Diabetes during Pregnancy: Gestational Diabetes

1. What is gestational diabetes?

Gestational diabetes is diabetes that develops in women for the first time during pregnancy. Some women found to have gestational diabetes actually may have had diabetes before pregnancy that was not diagnosed.

2. What causes gestational diabetes?

Gestational diabetes is caused by a change in the way a woman’s body responds to insulin during pregnancy. Insulin is a hormone which moves glucose out of the blood and into the body’s cells where it can be turned into energy. During pregnancy, a woman’s cells naturally become slightly more resistant to insulin’s effects. This change is designed to increase the mother’s blood glucose level to make more nutrients available to the baby. The mother’s body makes more insulin to keep the blood glucose level normal. In a small number of women, even this increase is not enough to keep their blood glucose levels in the normal range. As a result, they develop gestational diabetes.

3. What are the symptoms of gestational diabetes?

Because gestational diabetes in most cases does not cause symptoms, you need to be tested for the condition. All pregnant women are screened for gestational diabetes. You may be asked about your medical history and risk factors or you may have a blood test to measure the level of glucose in your blood. This test usually is done between 24 weeks and 28 weeks of pregnancy. It may be done earlier if you have risk factors.

4. If I develop gestational diabetes, will I always have diabetes mellitus?

For most women, gestational diabetes goes away after childbirth. However, they remain at much high risk of having diabetes later in life. For women who had diabetes before pregnancy, it is a lifelong condition in most.

5. Who is at risk of gestational diabetes?

Gestational diabetes is more likely in women who

· are older than 25 years

· are overweight

· have had gestational diabetes in previous pregnancies

· have had a large size baby previously (birth weight more than 3.5 kg)

· have family history of diabetes

· have had a stillbirth in a previous pregnancy

· are African American, American Indian, Asian American, Hispanic, Latina, or Pacific Islander

6. Can gestational diabetes be prevented?

You may be able to lower your chance of getting gestational diabetes by staying at a healthy weight and not gaining too much weight during pregnancy. Regular exercise can also help keep your blood sugar level within a target range and prevent gestational diabetes.

7. How can gestational diabetes affect pregnancy?

Gestational diabetes increases the risk of having a large size baby (a condition called macrosomia) and possible caesarean birth. High blood pressure and preeclampsia are more common in women with gestational diabetes.

8. What are the risks to babies born to mothers with gestational diabetes?

Babies born to mothers with gestational diabetes may have problems with breathing, low glucose levels, and jaundice. With proper prenatal care and careful control of glucose levels, the risk of these problems decreases.

9. What are the long-term effects of gestational diabetes for both mothers and babies?

Women who have had gestational diabetes are at higher risk of having diabetes in the future, as are their children. Women with gestational diabetes will need to have regular diabetes testing after pregnancy. Their children also will need to be monitored for diabetes risks in future.

10. If I have gestational diabetes, how can I control it?

If you have gestational diabetes, you will need to keep your blood glucose level under control. Controlling your blood glucose level may require daily tracking of your glucose level, eating healthy foods, exercising regularly, and sometimes, taking medications.

11. If I have gestational diabetes, will I have to take medication?

Gestational diabetes often can be controlled with diet and exercise. If diet and exercise are not enough, medication may be needed to control your blood glucose level. Some women may take oral medications; others may need insulin.

12. Will gestational diabetes affect the delivery of my baby?

Most women with gestational diabetes are able to have a vaginal birth but are more likely to have a caesarean delivery than women without diabetes to prevent delivery problems. Labor also may be induced (started by drugs or other means) earlier than the due date.

13. If I had gestational diabetes, is there anything I should do after my pregnancy?

You should have a test for diabetes 6–12 weeks after you give birth. If your postpartum glucose test result is normal, you need to be tested for diabetes every 3 years. Your child also should be checked throughout childhood for risk factors for diabetes, such as obesity.