What is Gestational Diabetes?

You’ve just found out from your health practitioner that you have gestational diabetes from a simple glucose tolerance test. Should you be concerned that you’ve been diagnosed with gestational diabetes? Yes. It means that you will need to take good care of your health by watching your diet to keep you and your baby in good health.

Gestational diabetes is a condition developed during pregnancy, and is a type of diabetes that non-diabetic women can experience. Approximately 2 to 7 percent of expectant mothers develop this condition and is one of the most common health problems experienced during pregnancy.

Typically in your stomach and intestines, carbohydrates found in your food is turned into a sugar called glucose. Glucose is your body’s main source of energy and is transported to your body’s cell by a hormone produced by your pancreas (insulin). In diabetes, either your body is unable to meet demands and produce enough insulin to remove glucose from your blood or your cells cannot use it in the way they should. The glucose ends up building up in the blood, causing high blood sugar, otherwise known as diabetes. Some think that the woman is developing the right amount of insulin, but the effect of insulin is blocked partly by a variety of other hormones produced in greater amounts during pregnancy: progesterone, prolactin, estrogen, cortisol and human placental lactogen – which are made in the placenta. As the placenta grows, these hormones are produced in greater amounts.

Only 5 percent of pregnant women develop gestational diabetes, which is about 200,000 cases a year in the United States. Your risk for gestational diabetes increases with age and is more common among women who become pregnant after the age of 25, who are obese or overweight, have high blood pressure, or have a family history of diabetes. If you’ve had gestational diabetes in the past, you will also be at higher risk with the next pregnancy.

In addition, Native American, Hispanic, African American, South or East Asian, Pacific Islander or Indigenous Australian descents are more likely to have the condition.

The exact cause for gestational diabetes is unknown, but there are some clues. The placenta supports the baby as it grows in the uterus. Hormones from the placenta help the baby develop but but also block the action of the mother’s insulin in her own body. The insulin resistance makes it hard for the mother’s body to absorb the sugar and use insulin in the correct way. She may instead need up to 3 times as much insulin. If the woman’s body is unable to make and use all the insulin it needs for pregnancy, then the pregnant woman develops gestational diabetes. Without enough insulin to transport glucose to the body’s cell it cannot leave the blood and be converted into energy. The glucose will build up in the mother’s blood to high levels inducing hyperglycemia.

Gestational diabetes affects moms-to-be in late pregnancy, after the body of the baby has formed but is still continuing to grow. For this reason, gestational diabetes does not cause birth defects similar to women who had diabetes early or before pregnancy. But, left untreated or poorly controlled, gestational diabetes can hurt your baby. Your pancreas will be working overtime to produce insulin, but the insulin will be unable to lower the glucose levels in the blood. Insulin doesn’t cross the placenta, but glucose and other nutrients will and will cause the baby’s pancreas to compensate to make extra insulin. Since the baby is now getting more energy than it needs to grow and develop, the extra energy is converted and stored as fat. Thus, gestational diabetes can increase the size of the baby which may require a c-section when the baby is due.

Very few women actually need insulin injections when they have Gestational Diabetes (Gestational Diabetes Mellitus) if a proper diet plan is followed. The disease used to be a sneaky one until tests were introduced to screen all pregnancies (1 hour blood glucose drink). If the first test is failed, then a full 3 hour glucose gestational diabetes tolerance test is taken after a night of fasting. This test will determine for your doctor if you really do have gestational diabetes.

Symptoms of Gestational Diabetes

You may not show any symptoms, but you may notice some symptoms (which can overlap with pregnancy symptoms), such as increased thirst, frequent urination, nausea, or fatigue.

Doctors will test most women between the 24th and 28th week of pregnancy, although if you are seen as high risk, then your doctor may test you during early pregnancy.

Most women will only have to take the first 1 hour glucose test, but if this test is failed, another test is required to measure the woman’s blood sugar. The 3 hour glucose tolerance test will rule out any “false positives” from the 1 hour test and truly tell your doctor if you have gestational diabetes.

A normal reading should be less than 140 milligrams per deciliter. If the reading is over 200 mg/dl, you probably have gestational diabetes and your doctor will work with you closely on a diet and exercise plan. If your reading is between 140 mg/dl and 200 mg/dl, then your diagnose is less clear and you will need to take the 3 hour glucose tolerance test (GTT).

How will Gestational Diabetes Affect My Baby?

Most women who have gestational diabetes will go on to deliver a healthy baby, due to careful control of their blood sugar, eating a healthy diet, exercising and maintaining a healthy weight.

There are potential risks to some women in some cases:

The baby’s body is larger than normal, a condition called “macrosomia“. A large baby may need to be delivered by cesarean section, instead of naturally through the vagina.
The baby’s blood sugar may be low and will need to be breastfeed right away to get some glucose into the baby.
The baby’s skin may be yellowish, showing a sign of jaundice. Jaundice can be easily treated and is not serious if treated.
The baby may have trouble breathing and require oxygen or other help.
The baby may have low mineral levels in the blood. It may cause the baby’s muscles to twitch or cramp and can only be treated by administered additional minerals to the baby.
Uncontrolled gestational diabetes will put you at greater risk for preeclampsia, a disorder resulting in high blood pressure and protein in the urine. This can cause problems for you and your baby. You may be required to delivery the baby early, or be confined to bed rest either at home or the hospital. In extreme cases, preeclampsia can lead to seizures.

Gestational Diabetes can also put you at higher risk for a condition called polyhydramnios, which means there is too much amniotic fluid around the fetus and can cause the amniotic sac to break or lead to preterm labor.

Gestational Diabetes Treatment

Each pregnant woman should have a gestational diabetes low carb diet and exercise plan designed for her needs. Although, here are some general guidelines to follow to stay healthy with gestational diabetes:

Know your blood sugar and keep it under control by testing how much sugar is in your blood. Test a drop of blood several times during the day to find out your blood sugar level.
Monitor your urine for ketones (an acid that indicates your diabetes isn’t under control).
Eat a healthy diet which your doctor will create for you. Carbohydrates affect blood sugar, so it is very important to watch your diet closely.
Get regular and moderate physical activity to control your blood sugar levels.
Maintain a healthy weight and weight gain, that is healthy for you depending on how much you weighed before pregnancy.
Track your diet, activity and glucose level daily to double-check what is working and what is not.
There are some women who will need to take insulin to manage their gestational diabetes. The additional insulin can assist with lowering blood sugar level.

If you are able to check your blood sugar at home, you will need to check your glucose before eating and 2 hours afterward. A normal plasma blood sugar level in the morning prior to eating should not be higher than 105 mg/dl. 155 mg/dl or less one hour after a meal, and 130 mg/dl or lower 2 hours after eating.

Gestational Diabetes Diet

To help maintain a “normal” blood sugar level (60 to 120 mg/dl):

Avoid sugar and foods high in sugar
Eat complex (not simple) carbohydrates such as pasta, cereals, crackers, bread, potatoes, peas, rice, grains and dried beans.
Avoid saturated fats such as butter, bacon, cream and whole milk cheese, and fatty meats
Eat a snack before bedtime that is high in protein and carbohydrate based.
Eat fiber-rich foods such as breads, fruits, vegetables and whole grain cereals.
Exercise

Talk with your doctor about what type of exercising program is right for you. Women are typically encouraged to get at least three to four days a week, with each session lasting 15 to 30 minutes. Pregnant women should not take on very strenuous activity and should not become overheated.

Pregnancy Weight

If a woman is at a desirable weight for her body size and height, a weight gain of 25 to 35 pounds is recommended. For a woman who is 20 pounds overweight, a weight gain of 20 to 24 pounds is recommended. If she is underweight, then a weight gain of 28 to 36 pounds is recommended. Although, it depends on how underweight the woman is before getting pregnant.

After the Baby is Born

Blood sugar levels can return to normal quickly after the baby is born. About six weeks after the birth, you should get another blood test to check your blood sugar levels, which will also check for your risk of developing diabetes in the future.

Children born to women who had gestational diabetes have a higher risk for obesity, diabetes and an abnormal glucose tolerance. For the mom, there is a higher chance of developing type 2 diabetes later in age.

By eating a healthy diet and exercising regularly, you and your baby will both benefit.