What is Gestational Diabetes?
Diabetes is a disease that occurs when there are consistently high levels of sugar, or glucose, in the bloodstream.
Read more about diabetes.
Gestational Diabetes is diabetes that occurs during pregnancy. Gestational Diabetes affects women who have never been diagnosed with non-gestational diabetes before, but who are found to have high glucose levels after becoming pregnant.
Read more about high risk pregnancy.
Gestational diabetes occurs in approximately 18% of all pregnancies.
Causes of Gestational Diabetes:
Insulin is a hormone produced by the pancreas that helps cells in the body remove glucose from the blood. The glucose is then converted into energy.
During pregnancy, the placenta provides the baby with nourishment, and it can trigger the release of hormones that help the baby to grow. Hormones released by the placenta during pregnancy can block insulin from regulating blood glucose levels properly, creating what is called "insulin resistance."
Expectant mothers can require up to three times the normal amount of insulin; if the necessary levels of insulin aren't maintained, then glucose will build up in the bloodstream, causing hyperglycemia and, consequently, diabetes.
Gestational diabetes typically occurs later in the pregnancy, after the baby is fully-formed but still growing rapidly. High glucose levels can transfer from the placenta into the fetus, causing macrosomia (also known as a "fat" baby). Gestational Diabetes can cause problems during birth, can cause hypoglycemia (low blood sugar) in the baby after delivery, and can cause obesity and Type 2 diabetes later in the child's life.
After childbirth, the mother's blood sugar levels generally return to normal, but having gestational diabetes increases the risk for future development for Type 2 diabetes in the future (usually within 5-10 years of the pregnancy).
The mother is also likely to have recurring gestational diabetes during subsequent pregnancies.
Risks for Developing Gestational Diabetes:
It's always recommended to start prenatal care as early in the pregnancy as possible. Prenatal screenings for gestational diabetes may be performed 24-28 weeks into the pregnancy.
If it is determined that the mother is at risk for Gestational Diabetes, then the OB-GYN will suggest appropriate measures to minimize the impact of Gestational Diabetes on both the mother and the growing fetus.
Individuals with the following conditions may be at a higher risk for developing gestational diabetes:
- Overweight or obese prior to pregnancy
- High blood pressure
- A family history of diabetes
- Maternal age greater than twenty-five
- Already gave birth to a baby bigger than nine pounds or a baby who was born with a birth defect
- Abnormally high levels of amniotic fluid
- Experienced an unexplained miscarriage or stillbirth in the past
- Non-Caucasian race
For mothers who are attempting to conceive or plan on conceiving in the future, losing weight and reducing one's body mass index, or BMI, can help to decrease the risk of gestational diabetes.
Symptoms of Gestational Diabetes:
Women with gestational diabetes do not tend to exhibit symptoms. Symptoms that are observable are generally not life-threatening, and glucose levels quickly normalize post-pregnancy.
Possible symptoms are as follows:
- Infections (bladder, vagina, and skin)
- Blurry vision
- Nausea and/or vomiting
- Increased appetite with inexplicable weight loss
If you are experiencing any of these symptoms, it is advisable to consult with your doctor.
Diagnosis of Gestational Diabetes:
Regular consultations with the OB-GYN will help to determine if the mother is at risk for developing gestational diabetes, which can occur about halfway through the pregnancy. An oral glucose tolerance test can be performed near the end of the second trimester.
Other glucose monitoring tests can be performed, which may include drinking a syrup-like glucose solution. Afterwards, blood sugar levels will be monitored to observe how well the glucose is absorbed into and out of the bloodstream. The mother may also be asked to fast so blood sugar levels can be monitored to determine the baseline glucose level when minimal food is ingested.
Treatment for Gestational Diabetes
Treatment for gestational diabetes includes frequent monitoring to ensure that normal glucose levels are maintained throughout the pregnancy. The expectant mother can monitor blood sugar levels herself with an in-home machine, and the doctor will conduct fetal monitoring as well to make sure the baby is healthy.
Other tests can include:
- Non-stress tests (a comparison of fetal heart rate to level of fetal movement)
- Biophysical profile, or BPP (combined non-stress test and ultrasound)
Maintaining a healthy diet is the best way to manage gestational diabetes. If you are found to have gestational diabetes, you should consult with your doctor to determine the best diet for you.
The following food regimen is most often recommended:
- Minimal intake of high sugar foods and drinks (like soft drinks, fruit juice, candy, and confections)
- Fruits and vegetables
- Controlled carbohydrate intake
- Minimal fat intake
- Moderated protein intake
- Controlled calorie intake (a pregnant woman only needs 300 more calories per day than when not pregnant)
- 3 moderate-sized meals per day, in addition to 1-2 snacks (do not skip any meals or snacks)
- Prenatal vitamins
Regular exercise helps the body to naturally burn glucose without requiring additional insulin. While an intense or excessive exercise regimen is not recommended during pregnancy, but moderate exercise can be very beneficial. Consult with your doctor to determine the right amount of exercise for you.
Glucose levels are usually controllable via the above-mentioned diet and exercise measures; however, if blood sugar is still high, medication or insulin therapy may be required.
Additional Resources For Gestational Diabetes:
American Diabetes Organization - This site provides information on gestational diabetes and treatment, links to message boards, and educational videos.
Diabetic Mommy provides nutrition information and tips for expectant mothers with gestational diabetes.
Gestational Diabetes Recipes - A fun site with great recipes and meal ideas of expectant mothers with gestational diabetes.