Gestational Diabetes

Gestational diabetes is a condition that occurs only during pregnancy. It is different then having type 1 or type 2 diabetes while being pregnant. Gestational diabetes usually appears between weeks 24-28 weeks of pregnancy. In some cases it can show up earlier. About 2-10% of all cases of pregnancy in the United States develop gestational diabetes.

What you are eating during pregnancy does not cause gestational diabetes. Normally in your body insulin breaks down sugar and delivers it to your cells. Gestational diabetes occurs when either the insulin isn’t working right, or there isn’t enough insulin in the body to break down all the sugar. This in return causes the sugar to back up in your blood. Usually gestational diabetes is not caused by the lack of insulin in the body. It is more often caused by the hormones during pregnancy that make insulin less effective. There are two types of gestational diabetes. Class A1 is when your gestational diabetes can be managed through your diet. Class A2 is when insulin or oral medications are needed to manage the condition.

Risk

You are at a higher risk of developing gestational diabetes if you have had it in a previous pregnancy. Having birthed children over 10 pounds also puts you at a higher risk. Other risks are being overweight, being prediabetic, you have high blood pressure, or are not physically active. If you have a condition like polycystic ovarian syndrome, or metabolic syndrome you are also at a higher risk. Gaining a lot of weight during your pregnancy can also be a risk factor. As well as women who are over the age of 25 years old.

Symptoms

Gestational diabetes may not cause any symptoms. Sometimes symptoms can be so mild that they go unnoticed. Symptoms you can experience are fatigue, blurred vision, excessive thirst, excessive urge to urinate, and developing yeast infections.

Diagnosis

When you are pregnant it is normal in your pregnancy care for you to undergo a test to check for gestational diabetes. This test is usually done between 24-28 weeks. This is when the hormones in pregnancy that can affect how insulin works start to be produced. Your doctor may want to test you earlier for gestational diabetes if you have an increased risk. You may have an increased risk if you have a family history of gestational diabetes, you have had gestational diabetes in an earlier pregnancy, you are obese, or you have a condition such as polycystic ovarian syndrome or metabolic syndrome. You can test as early as 12 weeks for gestational diabetes.

The first test your doctor will have you do is the glucose challenge test. First a lab technician will draw blood to get a baseline blood sugar level from you. You drink a sugary drink, about 8oz, then wait an hour to have a blood test to check what your blood sugar levels are. If you fail the one hour test your doctor will have you come back to take a glucose tolerance test. This is done over the course of three hours. You will drink sugary drink, then have your blood drawn at the one hour, two hour, and three hour intervals. The glucose challenge test does not have to be fasting. The glucose tolerance test they want you to be fasting for at least 8 hours beforehand. When looking at your blood sugar levels after one hour of drinking the drink your blood sugar should be lower than 180 milligrams per deciliter. After two hours it should be lower than 155 mg/dL. After three hours it should be lower than 140 mg/dL. You must fail 2 of the levels to be confirmed with gestational diabetes. If you only fail one level your doctor will suggest that you retake the test in a few weeks.

Complications

Complications of gestational diabetes can affect the mother and the baby. One of the most common complications is excessive birth weight. This is when the baby weighs more than 9 pounds at delivery. Preterm or early labor can occur because it is common for women with gestational diabetes to have too much amniotic fluid. Your baby may experience difficulty breathing. Your baby can develop low blood sugar. Gestational diabetes also puts your child at risk for being overweight or at a higher risk of developing type 2 diabetes later on in their life. Stillbirth is another complication. For the mother, gestational diabetes can cause a raise in blood pressure. It also puts the mother at higher risk for preeclampsia. C-sections are more likely with gestational diabetes. It also raises the mother’s risk of developing type 2 diabetes later in life as well.

Treatment

There are three ways to treat gestational diabetes. You can’t get rid of gestational diabetes once you have it. Most of the time it goes away after delivery. It is common for your doctor to run a diabetes test on you after giving birth about 6 weeks after delivery.

The most common way of treating gestational diabetes is with diet changes and exercise. How you eat and how you move can usually manage gestational diabetes. It is important when eating to focus on fruits, vegetables, whole grains, and lean proteins. While staying clear of highly refined carbohydrates. If you end up being diagnosed with gestational diabetes your doctor will usually have you meet with a nutritionist to help you make sure you are eating the right kinds of foods.

It is also important to make sure you are exercising. Exercise should happen at least every day for 30 minutes. Light to moderate exercise can include walking, swimming or even housework or gardening.

Sometimes treatment may include monitoring your blood sugar. This will usually be done with a prick test done at home with a glucose monitor. You will be advised to check your blood sugars in the morning first thing upon waking up, and then after every meal. The third form of treatment which is not very common is the use of insulin or oral medications to manage.