About gestational diabetes

What is gestational diabetes?

Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have never had diabetes.



What are the symptoms for gestational diabetes?

For most women, gestational diabetes doesn't cause noticeable signs or symptoms.

When to see a doctor

If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you're pregnant, your doctor will check you for gestational diabetes as part of your prenatal care. If you develop gestational diabetes, you may need more-frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health.

Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy.

To make sure your blood sugar level has returned to normal after your baby is born, your health care team will check your blood sugar right after delivery and again in six weeks. Once you've had gestational diabetes, it's a good idea to have your blood sugar level tested regularly.

The frequency of blood sugar tests will, in part, depend on your test results soon after you deliver your baby.



What are the causes for gestational diabetes?

Researchers don't know why some women develop gestational diabetes. To understand how gestational diabetes occurs, it can help to understand how pregnancy affects your body's glucose processing.

Your body digests the food you eat to produce sugar (glucose) that enters your bloodstream. In response, your pancreas — a large gland behind your stomach — produces insulin. Insulin is a hormone that helps glucose move from your bloodstream into your body's cells, where it's used as energy.

During pregnancy, the placenta, which connects your baby to your blood supply, produces high levels of various other hormones. Almost all of them impair the action of insulin in your cells, raising your blood sugar. Modest elevation of blood sugar after meals is normal during pregnancy.

As your baby grows, the placenta produces more and more insulin-counteracting hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and welfare of your baby. Gestational diabetes usually develops during the last half of pregnancy — sometimes as early as the 20th week, but generally not until later.



What are the treatments for gestational diabetes?

It is important to receive proper treatment for gestational diabetes, since research studies have shown that the incidence of problems and complications is decreased when treatment plans are followed. Treatment for gestational diabetes involves attention to maintaining a proper diet and exercise as advised by your doctor. Nutritional therapy is the first approach, and many women will achieve adequate glucose control by following a nutritional plan.

Testing your blood glucose levels at home at specific times or after meals as recommended by your doctor will determine if your glucose levels are within recommended limits. Testing at least four times per day is typical. You may also be asked to test your urine for ketones, substances that are produced when your body metabolizes fat. Ketones are elevated when the body is unable to use glucose for energy.

If diet and exercise are not sufficient to maintain good control of your blood glucose levels, you may need to take insulin. Insulin is the only approved medication used to treat gestational diabetes in the U.S.; however, some clinicians may choose to use an oral agent to control the blood sugar in some patients. As the pregnancy progresses, your insulin needs may change and insulin doses may have to be adjusted.



What are the risk factors for gestational diabetes?

Any woman can develop gestational diabetes, but some women are at greater risk. Risk factors for gestational diabetes include:

  • Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes.
  • Family or personal health history. Your risk of developing gestational diabetes increases if you have prediabetes — slightly elevated blood sugar that may be a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You're also more likely to develop gestational diabetes if you had it during a previous pregnancy, if you delivered a baby who weighed more than 9 pounds (4.1 kilograms) or if you had an unexplained stillbirth.
  • Excess weight. You're more likely to develop gestational diabetes if you're significantly overweight with a body mass index (BMI) of 30 or higher.
  • Nonwhite race. For reasons that aren't clear, women who are , Hispanic, American Indian or Asian are at higher risk to develop gestational diabetes.



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