What is Gestational diabetes?
The term “gestational” means pregnant. Gestational diabetes is diabetes that happens for the first time in a woman who is pregnant. Most of the time, it goes away after you have your baby. But it does increase your risk for developing type 2 diabetes later on in life. Approximately 2-10% of pregnant women in US develop gestational diabetes.
Why do only some women get gestational diabetes and what are the risk factors?
Your body controls the blood sugar by producing a hormone called insulin which moves glucose out of the blood and into the cells of the body. In women with gestational diabetes, the blood sugar can get into the cells, so the amount of glucose in the blood gets higher and higher.
- Women who are overweight
- Hispanic woman, African American, American Indian, Asian American, Alaska native, Pacific Islander
- Family history of diabetes
- Pregnant women older than 25
- Women who had gestational diabetes, stillbirth or large baby weighing more than 9 pounds with her previous pregnancy
- Women who have polycystic ovary syndrome
Who should be tested for gestational diabetes?
All pregnant women should be tested for diabetes during 24-28 weeks of pregnancy. But if you are high risk for developing gestational diabetes based on your risk factors, your doctor may test you for diabetes at the first visit after you become pregnant.
How will I know if I have gestational diabetes?
Your health care provider will do a glucose screening test when you are pregnant. In this test, you’ll drink a sugar liquid then you will have your blood sugar checked one hour later. If your blood sugar is normal, then you don’t have gestational diabetes. If your blood sugar is high, then you will need oral glucose tolerance test. In this test, your health care provider will check your blood sugar after 8 hours of fasting and then you will drink a sugar liquid. Your blood sugar will be tested after 1 hour, 2 hours and 3 hours. If your blood sugar is high in 2 or more of these measurements, then you may have gestational diabetes.
What are the effects of gestational diabetes on me and my baby?
Most women with gestational diabetes have healthy pregnancies as long as they control the blood sugars well. Women with gestational diabetes are at higher risk for high blood pressure, preeclampsia and even after pregnancy, they are at higher risk of developing type 2 diabetes during their lifetime.
For the baby, there is risk of having a large baby which can cause problems and injuries during delivery, the baby may have low blood sugar at birth, premature birth, jaundice, breathing problems and later in the life they may be at risk of being overweight or obese, may even develop diabetes.
How is gestational diabetes managed?
Most of treatment plans include eating a healthy diet to maintain normal blood sugars, doing regular physical activity and maintaining a healthy weight.
Some women may have to take insulin to control the blood sugars during pregnancy.
What are the problems with high blood sugar levels during pregnancy?
Whether you have type I or type 2 diabetes, poorly controlled blood sugars during pregnancy can lead to problems for the mother and the baby. These are some of the problems of poorly controlled blood sugars-
- Increased chance of miscarriage.
- Preterm birth where baby can be born too early which will result in the baby having breathing problems, intestinal problems, vision problems, heart problems, bleeding into the brain, etc.
- Increased chance that the baby will be born with birth defects of brain, spine and heart.
- Large baby, that can lead to damage to the mother’s body or may require you to have C-section.
- High blood pressure (preeclampsia). Women with the diabetes have high blood pressure more often than women without diabetes. When pregnant woman has high blood pressure, protein in her urine and swelling of feet that does not go away, she may have preeclampsia. This can be serious complication to the mother, may lead to preterm delivery or can cause seizures or stroke in the women during labor.
- Your child is at risk for obesity and type 2 diabetes
How do I prevent complications when I already have diabetes and get pregnant?
- Plan well in advance for pregnancy. Consult your doctor before getting pregnant. It is important to control your blood sugars well before getting pregnant.
- Monitor blood sugars on a daily basis.
- Eat healthy
- Take your pills and insulin as directed
- Moderate-intensity exercise for 30 min. at least 5 days a week
- Watch out for low blood sugars. If your blood sugars drop, eat something for quick recovery of your blood sugar like hard candy or glucose pills.
REFERENCES:
1. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/gestational-diabetes/Pages/index.aspx
2. Gupta Y, Kalra B, Baruah MP, Singla R, Kalra S. Updated guidelines on screening for gestational diabetes. Int J Womens Health. 2015 May 19;7:539-50.