Gestational Diabetes During Pregnancy

What is Gestational Diabetes During Pregnancy?

Gestational Diabetes is high blood sugar levels during pregnancy.

During pregnancy, your body processes carbohydrates (sugars) differently than it does when you’re not pregnant. Gestational diabetes (GD or GDM) is defined as glucose (sugar) intolerance identified during pregnancy. It means your body isn’t making enough insulin to handle the glucose that is coming in.

What Problems Can Gestational Diabetes Cause?

Though the likelihood of problems is significantly decreased with any treatment, researchers found that people with higher blood glucose levels have an increased risk of:

• Big babies (> 8lbs 14oz)
• Cesarean birth
• Pre-eclampsia
• Shoulder dystocia
• Birth injury
• NICU stay
• Premature delivery
• Newborn jaundice

How Do I know if I have Gestational Diabetes?

Routine care is to test for GD between 24-28 weeks of pregnancy, because that’s when it typically develops if it’s going to. If you’re at higher risk, your doctor may want to test you earlier. There typically aren’t any symptoms.

If There are Symptoms of Gestational Diabetes, They May Include:

• Frequent need to pee
• Extreme thirst
• Tiredness
• Snoring

How Do They Test for Gestational Diabetes?

As part of your prenatal care you will be tested for gestational diabetes. The oral glucose tolerance test consists of drinking a sugary glucose drink (sometimes called glucola) and then having your blood drawn one hour later. If your blood sugar comes back high, you’ll have another test. A normal blood sugar level is usually between 130-140 mg/dL, but this varies by lab and provider.

Are There Alternatives to the Glucola Test?

Yes, but none that are well-researched. Researchers reviewed findings from 5 randomized, controlled trials comparing the candy bar test, the 50g glucose food test, and the 50g screening test in comparison with the gold standard glucose drinks (Glucola).

Unfortunately, their findings were disappointing due to small sample sizes and overall poor quality of the available research.  So, as a result, researchers cannot currently recommend any of the alternative screening tests for Gestational Diabetes due to a lack of good evidence. A midwifery group in New Jersey published this article on the topic Pregnant Women May Want To Avoid Toxic Glucose Testing Drinks

What are the Risk Factors for Gestational Diabetes?

You May be at Increased Risk of GD if You:

• Are obese
• Physically inactive
• Have high blood pressure
• Have previously had GD
• Had a very large baby in a previous pregnancy
• Have a history of heart disease
• Are of African-American, Asian-American, Hispanic, Native American, or Pacific Island background
• Have Polycystic Ovary Syndrome (PCOS)

Can I Prevent Gestational Diabetes?

The American College of Obstetricians and Gynecologists (ACOG) says you may be able to prevent the development of GD by doing more physical activity and exercise if you do not currently do much. But certainly do not try to lose weight during pregnancy, no matter how overweight you are.

Here is a post on healthy weight gain in pregnancy.

Additionally, you may also benefit from making healthier food choices. Eat regular meals throughout the day, including small snacks. Also, try to eat whole foods and choose low-sugar options. What to eat during pregnancy offers some good ideas on healthy food choices during pregnancy.

Managing Gestational Diabetes

You can often control your blood sugar with diet and regular exercise.  If not, or if your blood sugar levels are very high, your doctor will recommend insulin (most common) or an oral medication.

Additionally, you will need to monitor and manage your blood sugar multiple times a day yourself. You’ll prick your finger with a device that tests your blood sugar level. Often a meal plan and a commitment to exercise regularly will be recommended.

Is Gestational Diabetes Scary?

Most women who have GD go on to have healthy pregnancies, safe deliveries, healthy babies, and no diabetes postpartum.

Midwives and doctors monitor babies more closely to watch for complications due to GD. At some point, you may also be asked to do kick counts, have a non-stress test, or do a biophysical profile test.

An induction may be recommended if your diabetes is uncontrolled or due to complications that develop for you or baby.

Did I Do Something to Cause Gestational Diabetes?

No. No one really knows why some people are more likely to be at risk for gestational diabetes than others. Many healthy, thin, active women with excellent diets develop gestational diabetes. Try not to worry. You and your provider will figure out the least invasive way to manage it.

Will My GD Baby be at Risk of Diabetes after Baby is Born?

Your baby may be at increased risk of obesity or diabetes. As a result, your pediatrician may want to monitor his/her blood sugar levels throughout childhood.

Does Having GD Mean that I am at Increased Risk of Developing Type 2 Diabetes Later in Life?

Yes, but not it’s likely you will not. The test was actually developed to identify people who were at risk of developing Type II Diabetes later in life, not to screen for possible pregnancy-related issues. About 20-50% of women with GD will eventually develop type 2 diabetes.

You may especially benefit from lifestyle changes like a better diet and more exercise to curb the likelihood of diabetes. You are still more likely (50%-80%) NOT to get diabetes at all.  

Disclaimer: Pregnancy by Design’s information is not a substitute for professional medical advice or treatment.  Always ask your health care provider about any concerns you may have.

Cited Research:

CDC (2017). Gestational Diabetes. Retrieved July 11, 2018, from https://www.cdc.gov/diabetes/basics/gestational.html.

Dekker, R. (2013). Diagnosing Gestational Diabetes: The NIH Consensus Conference. Retrieved July 10, 2018, from https://evidencebasedbirth.com/diagnosing-gestational-diabetes-the-nih-consensus-conference-day-2/

ACOG. (2017). Gestational Diabetes. Retrieved July 11, 2018 from https://www.acog.org/Patients/FAQs/Gestational-Diabetes#tested