According to the Centers for Disease Control and Prevention (CDC), 2-10% of pregnancies in the United States are affected by gestational diabetes every year. Mohamed El Nemr, MD, PPG – OB/GYN, helps explain what gestational diabetes is, how it impacts both mother and baby and the ways women can lower their risk of developing the condition.
What is gestational diabetes?
Gestational diabetes is one of the most common conditions or complications during pregnancy, and is when a woman develops high blood sugar levels. Typically, the condition develops later in gestation, between 24 and 28 weeks.
Moreover, if a woman acquires gestational diabetes during her pregnancy, it doesn’t necessarily mean she had diabetes before becoming pregnant or that she will have it after delivery. However, it does raise her risk of developing Type 2 diabetes in the future.
What causes gestational diabetes?
While the exact cause is unknown, hormones play a significant role. For example, when pregnant, a woman’s body produces more hormones than normal, including human placental lactogen (hPL). Over time, the amount of hPL increases, causing the mother’s body to become resistant to insulin, a hormone that helps regulate blood sugar and moves glucose from the bloodstream into the cells.
Furthermore, a woman’s body naturally becomes slightly insulin resistant throughout pregnancy, so more glucose is readily available in the bloodstream for the baby. However, if the insulin resistance becomes too strong, a mother’s blood glucose levels could rise, causing her to develop gestational diabetes.
What factors put women at greater risk for developing the condition?
Gestational diabetes can develop in any woman who is pregnant. However, women over the age of 25 with African, Asian, Hispanic, Native American or Pacific Island ancestry may be at a higher risk. Additional factors that may increase a woman’s chances of acquiring gestational diabetes during pregnancy could also include:
- High blood pressure
- Inactivity or a sedentary lifestyle
- An unhealthy diet or poor eating habits
- Obesity or being overweight before pregnancy
- Gaining a large amount of weight during pregnancy
- A personal or family history of gestational diabetes
- Previous births of babies weighing nine pounds or more
How can gestational diabetes affect the health of both mother and baby?
If improperly managed or left untreated, gestational diabetes can pose health risks to both mother and baby. If a mother’s blood sugar levels remain higher than they should throughout pregnancy, it could lead to complications in both the short- and long-term.
For example, gestational diabetes increases a mother’s risk of:
- A cesarean birth (C-section) if the baby is too big
- Hypoglycemia (low blood sugar)
- Preeclampsia (high blood pressure during pregnancy)
- Type 2 diabetes
Also, gestational diabetes increases a baby’s risk of:
- Premature birth
- A high birth weight
- Shoulder dystocia (when a baby’s shoulders get stuck in the birth canal during labor)
- Breathing problems
- Hypoglycemia
- Type 2 diabetes
How would someone know if they have gestational diabetes?
Gestational diabetes rarely causes symptoms, but if someone does encounter them, they are usually mild and could include:
- Fatigue
- Blurred vision
- Excessive thirst
- An excessive need to urinate
If a woman does not present with any symptoms and is not at risk for gestational diabetes, her provider may still request that she complete a routine screening test for the condition. The first is a glucose challenge test where she must drink a glucose solution, then have a blood test one hour later to measure her blood sugar levels.
However, if her blood sugar levels come back as elevated, another glucose tolerance test may be warranted to determine if she has gestational diabetes. This test is like the first, except the solution contains more glucose or sugar. Then, after drinking the solution, the patient’s blood sugar will get checked every hour for three hours. If two of the readings are higher than normal, she has gestational diabetes.
How is gestational diabetes treated?
In most cases, the treatment for gestational diabetes includes making healthy lifestyle changes like eating a nutritious, balanced diet and staying active or exercising regularly. Additionally, your provider and healthcare team may ask that you closely monitor your blood sugar levels and take any necessary medications if needed. Close management of the condition can be extremely beneficial to mother and baby by helping them both avoid any complications during pregnancy and/or delivery.
What can women do to lower their risk of developing gestational diabetes?
Adopting healthy habits like eating a balanced diet and incorporating regular exercise into their routine can be highly beneficial and reduce their risk of gestational diabetes. Moreover, if a woman is overweight but plans to become pregnant in the future, we recommend speaking with your provider on healthful ways to lose weight. Even losing a small amount of weight can help reduce a woman’s risk of gestational diabetes and ensure a healthy pregnancy and delivery.
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