Gestational Diabetes

What is gestational diabetes?

Gestational diabetes is a type of diabetes that some women develop during pregnancy. Diabetes means that your blood glucose (sugar) is higher than normal.

Blood sugar is the fuel your body makes from the food and beverages you eat and drink. Your body also makes insulin which helps you use blood sugar for energy. If you have gestational diabetes, your body cannot make enough insulin or use all the insulin it needs for pregnancy. When this happens, your blood sugar gets too high.

Any pregnant woman can be at risk for gestational diabetes. However, it is more common in some groups, such as Native American, Alaskan Native, Hispanic, Asian, and African American women. 

Gestational diabetes is different than other types of diabetes (such as Type 1 or Type 2 diabetes) since it develops during pregnancy. In many cases, it will go away once you are no longer pregnant. However, it’s important to be treated if you develop gestational diabetes because high blood sugar can affect both you and your baby. 

Visit the CDC Website for more information on Type 1 or Type 2 Diabetes and Pregnancy.

What causes gestational diabetes?

Gestational diabetes is caused by changes to your body during pregnancy, such as hormonal changes and weight gain. In some women, these changes will temporarily make your body less able to use insulin and cause gestational diabetes.

What are the symptoms?

Many women with gestational diabetes have no symptoms or the symptoms are very mild—such as being more thirsty than normal or needing to urinate more often. Doctors usually test for gestational diabetes between weeks 24 and 28 of pregnancy.  

How does it affect me?

When blood sugar is elevated due to gestational diabetes, you can have problems that affect your health including:

• Cesarean section: You have a higher chance of needing a cesarean section (C-section) to deliver your baby. When the baby is delivered by a C-section, it takes longer to recover from childbirth.
• High blood pressure: Women with diabetes have high blood pressure more often than women without diabetes. If you are pregnant with high blood pressure, protein in your urine, and swelling in your fingers and toes that don’t go away; you might have preeclampsia. It can lead to premature birth or cause you to have seizures or a stroke during labor and delivery. Preeclampsia is a serious and potentially life-threatening condition. You should call your doctor right away if you have concerns regarding these symptoms. 
• Urinary tract infections: Glucose (sugar) in your blood and urine can contribute to a greater risk of developing urinary tract infections.
• Low blood sugar: If you take insulin or other diabetes medications, you can develop a serious condition called low blood glucose (hypoglycemia). You can avoid this by monitoring blood glucose levels closely and treating low blood sugar quickly.
• Type 2 diabetes: If you have gestational diabetes, you have a higher chance of developing type 2 diabetes after your pregnancy.

How does it affect my baby?

When blood sugar is elevated due to gestational diabetes, your baby may have problems including:

• Jaundice: Many newborns will have yellowish skin after birth, a condition called jaundice. This is caused by a chemical called bilirubin building up in the baby’s blood. Although this condition is common in many babies and will usually go away on its own, it can be much worse in babies born to mothers who have diabetes. Brain damage can happen if severe jaundice is not treated quickly.
• Low blood sugar: Babies born to mothers with gestational diabetes have a higher risk of low blood glucose (sugar) after birth. Your baby’s doctor will monitor their blood glucose (sugar) after birth to treat low blood sugar if it occurs. 
• High birth weight: High blood glucose (sugars) due to gestational diabetes can cause babies to grow very large. A large baby can have difficulties during delivery, including nerve injuries in their shoulders or collarbone fractures. Although it is rare, a very serious complication can cause brain damage. This is because the baby does not get enough oxygen during birth. 
• Type 2 diabetes: Babies born to women with gestational diabetes are at greater risk for obesity and developing type 2 diabetes later in life.

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How is gestational diabetes treated?

You may be able to reduce the risk of developing gestational diabetes if you maintain a healthy weight, eat nutritious food, and stay physically active both when you are planning to become pregnant, and during your pregnancy. If you are diagnosed with gestational diabetes, follow your doctor's guidance. This may include a healthy eating plan and being physically active. You might need medicine if eating healthy and being active don't keep your blood glucose within the range set by your doctor.

Having gestational diabetes does not mean you will have diabetes after the baby is born or that your baby will have diabetes. It does increase the chances for both mother and baby to develop type 2 diabetes at some point in time in the future. Also, if you have had gestational diabetes with a previous pregnancy, you are at risk to develop it with the next pregnancy. That is why it’s important to maintain a healthy lifestyle before and during every pregnancy to reduce your risk. 

Visit the CDC Website for more information on how Lifestyle Change Programs Can Help Prevent or Delay Type 2 Diabetes.

What can I do if I experience low blood sugar (hypoglycemia)?

If you develop gestational diabetes and experience low blood sugar, the American Diabetes Association recommends that you quickly eat or drink 15 grams of carbohydrates, such as: 

• Glucose tablets or gel tube (see label instructions for each)
• 4 ounces (1/2 cup) of juice or regular soda (not diet)
• 1 tablespoon of sugar, honey, or corn syrup
• Hard candies, jellybeans, or gumdrops (see food label for how many to consume)

Wait 15 minutes and check your blood glucose again. If your glucose level is still low, eat or drink another 15 grams of glucose or carbohydrates. Check your blood glucose again after another 15 minutes. This is known as the 15-15 Rule which helps raise blood sugar levels when they are low. It is important to follow the steps in this rule. That way blood sugar levels increase gradually and you don’t end up with a high blood sugar after treating a low blood sugar.        

Can I still breastfeed my baby?

Yes! Breastfeeding is healthy for you and your baby. It helps keep your blood glucose (sugar) in your target range after delivery and helps you lose the weight you gained during pregnancy. It also lowers the chance that you or your baby will develop diabetes later in life.  Babies who are breastfed also have a lower risk of being overweight or obese later in life.  

Should I participate in a pregnancy registry?

If you take diabetes medicine or other prescription or nonprescription medicine, you may want to participate in a pregnancy registry. Pregnancy registries are studies that collect information from women who must take prescription medicines or vaccines during pregnancy. These registries can help researchers and the public learn more about how medicines for diabetes and other diseases affect women during pregnancy.

The Food and Drug Administration keeps a list of pregnancy registries. If you must take medicine for your gestational diabetes, check to see if there is a registry for it or any other medicines you take.

Sources:

• American Diabetes Association – Gestational diabetes 
• Cleveland Clinic – Gestational Diabetes: Outlook/Prognosis
• Mayo Clinic – Gestational diabetes symptoms, causes, diagnosis and treatment 
• Centers for Disease Control and Prevention – Diabetes and Pregnancy [pdf]

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