Gestational Diabetes

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KEY POINTS

• Having diabetes means that there is too much glucose (sugar) in your blood. Diabetes that starts during pregnancy is called gestational diabetes. It can add risk to the pregnancy and cause problems for the baby.
• The main goal of treatment is to keep your blood glucose level in a healthy range through diet, exercise, and medicine.
• Your healthcare provider will tell you when you should check your blood glucose at home, and what to do if it gets too high or too low. Keep all appointments for provider visits or tests.

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What is gestational diabetes?

Having diabetes means that there is too much glucose (sugar) in your blood. Some women have this problem during pregnancy. Diabetes that starts during pregnancy is called gestational diabetes.

Diabetes is a problem with the way your body makes or uses insulin. Insulin is made by the pancreas, which is an organ in your upper belly. Your body uses insulin to help move glucose from the blood into the cells. When your body does not have enough insulin or has trouble using insulin, glucose builds up in your blood and cannot get into your cells.

Pregnancy hormones can change the way insulin works. During pregnancy, your pancreas needs to make more insulin than normal. If your pancreas cannot make enough insulin to control your glucose level, you become diabetic. Gestational diabetes develops in about 1 in 14 pregnancies.

Gestational diabetes usually goes away after the baby is born. However, you have a higher risk of having diabetes later in your life.

What are the risks for me and my baby?

Gestational diabetes increases the risk for high blood pressure during your pregnancy. High blood pressure during pregnancy can lead to other health problems. Gestational diabetes also increases the risk of birth defects, such as a problem with your baby’s heart, kidney, spine, or brain.

If you have gestational diabetes, controlling your blood glucose is important. If blood glucose is not kept within a healthy range, it may cause:

• Your baby to get too big before birth. Very large babies may need to be delivered by C-section.
• You to develop a buildup of acids in the blood. This can cause a very serious, life-threatening condition called diabetic ketoacidosis.
• Your baby to have jaundice (yellowish skin) after he is born
• Your baby to have low blood glucose after he is born
• You to have miscarriage or your baby to die before delivery

What is the cause?

No one knows why some people develop diabetes and others do not. You are at higher risk for gestational diabetes if:

• You have a family history of diabetes
• You are overweight, especially over 200 pounds
• You had gestational diabetes before
• You had a previous baby that weighed 9 pounds (4000 grams) or more at birth
• You had a previous baby that was stillborn or born with birth defects
• You have had multiple previous miscarriages
• You are over 35 years of age

What are the symptoms?

Most of the time, gestational diabetes does not cause symptoms. Sometimes, you may feel more tired, thirsty, or have to urinate more than normal. You may also lose weight. Urine and blood tests during your pregnancy may show that your blood glucose is high.

How is it diagnosed?

If you have a high risk for diabetes, you will probably have a blood test to screen for diabetes at your first prenatal visit or soon afterwards. If you had gestational diabetes before, you should be tested early for diabetes the next time you are pregnant. If the early test is normal, you will have another blood test later in the pregnancy.

If you are not at high risk for gestational diabetes, you should be screened with a blood test between weeks 24 and 28 of your pregnancy.

How is it treated?

The main goal of treatment is to keep your blood glucose level in a healthy range. You may be able to control your blood glucose level by:

• Following a special diet
• Getting regular, moderate exercise, as recommended by your healthcare provider

You may also need insulin shots or diabetes medicines taken by mouth to control your blood glucose level. If you need insulin, make sure you know the right amount to use and how to give yourself shots. It is also a good idea for another person, such as your partner, to learn how to give you insulin in case of an emergency. Your healthcare provider will tell you how much insulin to take and when you need to take it.

Your healthcare provider will tell you when you should check your blood glucose at home, and what to do if it gets too high or too low.

When you are in labor, your provider will watch your blood glucose closely and test it often. During labor you may need to have sugar water and insulin given through an IV to control your blood glucose level.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep good control of your blood glucose. You may need to check your blood glucose several times a day.
• Make sure you and your family members know how to treat low blood glucose.
• Eat healthy meals that include whole grains, fresh fruits and vegetables, and calcium-rich foods, such as milk, cheese, and yogurt. Choose foods low in saturated fat. Ask your provider if there are foods you should not eat or if you should limit how much you eat.
• Drink plenty of water each day.
• Take vitamins, other supplements, and medicines as recommended by your healthcare provider. Talk to your provider before you take any medicine, including nonprescription and herbal medicines. Some medicines are not safe during pregnancy.
• Unless your healthcare provider tells you not to, try to be physically active for at least 30 minutes a day, most days of the week. You might find it easier to exercise 10 minutes at a time, 3 times a day. You may want to take a prenatal exercise class.
• Do not smoke, drink alcohol, or take illegal drugs.
• Ask your provider:
  • How and when you will get your test results
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.