothers may not know that they have developed gestational diabetes. This differs from other types of diabetes, such as type 1 type 2 diabetes, which may cause noticeable symptoms, such as increased thirst or frequent urination.

Therefore, it is very important that glucose levels are tested when you are pregnant. Your doctor will test for gestational diabetes sometime between the 24th and 28th week of your pregnancy.

Causes and Risk Factors

Gestational diabetes develops when your body is not able to make enough insulin during pregnancy. Insulin is a hormone necessary to for your body to convert glucose into energy. Without enough insulin, you can build up too much glucose in your blood, leading to a higher-than-normal blood sugar level and perhaps gestational diabetes.

The elevated blood sugar level in gestational diabetes is caused by hormones released by the placenta during pregnancy. The placenta produces a hormone called the human placental lactogen (HPL), also known as human chorionic somatomammotropic (HCS). This hormone is similar to a growth hormone, so it helps the baby grow. However, the hormone also changes the mother’s metabolism and how she processes sugars (carbohydrates) and fats (lipids). HPL raises the mother’s blood sugar level, and is she is not producing enough insulin, the blood sugar level goes up.

At 15 weeks gestation, another hormone increases production: human placental growth hormone. This hormone helps regulate the mother’s blood sugar level, again to make sure that the baby gets enough nutrients. It can, however, cause the blood sugar level in the mother to go too high.

In most women, it is normal for blood sugar levels to go up a bit during pregnancy because of the extra hormones produced by the placenta. However, sometimes, the blood sugar level is too elevated, leading to gestational diabetes.

While it is not completely known why some women develop gestational diabetes, there are several risk factors that increase risk. Those include:

  • Being overweight (have a body mass index—or BMI—above 25)
  • Having a family history of pre-diabetes or diabetes
  • Being African-Americans, Native Americans, Asian Americans, Hispanic people, and Pacific Islanders
  • A previous gestational diabetes diagnosis

 

Gestational Diabetes Treatments

While being diagnosed can be scary, the number one thing all pregnant women ask is what is needed to keep the baby safe. The key recommendations are to maintain blood sugars within a specific range by including physical activity, if allowed, and making meal planning changes..Medications may be needed, but not every woman with gestational diabetes will need it. It is estimated that 70-85% of women can manage GDM with lifestyle modification alone.. It is recommended that all women with GDM receive some diabetes and nutrition education.

Gestational Diabetes Meal Plan

As with all meal planning for diabetes, there is no one size fits all plan that will work for everyone. It is highly recommended that a registered dietitian nutritionist (RDN) meet with you several times in order to individualize a meal plan that works for you and helps to maintain blood sugars before and after meals Consensus recommendations suggest that you meet with a RDN at least three times within a month to finetune the amount of carbohydrate, fat and protein intake to meet blood sugar and weight gain goals. Once you have an individualized plan from a RDN, check out the Diabetic Recipes Center for easy recipes ideas. Since all our recipes include nutritional information, you'll be able to closely watch what you eat and make sure it fits in with your gestational diabetes meal plan.

Exercise When You Have Gestational Diabetes

Physicial activity, or any movement at all, can actually help blood sugar levels AND give you a little more energy during pregnancy. When you work out, your body uses more sugar since our muscles use sugar as its most important fuel. Therefore, exercise can lower your blood sugar level.

Talk to your HCP about the types of activity you can safely do while pregnant. Ideally, we should all aim for at least 30 minutes of physical activity a day—walking, swimming, gardening or even dancing around the house are all great choices.

Medications or Insulin for GDM

If lifestyle changes do not maintain your blood sugar levels, your HCP may recommend medication or insulin to help. As a reassurance: these medications will not hurt the baby. Your HCP will talk to you about what medication may be best for you.

Diabetes During Pregnancy Is Manageable

You have a lot going on during pregnancy anyway, so being told you have gestational diabetes may seem like just another thing to add to the stress.

However, by working closely with your HCP and getting ongoing education, you can better manage your blood sugar levels and protect your baby when you have gestational diabetes.

Delivery When You Have Gestational Diabetes

When you are ready to deliver your baby, the HCP will watch your blood sugar level. If your level goes too high during labor, the baby may release more insulin in response. That increases the risk of the baby developing low blood sugar (hypoglycemia) after birth. If your baby is too large, you may need to have a C-section.

Will Gestational Diabetes Go Away?

Most likely, after you deliver your baby, gestational diabetes should go away. About six weeks after delivery, your doctor will check your blood sugar level to see if it is in the normal range again.

However, because you had gestational diabetes, you are at a higher risk for having it again in another pregnancy as well as developing pre-diabetes or type 2 diabetes. For this reason, it is essential that you are screened every year. To learn how to prevent type 2 diabetes,read our article on prevention.

Updated on: August 14, 2019
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