What is Gestational Diabetes?

This is a type of diabetes that happens only during pregnancy. Gestational diabetes affects about 2-5% of all pregnancies. This occurs when your body is unable to make and use all of the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood to be used for energy. This leads to hyperglycemia (high blood sugar).

Am I At Risk for Developing Gestational Diabetes?

According to the American Diabetes Association, you are considered at high risk for this condition if:

You’re obese (BMI>30)
You have had gestational diabetes in a previous pregnancy
You have a family history of diabetes
You have previously given birth to a large baby (>9 lbs)
You have had an unexplained stillbirth

How Does Gestational Diabetes Affect My Baby?

Gestational diabetes occurs later in the pregnancy, after the baby’s body is formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects seen in women with preexisting diabetes. These days, most women with gestational diabetes go on to have healthy babies. However, if this condition goes untreated or is poorly controlled, it can have serious consequences.

The extra glucose in your blood goes through the placenta to the baby, giving the baby high glucose levels. This causes the baby to produce more insulin to get rid of the glucose. Since the baby is getting more energy than it needs, it is stored as fat. This can lead to macrosomia. A macrosomic baby has a larger than normal head and/or shoulders, which can make it difficult for the baby’s head to enter the birth canal. Sometimes, the baby’s head may enter the birth canal and the shoulders get stuck. This is called shoulder dystocia. Shoulder dystocia can result in a large episiotomy for the mother and fractured bones and/or damaged nerves in the baby. Because of these risks, if your doctor suspects your baby may be overly large, he/she may recommend delivery by cesarean section.

Newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. These babies are also at greater risk of becoming obese and developing type 2 diabetes later in life.

How is Gestational Diabetes Treated?

Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don’t have gestational diabetes. Listed below is some of the most common ways to control your blood sugar:

Eat Right: You will be sent to a nutrition counselor, who will determine a target caloric intake. You will most likely have to eat three meals and several snacks per day. Portion control is very important. You will need to avoid foods that are high in sugar and/or fat. Never skip meals.
Exercise: Your body uses more glucose when you exercise. Many women benefit from 30 minutes of aerobic exercise, such as walking or swimming, each day.
Check Your Blood Sugar: You will be taught how to check your blood sugar and how often. In some cases, you may be instructed to go to the lab to get your blood sugar checked.
Take Your Medication: If you are not able to control your blood sugar well enough through diet and exercise alone, your doctor will prescribe medication or insulin shots.

Will I Have Additional Testing During My Pregnancy?

If you have gestational diabetes, you will most likely have to start antenatal testing at 32 weeks. This includes non-stress tests, biophysical profiles, and additional ultrasound exams to monitor growth and determine the size of your baby. You may also be instructed in the use of fetal kick counts.

Will I Have Diabetes After My Baby is Born?

Most women with gestational diabetes don’t remain diabetic once the baby is born. Once you’ve had it, though, your chances are 2 in 3 that it will return in future pregnancies. You are also at higher risk of becoming diabetic later in life. Certain basic lifestyle changes may help prevent you from developing Type 2 diabetes.