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Gestational Diabetes

What is gestational diabetes?

Diabetes is a medical condition that causes high blood glucose (blood sugar). When there is too much sugar in the blood, it can cause health problems. Insulin is a hormone that helps the body regulate glucose levels in the blood. When there isn’t enough insulin or the body can’t use it properly, blood sugar levels can get too high.

Diabetes that develops during pregnancy is called gestational diabetes. It can cause health problems for both the mother and her developing baby during the pregnancy, and it may cause problems after birth. For example, when a mother’s blood sugar levels are too high, the baby's development may be delayed. The baby could also grow very large, which may make a C-section delivery necessary.

All pregnant women will be tested for gestational diabetes at some point during the pregnancy. If mothers have risk factors, like age or weight problems, being pregnant with multiples, significant family history of diabetes or having gestational diabetes in a previous pregnancy, they may be tested earlier and more often than women without additional risk factors.

Diagnosing gestational diabetes

All pregnant women will be screened for gestational diabetes. Most health care providers recommend a glucose screening test between the 24th and 28th weeks of pregnancy. When women have risk factors for gestational diabetes, the test may be done in the first trimester.

If this test shows an increased blood sugar level, a three-hour glucose tolerance test may be done after a few days of following a special diet. If results of the second test are in the abnormal range, gestational diabetes is diagnosed. Once diagnosed, your doctor will likely recommend counseling that shows you how to eat properly and test your own blood sugar up to four times each day. You may also require additional testing such as non-stress tests (NST) at 32 weeks and a growth ultrasound at 35 to 36 weeks to determine the size of your baby.

What causes gestational diabetes?

Gestational diabetes occurs when a pregnant woman’s body stops responding to insulin the way it needs to in order to keep blood sugar levels in check. Unlike other types of diabetes, gestational diabetes occurs when hormones in the body block the insulin produced by the body so it can’t break down blood sugar. When the insulin can’t do its job, blood sugar levels can rise and cause symptoms of diabetes. This process usually begins between the 24th and 28th weeks of pregnancy, but it can happen earlier and later.

Risks for developing gestational diabetes

Any pregnant woman may develop gestational diabetes, regardless of her weight, overall health, diet, and family history. However, there are some factors that may increase a woman’s risk. For example:

  • having a significant family history of diabetes
  • having had gestational diabetes in a prior pregnancy
  • being overweight

Treatment for gestational diabetes

The goal of gestational diabetes treatment is to keep blood glucose levels in the normal range. Treatment typically starts with the proper diet – if blood glucose levels can be kept in the normal range, medication may not be necessary. However, some women may need medication or insulin injections.

Possible gestational diabetes complications for your baby

The complications of gestational diabetes are usually manageable and preventable. The key to prevention is careful control of blood sugar levels as soon as the diagnosis of gestational diabetes is made.

The major problems of gestational diabetes include the following:

  • macrosomia, which refers to a baby that is considerably larger than normal
  • increased amniotic fluid
  • preeclampsia
  • still birth

Possible long-term effects of gestational diabetes

Although gestational diabetes usually goes away after the baby is delivered, it can lead to diabetes in the future. If you have gestational diabetes, you and your baby will both be at risk for diabetes in the future. Because of that risk, you and your baby will have to be tested regularly. You will need to have a post-partum blood sugar test between six and 12 weeks after delivery. If that test is normal, you should be screened every three years.

Your child should be checked for diabetes and monitored for risk factors of diabetes, such as obesity. You should let your child’s doctor know that you had gestational diabetes so the doctor will know to keep an eye out for signs and symptoms of diabetes in the future.