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What is gestational diabetes?
Gestational diabetes is diabetes that develops in a woman during pregnancy. Warning signs of gestational diabetes include increased thirst, tiredness, nausea and vomiting, and other signs.
The term “diabetes” refers to a medical disorder that affects how the body turns food into energy. Around 10% of Americans have one of several forms of the disorder. However, one type of diabetes is different from the others because it only occurs in a specific population segment.
Gestational diabetes is a condition that develops in pregnant women who have not previously had diabetes. Annually, 2%–10% of pregnancies in the US are impacted by gestational diabetes.
Like the other diabetes types, gestational diabetes causes an increase in blood sugar. This shift can affect the duration of pregnancy and the health of both the mother and her baby. The good news is that in women with gestational diabetes, the condition goes away after the baby’s delivery. But, those who have had gestational diabetes are at an increased risk of eventually developing type 2 diabetes.
What causes gestational diabetes?
Gestational diabetes happens when the body cannot produce enough insulin during pregnancy. Insulin is vital for the regulation of blood sugar in the body. The body produces more hormones during pregnancy and causes body changes like weight gain. These changes cause abnormal use of insulin and trigger insulin resistance. Most pregnant women have some degree of insulin resistance later in pregnancy. But some women have some resistance before pregnancy, so they are more likely to develop gestational diabetes eventually.
What are some warning signs and risks for gestational diabetes?
The warning signs of gestational diabetes are very similar to diabetes mellitus, with a few exceptions. Medical history and risk factors help in determining if you will get gestational diabetes. Warning signs include:
- Increased thirst and frequent urination
- Glucose in the urine
- Tiredness
- Nausea/vomiting
- Vision problems
- Infections
Risk factors for eventually developing gestational diabetes include:
- Sedentary
- Being overweight
- Prediabetes
- Diabetes in the family
- Polycystic ovary syndrome
- Hispanic, Asian, Native American, and African American background
What complications can gestational diabetes cause?
Mothers with gestational diabetes may have babies with certain complications. Babies may be born very big. This includes a birth weight of 9 pounds or more. Larger babies can become stuck in the birth canal, and a C-section may be needed.
Preterm birth may also be a concern. Increased blood sugar levels in the blood can increase the risk of early delivery. Or, the doctor may choose to induce labor early because the baby is so big. Babies of moms with gestational diabetes may develop respiratory distress syndrome if they are born prematurely.
These babies may also have low blood sugar, or hypoglycemia, after birth. If the hypoglycemia is severe, the baby could develop seizures and need IV glucose solutions. Babies born of mothers with gestational diabetes may develop obesity and type 2 diabetes later in life. Untreated, gestational diabetes can also cause stillbirth.
Mothers may also develop complications from gestational diabetes. It increases the risk of developing high blood pressure. High blood pressure can lead to preeclampsia. Preeclampsia has serious symptoms in addition to blood pressure and can be fatal to mother and baby.
Though blood sugars return to normal after the baby is born, mothers are at a higher risk for developing type 2 diabetes. Approximately 50% of mothers with gestational diabetes develop type 2 diabetes later in life.
How do you diagnose gestational diabetes?
Doctors screen for gestational diabetes in the second trimester, between weeks 24 and 28 of pregnancy. If you have some of the risk factors for gestational diabetes, the doctor may test you early in the first trimester.
Testing usually includes an initial glucose challenge test and a follow-up glucose tolerance test. During the initial test, a syrupy glucose liquid is drunk. An hour later, a blood test is taken. If the blood sugar level is 190 mg/dL, the diagnosis is positive for gestational diabetes.
The follow-up test is like the initial one. The difference is that the sugar content is higher in the liquid. Blood sugar levels will be tested every hour for 3 hours. If two readings are higher than normal gestational diabetes will be diagnosed.
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How do you treat gestational diabetes?
Treatment of gestational diabetes is pretty straightforward. It includes monitoring blood sugar, lifestyle changes, and properly taking medications. Effectively keeping blood sugar levels at or below normal keep both mom and baby healthy. It also can help to avoid some of the complications mentioned earlier.
Lifestyle changes include a healthier diet and a decrease in sedentary habits. Though weight loss is not recommended during pregnancy due to the needs of the growing baby, the doctor will help to keep weight ranges within normal. Goals are usually set based on physical condition before pregnancy.
Dietary goals should include vegetables, fruit, whole grains, and protein. These types of food are nutritious, high in fiber, and low in calories and fat. A diabetes educator or dietitian can aid in the appropriate meal planning for individual weights, physical habits, blood sugar levels, and food tolerances.
Staying physically active is important in every pregnancy — not just with gestational diabetes. Exercise lowers blood sugar and can help with back pain, swelling, constipation, and problems sleeping. Many recommend up to 30 minutes of exercise a day.
Your doctor may prescribe medication if diet and exercise cannot adequately manage blood sugar levels. About 10% 20% of women need insulin to treat gestational diabetes. Research is not yet conclusive on if oral drugs are as effective.
Blood sugar levels should be checked after delivery and during follow-ups at 6–12 weeks. This is to make sure levels are back to normal. You should have them tested again about every three years if they are. If levels are high or prediabetic, your doctor will start a management plan that includes preventative measures.
Overall, gestational diabetes can be managed. With the help of family and medical professionals, both mom and baby can have a positive outcome.
