Gestational diabetes: Understanding your risk
If you're thinking about getting pregnant or are already pregnant, you may be considering your health risks and possible preventions. One condition that can happen during pregnancy is gestational diabetes. We’ll go over what gestational diabetes is, how it can affect you and your baby, and what you can do about it.
What is gestational diabetes?
Getting diagnosed with diabetes while you’re pregnant is known as gestational diabetes. The condition affects how certain cells use sugar and causes high blood sugar (like other forms of diabetes). Having high blood sugar can affect your pregnancy and the health of your baby.
Hormones that prevent your body from using insulin effectively, such as estrogen, cortisol, and human placental lactogen, can lead to this condition. If everything is normal, your pancreas can make additional insulin to overcome the effect these hormones have. Gestational diabetes occurs when these processes don’t work as expected.
Usually, gestational diabetes starts 20-24 weeks into your pregnancy and generally stops affecting your blood sugar levels shortly after delivering your baby. This is due to a certain hormone that is produced by the placenta called human placental lactogen. This hormone can contribute to the increasing insulin resistance that is sometimes seen in pregnancy.
Being diagnosed with gestational diabetes can at times put you at a higher risk of developing other forms of diabetes later in life. If you are pregnant, make sure to get all the recommended testing done, as one is a glucose test that can help with making a diagnosis. Also checking regularly to make sure your blood sugar levels don’t change significantly to avoid potential complications can be helpful.
So, what can lead to gestational diabetes? According to the NIH, risk factors include:
- Being overweight or obese prior to pregnancy
- Not getting enough physical activity
- A history of gestational diabetes or pre-diabetes in a previous pregnancy
- Polycystic ovarian syndrome
- Family history of diabetes
- Previous delivery of a baby that weighs 9 pounds or more
- Your age (higher risk over the age of 25)
- Gaining weight too quickly in pregnancy
How can gestational diabetes affect you and your baby?
Most women don’t experience noticeable symptoms, though your thirst may increase, and you may need to pee more frequently. You might experience complications like high blood pressure, preeclampsia, the need for a C-section, and type 2 diabetes (sometime in the future). Complications that affect your baby include:
- Higher birth weight (increasing the risk of birth injury or getting stuck in the birth canal)
- Preterm birth
- Breathing difficulties (a condition called respiratory distress syndrome)
- Low blood sugar
Gestational diabetes prevention and treatment
During your second trimester, 24-28 weeks into your pregnancy, you will most likely be screened for gestational diabetes. If you’re at higher risk for gestational diabetes, these tests will be done earlier, possibly at your first prenatal appointment. These tests include a glucose challenge test and, if your blood sugar levels are too high, a follow-up glucose tolerance test.
During the initial glucose test, you drink a glucose solution and, after an hour, your blood sugar levels will be measured. If results show a blood sugar level of 190 mg/dL or higher, you’ll likely be diagnosed with gestational diabetes. It’s normal to have blood sugar levels lower than 140 mg/dL.
You drink an even sweeter solution, and your blood sugar will be checked every hour for three hours during any follow-up tests. You’ll be diagnosed with gestational diabetes if two of these tests show high blood sugar levels.
Management of the condition includes making lifestyle alterations to promote better overall health. These changes are the first steps to managing gestational diabetes and include following a healthier diet and exercising regularly (recommendations call for at least 30 minutes of moderate activity on most days). Try to maintain a diet that’s higher in fiber and eat a variety of foods can balance nutritional needs.
It could be helpful to speak with a nutritional expert to customize a plan that works for you. You can use medications like insulin injections to help keep your blood sugar in the normal range, but this isn’t always necessary. To better manage the condition, it’s important to monitor your blood sugar levels and adjust your lifestyle accordingly. Medications are available to manage gestational diabetes if lifestyle changes do not work.
Having regular checkups during pregnancy will help you find and address any health concerns. Tests such as ultrasounds monitor the growth and development of your baby through your pregnancy. If you’re diagnosed with gestational diabetes, you will have more frequent checkups and ultrasounds throughout your pregnancy to stay aware of your health and the health of your baby.
Treatment for gestational diabetes will depend on factors including:
- Your age, overall health, and medical history
- The extent (severity) of the condition
- Your tolerance for specific medications, procedures, and therapies
- Expectations for the course of the disease
- Your preferences
Make sure to follow up after delivery to manage the health of you and your baby. If you do get gestational diabetes, experts recommend screening for pre-diabetes and other forms of diabetes at least every three years from that point on.
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