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Gestational Diabetes Overview

What Is Gestational Diabetes?

Gestational diabetes is a possible complication of pregnancy. It develops when the mother’s blood glucose 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. 

Doctors are vigilant about checking for gestational diabetes—because unchecked blood glucose levels can cause problems for the baby. Hyperglycemia during pregnancy may have many of the same harmful long-term health effects as full-blown gestational diabetes.

If you’ve diagnosed with gestational diabetes, your doctor will work with you to control your blood glucose levels so that you can have a uneventful pregnancy and protect the health of your baby.

Symptoms of Gestational Diabetes

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

Therefore, it is very important to be tested for a high blood glucose level 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 glucose level and perhaps gestational diabetes.

The elevated blood glucose 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 glucose level, and is she is not producing enough insulin, the blood glucose level goes up.

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

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

Most doctors still do not know why some women develop gestational diabetes, although there are several risk factors that make it more likely that you will develop it:

  • Are overweight  (have a body mass index—or BMI—above 25)
  • Have a family history of type 1 or type 2 diabetes
  • Have pre-diabetes, that is when your blood glucose levels are elevated, but they are not high enough to be considered diabetes.
  • Are African-Americans, Native Americans, Asian Americans, Hispanic people, and Pacific Islanders
  • Have had gestational diabetes before

Gestational Diabetes Treatments

We’re sure if you’ve been diagnosed with gestational diabetes, you want to know one thing:  how to keep this from affecting your baby.  You can treat gestational diabetes by controlling your blood glucose level so that it doesn’t go too high.

There are a variety of ways to try to control your blood glucose level while you’re pregnant.  You can eat well (and watch what you eat closely) and exercise—all according to your doctor’s instructions.  You may also take insulin or medications, but not every woman with gestational diabetes will need insulin or a medication.

Gestational Diabetes Meal Plan (Gestational Diabetes Diet)
There isn’t a “gestational diabetes diet” exactly, but there are ways to eat healthier so that you take care of your blood glucose levels and of your baby.

A registered dietitian (RD) or certified diabetes educator (CDE) can work with you to develop a meal plan.  This will be personalized; it will take into account your health, level of physical activity, and likes and dislikes.

It’s important to follow your meal plan precisely; when you eat and how much you eat at each meal affects your blood glucose levels.

You can visit our Diabetic Recipes Center for ideas of what to eat.  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
It may not sound like much fun when you’re pregnant, but exercising can help control your blood glucose levels.  When you work out, your body uses more glucose (makes sense since glucose is what we use for energy and you need more energy during exercise).  Therefore, exercise can lower your blood glucose level.

Talk to your doctor about what kinds of exercises you can do while you’re pregnant.  It’s a good idea to aim for 30 minutes of physical activity a day—be it walking, swimming, gardening, anything where you’re out moving.

Medications or Insulin for Type 2 Diabetes
If eating well and exercising aren’t working to control your blood glucose levels, your doctor may recommend medication or insulin to help.  As a reassurance:  these medications will not hurt the baby.

The doctor will talk to you about what medication he or she suggest and all the details of using it.

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 doctor, you can better manage your blood glucose 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 doctor will watch your blood glucose 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 glucose (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 glucose level to see if it is in the normal range again.

However, because you had gestational diabetes, you are at a higher risk (a 33% to 50% increased risk) for having it again in another pregnancy. You are also at a higher risk (35% to 60%) for developing type 2 diabetes in the next 10 to 20 years.1 To learn how to prevent type 2 diabetes, read our article on prevention.

Updated on: February 4, 2015
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