Gestational Diabetes

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Who is at highest risk of developing gestational diabetes?
 

Some women are at higher risk of developing gestational diabetes, including those:

  • overweight before pregnancy (BMI of 30 or higher)
  • who gain too much weight during pregnancy (more than the recommended weight gain)
  • older than 25 years
  • with a history of gestational diabetes
  • with a family history of diabetes
  • of African‐American, Asian, Hispanic or Native American descent

 

How is gestational diabetes diagnosed?
 

Most women receiving good prenatal care are routinely tested for gestational diabetes between weeks 24‐28 of their pregnancies. If you are at high risk of developing gestational diabetes, your doctor may check earlier and/or more than once during your pregnancy.

The test for gestational diabetes involves drinking a sweet drink provided by your doctor and having blood tests taken before and after the drink. If the results show that your blood glucose levels are higher than the recommended cut off limits at the specified times, a diagnosis of gestational diabetes is confirmed. Your doctor will talk to you about a treatment plan for gestational diabetes.

 

Why is it important to treat gestational diabetes?
 

As a mom, your instinct is to protect your child. It’s important to treat gestational diabetes as soon as it is diagnosed for your health and your baby’s health. If gestational diabetes is untreated, problems can occur. These include:

  • An increased chance of delivering a large baby weighing more than 9 pounds (4 kg), a condition known as macrosomia. This increases the chance of:
    • difficulty and injury during vaginal birth, and
    • a cesarean section (C‐section)
  • A high risk for pre‐term birth and breathing problems (respiratory distress) for your baby
  • A high risk for low blood sugar (hypoglycemia) in your baby soon after delivery
  • A higher chance of preeclampsia and high blood pressure for you

Following your doctor’s care plan and managing your gestational diabetes carefully can help greatly reduce the risk of developing these complications.

 

What can you expect when diagnosed with gestational diabetes?
 

If you are diagnosed with gestational diabetes:

  • Your doctor will recommend a healthy, carbohydrate‐controlled diet and exercise. In many cases, these steps will be enough to manage your blood glucose levels for the rest of your pregnancy.
  • You may need to work with a registered dietitian to create a healthy eating plan. The dietitian can teach you how to manage the amount and types of carbohydrates you eat to help control your blood glucose levels while still meeting your pregnancy needs. You may also be asked to keep a food journal and track your weight.
  • You may need to check your blood glucose daily at home, using a blood glucose meter. Ask your doctor or diabetes educator to recommend a blood glucose meter that is right for you. Testing and tracking your blood glucose will help you and your healthcare professionals manage your gestational diabetes.
  • It is common to have to check your blood glucose four or more times a day, usually fasting and then 1 to 2 hours after meals. Your doctor or health care professional will tell you how often to test and your blood glucose target range. Don’t forget to keep a record of your blood glucose tests, including when you test, what your result is, and whether it was before or after eating, including how long after eating.
  • Gentle exercise during pregnancy will help control your blood glucose levels. Types of exercises pregnant women can safely enjoy, include brisk walking and swimming. Talk to your health care professionals and get guidance for safe exercise with pregnancy.

At your obstetrician visits, your blood pressure and urine may be checked. You will also discuss your blood glucose test results with your doctor, as well as what you have been eating, how much you have been exercising, and how much weight you have gained. Your growing baby will also be monitored closely. All of this will help determine if the treatment plan for gestational diabetes is working and when changes may be needed.

If changing your eating plan and adding exercise do not keep your blood glucose levels in check, your doctor may recommend diabetes medicines: pills or Injections for the rest of your pregnancy.

 
Sources:
 

IDF Diabetes Atlas (8th Ed.) (2017). International Diabetes Federation: Brussels, Belgium. Online version accessed September 9, 2019

Mayo Clinic. Gestational Diabetes Symptoms and Causes. Online version accessed September 9, 2019

Mayo Clinic. Gestational Diabetes Diagnoses and Treatment. Online version accessed September 9, 2019

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