Gestational Diabetes


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Understanding Gestational Diabetes

What is Gestational Diabetes?

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who do not already have diabetes. It occurs when the body cannot produce enough insulin during pregnancy.

Causes

Insulin is a hormone made by the pancreas that helps blood sugar enter the body’s cells to be used as energy. During pregnancy, hormonal changes and weight gain can cause the body’s cells to use insulin less effectively, a condition known as insulin resistance. This increases the body's need for insulin, which can lead to gestational diabetes.

Symptoms and Risk Factors

Gestational diabetes often has no symptoms. Your medical history and risk factors might suggest the need for testing. Risk factors include:

  • Previous gestational diabetes
  • Birth of a baby over 9 pounds
  • Being overweight
  • Age over 25
  • Family history of type 2 diabetes
  • Polycystic ovary syndrome (PCOS)
  • Belonging to certain ethnic groups (African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, Pacific Islander)

Getting Tested

It is crucial to test for gestational diabetes to protect your health and your baby’s health. Testing usually occurs between the 24th and 28th weeks of pregnancy, but it may be earlier if you are at higher risk. High blood sugar early in pregnancy may indicate type 1 or type 2 diabetes rather than gestational diabetes.

Types of Diabetes

  • Type 1 diabetes: The body makes little or no insulin, typically diagnosed in childhood or young adulthood. Insulin shots or a pump are required.
  • Type 2 diabetes: The body cannot use insulin properly and eventually does not make enough. It is often found in overweight individuals with a family history of diabetes, those who are physically inactive, and people who are middle-aged or older. Type 2 diabetes can sometimes be managed with lifestyle changes and/or medications, but many people require insulin shots.

Effects on Your Baby

Gestational diabetes can increase the risk of:

  • Large baby (over 9 pounds), potentially causing delivery complications
  • Early birth, leading to breathing and other problems
  • Blood sugar issues after birth
  • Childhood obesity, which can lead to type 2 diabetes

Effects on You

Gestational diabetes can increase your risk of:

  • Difficult delivery
  • C-section delivery and longer recovery time
  • Developing preeclampsia (high blood pressure, protein in the urine, swelling), which can cause seizures or stroke and may lead to early birth

Managing Gestational Diabetes

The good news is that gestational diabetes can be managed. Here’s how:

  1. Regular Doctor Visits
    • Ask if more frequent visits are needed.
    • Work with your doctor to catch or prevent problems.
  2. Healthy Diet and Exercise
    • Develop a meal plan with a dietitian or diabetes educator.
    • Engage in regular, moderate exercise (e.g., brisk walking for 30 minutes, 5 days a week).
  3. Medication
    • Follow your doctor’s advice and take medications as directed.
  4. Blood Sugar Monitoring
    • Check blood sugar often as directed.
    • Adjust diet, exercise, and insulin (if prescribed) based on your blood sugar levels.
  5. Managing Low Blood Sugar
    • Be aware of symptoms like hunger, sweating, dizziness, and anxiety.
    • Treat low blood sugar with a quick source of sugar (e.g., hard candy, fruit juice).
    • Wear a medical alert bracelet.

Blood Sugar Levels

The American College of Obstetricians and Gynecologists (ACOG) recommends keeping blood sugar levels below:

  • 95 mg/dL before meals
  • 130 mg/dL one hour after eating
  • 120 mg/dL two hours after eating

High blood sugar

Your blood sugar is high when the numbers are 130 mg/dL or higher. High blood sugar can:

  • Make you thirsty
  • Cause headaches
  • Make you go to the bathroom often to urinate (pee)
  • Make it hard to pay attention
  • Blur your vision
  • Make you feel weak or tired
  • Cause yeast infections

Talk with your doctor if you notice any of these signs or symptoms.

Low Blood Sugar

Your blood sugar is low when the numbers are 70 milligrams/ deciliter or less. Low blood sugar is also called hypoglycemia (hipoh-gli-see-me-ah). Low blood sugar can:

  • Make you feel hungry
  • Make you sweat
  • Cause headaches
  • Cause weakness
  • Make you feel dizzy or shaky
  • Make you feel anxious or cranky
  • Cause you to feel confused
  • Make your heart feel like it’s beating too fast
  • Make you look pale

If you notice any of these signs or symptoms, check your blood sugar. If it is low, eat or drink a source of quick sugar—like a piece of hard candy or 4 ounces of fruit juice or skim milk. Check your blood sugar again in 15 minutes. If it’s not better, eat or drink a source of quick sugar again. When you feel better, have a protein snack like cheese and crackers or half a peanut butter sandwich. Talk with your doctor if you have 2 or more low blood sugars during 1 week.

After Pregnancy

Gestational diabetes usually resolves after pregnancy, but it increases the risk of developing type 2 diabetes later. Steps to stay healthy include:

  • Testing for diabetes soon after and 6 weeks post-delivery
  • Maintaining a healthy diet and exercise routine
  • Regular checkups and blood sugar tests every 1-3 years
  • Discussing future pregnancy plans with your doctor
  • Gradual weight loss to maintain a healthy weight

Adopting a healthy lifestyle can help delay or prevent type 2 diabetes in the future.

Source: Centers for Disease Control and Prevention (CDC)