Gestational Diabetes

Definition

Diabetes occurs when there is a higher level of glucose in the blood than is normal. Glucose comes from the breakdown of the food you eat. It travels through your body in the blood. A hormone called insulin then helps glucose move from your blood to your cells. Once glucose is in your cells, it can be used for energy. A problem making or using insulin means glucose cannot move into your cells. Instead, the glucose builds up in your blood. The build-up is called hyperglycemia.

Gestational diabetes is a type of diabetes that occurs or is first recognized during pregnancy. The extra glucose can affect the mother and the baby.

Large Baby Due to Gestational Diabetes

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Causes

Gestational diabetes is caused by reduced sensitivity to insulin during pregnancy.

Risk Factors

Gestational diabetes is more common in women who are 25 years and older. It is also more common in women of Hispanic, African-American, Native-American, Asian-American, Indigenous Australian, or a Pacific Islander descent.

Factors that may increase the risk of gestational diabetes include:

• Obesity or being overweight—This can affect the body's ability to use insulin.
• Gestational diabetes in a previous pregnancy
• Family history of type 2 diabetes
• Previous delivery of a large baby
• Sleep-disordered breathing—abnormal breathing during sleep ranging from snoring to sleep apnea
• History of polycystic ovary syndrome
• Multiple pregnancy—carrying 2 or more babies

Also, hormones that help the baby's growth may interfere with insulin.

Symptoms

This condition usually does not cause any symptoms. If symptoms do occur, they may include:

• Increased urination
• Thirst
• Hunger
• Weakness
• Vaginal or urinary tract infections

Diagnosis

As part of prenatal screening, you will be tested for gestational diabetes. If you don't have a history of diabetes, the test will be done at 24-28 weeks of gestation. If you have any risk factors, the test may be done earlier in pregnancy. You will be given a drink that has a special glucose solution in it. The level of glucose in your blood will be measured. Other tests may be used that require fasting (not eating or drinking anything). If you are high risk for gestational diabetes or have symptoms, you will be tested earlier in the pregnancy.

Treatment

The goal of treatment is to return blood glucose levels to normal. Treatment may include:

Diet

A dietitian can help develop a healthy meal plan. Guidelines include:

• Eat a balanced diet . Do not skip meals.
• Eat plenty of fruits, vegetables , and high fiber foods .
• Avoid foods high in sugar such as soda, candy, and cookies.
• Manage portion sizes at each meal.
• Plan a bedtime snack each night. It should include protein and complex carbohydrates such as legumes, potatoes, corn, or rice.
• Keep a record of food intake.

Do not gain more weight during pregnancy than advised. Excess weight can increase complications in pregnancy. It will also make it more difficult to control diabetes.

Exercise

Physical activity can make it easier for the body to use glucose. There are some precautions and certain exercises that should be avoided.

Blood Sugar Testing

A blood glucose monitor will help check glucose levels throughout the day. The glucose level will help plan meals, activities, and medication. Record the results. Discuss them at doctor visits.

Medication

Insulin injections may be needed to control diabetes. For some pregnant women, oral medication is recommended.

After delivery, glucose levels usually return to normal. Your glucose levels will be checked to make sure that you no longer have diabetes.

Prevention

The following may help prevent gestational diabetes:

• Do not gain more weight than recommended during pregnancy.
• Eat a healthy diet.
• Exercise regularly. Talk to your doctor before starting an exercise program.
• If you smoke , talk to your doctor about ways to quit.