Guarding Against Gestational Diabetes

You’re almost finished with your second trimester of pregnancy. You find you’re constantly thirsty and you’re urinating a lot. Diabetes runs in your family. Could you have gestational diabetes?

Gestational diabetes happens when certain hormones produced during pregnancy interfere with the production of insulin, the hormone needed to carry glucose from the bloodstream to the cells, which convert it into energy.

As the baby grows, the placenta makes more and more of the insulin-interfering hormones. In most women, the pancreas compensates by producing more insulin. But when that doesn’t happen, blood sugar rises, resulting in gestational diabetes.

The condition, which usually occurs in the last trimester, doesn’t cause the mother noticeable symptoms. It takes an oral glucose or blood screening test to detect.

The percentage of mothers giving birth who received a diagnosis of gestational diabetes increased from 6.0 percent in 2016 to 8.3 percent in 2021.

Women who are at greater risk of developing gestational diabetes during pregnancy:

§  Are 25 or older.

§  Are obese (BMI greater than 30).

§  Have prediabetes (insulin resistance) before pregnancy.

§  Have a parent or sibling with Type 2 diabetes.

§  Had gestational diabetes in a previous pregnancy.

§  Delivered a baby weighing more than nine pounds.

§  Had an unexplained stillbirth.

§  Are black, Hispanic, American-Indian or Asian.

Some risks to the baby are the infant’s larger size (macrosomia) may mean a Caesarean section, breathing problems at birth, low blood sugar at birth, jaundice at birth, Type 2 diabetes later in life and obesity later in life. The mother faces the risk of preeclampsia (high blood pressure during pregnancy), a C-section delivery and possible future Type 2 diabetes.

Although gestational diabetes usually subsides after giving birth, you may still run the risk of developing it in the future.

Any pregnant woman with high blood sugar levels is at risk of developing this condition but obesity raises that risk.

In order to diagnose gestational diabetes, your health provider will test your blood sugar. The test has two parts:

§  Glucose challenge test where you drink a sweet liquid. After about an hour, you will undergo a blood test to check your blood sugar level. If the level is high, your provider will do a glucose tolerance test.

§  An oral glucose tolerance test is only done if your challenge results are unusual. You fast (don’t eat for eight hours) before the tolerance test. Your provider draws blood before and at one-, two- and three-hour intervals after you drink a sweet liquid. This test can confirm a diagnosis of gestational diabetes.

Once you are diagnosed, the first step is meeting with a nutritionist or another health provider who will help you with a healthy diet so instead of three large meals a day, you will have three small meals and three snacks. You may be required to keep a food log. It is important that pregnant women with gestational diabetes watch what they eat, especially carbohydrates.

It is also recommended that those with gestational diabetes engage in 30 minutes three days per week of light physical activity such as walking.

Although many women with gestational diabetes can control their blood sugar levels through diet alone, some women might require insulin shots. They must also test their blood sugar throughout the day. You may need to monitor your blood sugar levels at home with a glucose meter.

A diagnosis of gestational diabetes can be scary, but with proper treatment, most mothers and babies turn out fine.