Most women who develop gestational diabetes have normal blood sugar levels before pregnancy. They may not have any symptoms, and their condition is only discovered when they have a routine blood test during pregnancy (usually between weeks 24 to 28). About 50% of women who have gestational diabetes go on to develop type 2 diabetes. This article gives you a complete overview of gestational diabetes.
Healthy eating and moderate exercise are essential to preventing gestational diabetes.
What is Gestational Diabetes?
Gestational diabetes (GD) develops in pregnancy when blood sugar levels are higher than normal. GD can affect between 2% and 10% of pregnancies each year. GD usually appears between the 24th and 28th week of pregnancy and is caused by hormonal changes. High blood sugar can harm both mother and baby, so it's essential to manage it.
Pregnancy hormones inhibit insulin's ability to do its job, leading to high blood glucose levels. The condition is diagnosed through a routine glucose tolerance test during pregnancy. Many women don't experience symptoms, but those who do may be thirstier than usual or need to urinate more often.
Those who have gestational diabetes will need to follow a healthy diet, exercise and take medication if necessary. Those who don't control their blood sugar can have problems with their pregnancy and increase their risk of developing type 2 diabetes later in life. Screening for gestational diabetes is generally offered to pregnant people between their 24th and 28th weeks. However, those with certain risks might be encouraged to be screened sooner.
Causes of Gestational Diabetes
Many women get gestational diabetes because their hormones become insensitive to insulin, a hormone that helps move sugar from the blood into cells where it can be used as energy. Women who are overweight before pregnancy have a higher risk because excess weight makes the placenta unable to use insulin properly.
Other causes include polycystic ovarian syndrome and having a family history of type 2 diabetes. If the disease is not treated, it can lead to complications such as serious breathing difficulties in babies (fetal distress syndrome) or low blood sugar levels shortly after birth (hypoglycemia).
If you have gestational diabetes, you are more likely to get it again in future pregnancies and at a later age, which can put your child at risk of obesity and type 2 diabetes.
Risk Factors
The most common risk factor for gestational diabetes is being overweight before becoming pregnant, although women of average weight can get it too. It also occurs in women with a family history of diabetes. Other risk factors include:
- Having a history of polycystic ovary syndrome.
- Having a giant baby (macrosomia).
- Having a previous C-section birth.
People of color are at greater risk for gestational diabetes because of social determinants of health, such as chronic stress, lack of access to healthy foods and housing, and the effects of racism.
Symptoms and Diagnosis
Most women with gestational diabetes have normal pregnancies and healthy babies. They often don't have symptoms or might chalk them up to pregnancy, so they only discover their condition during a screening test.
A doctor can diagnose gestational diabetes with a glucose challenge or tolerance test. For the challenge test, the patient drinks a sweet liquid and has her blood tested before, at one, two, and three-hour intervals afterward. The tolerance test involves fasting and drinking a syrupy solution to measure blood sugar levels. If the results are abnormal, a doctor can confirm gestational diabetes with a simple finger-prick test. Keeping blood sugar levels in check is the focus of treatment, and doctors also use ultrasounds to monitor the baby's health.
Symptoms include feeling shaky or sweaty, hungry all the time, and tired. If you notice these symptoms, immediately check your blood sugar and talk to your doctor.
Management and Treatment
Treatment for gestational diabetes starts with regular blood sugar checks and a healthy diet. If these don't control your blood sugar, you might need medicine -- usually insulin. Your healthcare provider will tell you how much insulin to take.
Untreated or poorly managed gestational diabetes increases your risk for problems during delivery. High blood sugar levels can cause the fetus to grow too large (macrosomia). A large baby can become wedged in the birth canal and have difficulty breathing, which may lead to a C-section delivery or injury to the mother during labor.
Potential Complications of Gestational Diabetes
Women who have gestational diabetes may have a higher risk of developing type 2 diabetes in the future. Pregnancy hormones interfere with how your body processes glucose and insulin.
Having gestational diabetes also increases your chances of having a large baby, which can increase the chance that you'll need a cesarean section or have complications during delivery, such as shoulder dystocia (when the head gets stuck in the vagina). It can also increase the risk of pre-eclampsia, which causes high blood pressure and protein in the urine.
Preventive Measures and Lifestyle Changes
It is not fully understood why some women get gestational diabetes, and others don't. Excess weight gain before pregnancy and hormone levels in the early stages of pregnancy seem to play a role.
The good news is that the most important way to prevent gestational diabetes is healthy eating and moderate exercise. These changes can also reduce the risk of developing diabetes in future pregnancies and lower a woman's risk for type 2 diabetes later in life.
Some studies have shown that 12-week moderate-intensity lifestyle intervention, including two face-to-face individualized dietary consultations and two telephone counseling sessions by a licensed dietitian, can significantly reduce the incidence of GDM in high-risk pregnant women. This program focuses on recommended weight gain, appropriate calorie intake, low-glycemic index meals, plant-based choices, and physical activity.
The Bottom Line - Gestational Diabetes
The best way to protect your baby is to work closely with your health care provider (HCP) to control your blood sugar levels. Changing your diet and regular physical activity, like brisk walking, is possible. If these aren't enough to keep your blood sugar within target, your doctor may recommend medications such as insulin.
Carbohydrate foods such as bread, cereals, sweets, berries, milk, and some fruits and vegetables, such as bananas, can all increase your glucose levels, but protein-rich foods such as lean meats, fish, chicken, eggs, and legumes can help to control them. Your HCP can help you find food options that are right for you.
Taking a friend or family member to your appointments can be helpful, especially when you need to fast for testing. And remember to write down what you eat, when, and how much to help track your daily habits.
