Gestational diabetes is glucose intolerance, or high blood sugar, that is first recognized during pregnancy in a woman who was not previously diagnosed with diabetes. It has become much more common in recent years, as approximately 10 percent of women experience gestational diabetes. The condition can cause serious complications, but with the care and attention of our experts at the Center for Diabetes in Pregnancy, the condition can be managed with comprehensive education and medical care before, during and after pregnancy.
If you are diagnosed with gestational diabetes, we'll focus on keeping your blood sugar in a normal range to prevent your baby from growing too large. In some cases, if the baby is very large, a C-section might be necessary to prevent birth injury at the time of delivery. In addition, a large baby is at risk for hypoglycemia (low blood sugar) and other kinds of metabolic disorders after birth.
Frequent ultrasounds and fetal monitoring will help us keep a close eye on your baby's growth and health. If he or she grows too large, the baby may be delivered a week before your due date. If the baby grows at a normal rate, and your blood sugars are well controlled without the need for medication, you can go up to a week past your due date. An individualized delivery plan will be developed for you based on your specific circumstances.
Risk factors for developing gestational diabetes include:
- Previous pregnancy with gestational diabetes
- Belonging to a certain ethnic group:
- Hispanic/Latino American
- Native American
- Asian American
- A family history of diabetes
- Being overweight (BMI of 30 or more)
- Having had a baby who weighed more than nine pounds at birth
- Previous stillbirth or malformation
- Medical conditions associated with diabetes such as polycystic ovary syndrome (PCOS)
If you have gestational diabetes, you may be at risk for:
- Developing type 2 diabetes later in life
- Developing preeclampsia, a condition that could occur after week 20 in pregnancy
- High blood pressure
- Delivery by C-section
Some risks for the baby may include:
- Low blood glucose levels after delivery and other metabolic complications
- Jaundice (yellowing of the skin)
- Respiratory distress syndrome (breathing problems after birth)
- High birth weight leading to physical injuries to your baby during delivery
- A stillbirth (a baby that dies before birth)
- Premature birth
- Increased risk for childhood obesity and diabetes
Usually, there are no symptoms from gestational diabetes, but women with extremely high blood sugar may experience:
- Excessive thirst
- Frequent need to urinate
As part of your prenatal care, you will be tested for gestational diabetes between weeks 24 to 28, which is the time that glucose intolerance usually begins to appear. This includes a glucose screening test where you are asked to consume a sugary drink and wait an hour to see if your blood level is high. If the test is positive, you will be asked to come back after fasting and do a three-hour screening to see if you have gestational diabetes. If you have high risk factors for diabetes, you may be given the glucose test earlier in the pregnancy as well as at the usual time.
Diet and exercise are the primary treatments associated with gestational diabetes. Blood sugar is also usually monitored four times a day, and if that doesn't keep your blood sugar within the normal range, your physician will prescribe medication.
An individualized meal plan where carbohydrates are limited is key to helping maintain normal glucose levels. You’ll be encouraged to eat three meals day and a snack in between. Overall caloric intake will be based on your recommended body weight, and you will be advised to avoid concentrated sweets and incorporate exercise into your daily routine.
- Preconception Counseling for Women with Diabetes — We offer preconception planning, an important step for women who have diabetes or another pre-existing medical condition. Maternal fetal medicine specialists work with obstetricians and other OB/GYN providers to discuss your medical history and recommend proper care before and during pregnancy. You may need to make changes in your medications, insulin or self-care while preparing for pregnancy.
- Pre-existing Diabetes Education and Management Program — This program provides information and care for women who have diabetes before they become pregnant. During pregnancy, the body’s ability to manage blood sugar may change. Physicians can determine whether you may need to adjust your medications or have additional testing. The team also provides information on healthy eating and physical activity.
- Gestational Diabetes Mellitus (GDM) Management Program — This program provides complete care for women who develop gestational diabetes in pregnancy. Specialists help you manage blood sugar levels to ensure that they don’t become too high or too low. The team provides education about blood sugar monitoring, healthy eating and physical activity. They may also recommend oral medications or insulin therapy if needed for good blood sugar control during pregnancy.
- Post Partum Gestational Diabetes Program — This program offers classes on healthy lifestyle choices to help women prevent developing diabetes later in life. Women with gestational diabetes are at a higher risk of developing type 2 diabetes. Educators teach you about healthy diet, physical activity and other important tips to help you and your family prevent diabetes.