About Gestational Diabetes

Gestational diabetes is a problem of elevated blood sugar that only happens when a woman is pregnant. It develops at around 24 weeks gestation and occurs in between 2-10 percent of pregnant women. Because it is one of the more common disorders of pregnancy, it is one that every pregnant woman should be screened for.

What happens in pregnancy with blood sugar?

Normally, your body breaks down your food into a simple sugar called glucose. The glucose goes into your bloodstream and this triggers insulin, a hormone made by the pancreas, to be released. Insulin helps put glucose into the cells of the body to be used in metabolism and gathering energy.

In gestational diabetes, there are hormonal changes that happen in pregnancy that make the cells less responsive to the effects of insulin. The insulin level goes up in pregnancy to compensate for the less responsive cells but some women cannot keep up with the insulin needed to put the glucose in the cells and the glucose or “blood sugar” level goes up.

Fortunately, the vast majority of women resolve their gestational diabetes after the pregnancy is over with but the medical recommendations are that if you have gestational diabetes, you should be checked every three years after the baby is born because half of all women will get regular diabetes at some point in their later lives.

Are there any symptoms of gestational diabetes?

There are usually no symptoms of gestational diabetes. This is why nearly all pregnant women get screened for the disease at 24-28 weeks gestation. If you have symptoms of the disease such as frequent urination or excessive thirst or if you are otherwise at high risk for the disease because you are obese or are showing sugar in your urine, the screening test may be done earlier than that, perhaps even at your first prenatal visit in your first trimester. If the prenatal screening test is negative in the beginning of the pregnancy in high risk patients, it will be repeated at 24-28 weeks gestation.

What is the test for gestational diabetes like?

At 24-28 weeks gestation, your doctor will ask you to come into the office and drink a 50 gram amount of a sweet drink containing glucose. You will be asked to stay at the doctor’s office for an hour and then they will check your blood sugar. If the number is greater than g/dL, it doesn’t necessarily mean that you have diabetes. It means that you need to have a longer three hour test where you drink a 100 gram load of the same sweet liquid you drank at the screening test but your blood sugar will be checked at least once an hour for three hours in order to determine if you really have gestational diabetes.

How do you know if you are high risk for gestational diabetes?

The following criteria have been set in place by the American Diabetes association that describes those who are high risk for gestational diabetes:

• You’ve had gestational diabetes before
• You have problems with obesity and have a body mass index over 30.
• The lab shows you have sugar in your urine.
• You have several other family members who have or have had diabetes.
• You once had an unexplained stillbirth.
• You have high blood pressure.
• You have previously given birth to a baby that was large, over 4000-4500 kg (about 9 -9.5 pounds)
• You are more than thirty five years old
• You have gained a lot of weight in the first trimester

How is my baby affected by gestational diabetes?

Fortunately, most women with gestational diabetes deliver normal and healthy infants. If the diabetes is unchecked, the baby can be overly large and you may have to have cesarean section as a result. The baby will have too much sugar in his or her own system and at birth, without the high blood sugar conditions of the womb, the blood sugar can plummet to dangerous levels. The baby’s lungs mature more slowly with unchecked gestational diabetes and may have breathing problems as a result. There is a greater risk of stillbirth in women with gestational diabetes.

How is gestational diabetes treated?

Your doctor or a nutritionist will give you a meal plan to follow that will keep your blood sugar low. Moderate exercise is recommended as this, too, can help your blood sugar. In rare cases, a woman may have to be on insulin shots during the last part of the pregnancy. In almost all cases, the problem resolves itself once you deliver.