What is gestational diabetes?
During pregnancy – usually around the 24th week – many women develop gestational diabetes. A diagnosis of gestational diabetes doesn't mean that you had diabetes before you conceived, or that you will have diabetes after giving birth. But it's important to follow your doctor's advice regarding blood glucose (blood sugar) levels while you're planning your pregnancy, so you and your baby both remain healthy.
If your blood sugar level first becomes too high when you are pregnant, you have gestational diabetes. It usually goes back to normal after the baby is born.
High blood sugar can cause problems for you and your baby. Your baby may grow too large, which can cause problems during delivery. Your baby may also be born with low blood sugar. But with treatment, most women who have gestational diabetes are able to control their blood sugar and give birth to healthy babies.
Women who have had gestational diabetes are more likely than other women to develop type 2 diabetes later on. You may be able to prevent or reduce the severity of type 2 diabetes by staying at a healthy weight, eating healthy foods, and increasing your physical activity.
What causes gestational diabetes?
The pancreas makes a hormone called insulin. Insulin helps your body properly use and store the sugar from the food you eat. This keeps your blood sugar level in a target range. When you are pregnant, the placenta makes hormones that can make it harder for insulin to work. This is called insulin resistance.
A pregnant woman can get diabetes when her pancreas cannot make enough insulin to keep her blood sugar levels within a target range.
How does gestational diabetes affect the baby?
Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.
What are the symptoms?
Because gestational diabetes may not cause symptoms, it is important for you to be tested for gestational diabetes.
Sometimes a pregnant woman who has symptoms has been living with another type of diabetes without knowing it. If you have symptoms from another type of diabetes, they may include:
Pregnancy causes most women to urinate more often and to feel hungrier. So having these symptoms doesn't always mean that a woman has diabetes. Talk with your doctor if you have these symptoms, so that you can be tested for diabetes at any time during pregnancy.
How is gestational diabetes diagnosed?
Most women are screened for gestational diabetes between the 24th and 28th weeks of pregnancy. The oral glucose tolerance test is used to diagnose the condition.
How is it treated?
Some women with gestational diabetes can control their blood sugar level by changing the way they eat and by exercising regularly. These healthy choices can also help prevent gestational diabetes in future pregnancies and type 2 diabetes later in life.
Treatment for gestational diabetes also includes checking your blood sugar level at home and seeing your doctor regularly.
You may need to give yourself diabetes medicine or insulin shots to help control your blood sugar. This insulin adds to the insulin that your body makes.
Changing the way you eat, exercising more, and monitoring your blood sugar levels can all help you treat your gestational diabetes. The good news is that with treatment, most women are able to control their blood sugar and give birth to healthy babies.
New West Physicians has an integrated Diabetes and Nutrition Center that helps patients achieve better health every day.