Contents:
- Medical Video: What is Gestational Diabetes?
- What causes gestational diabetes?
- What are the factors that can make me at risk for gestational diabetes?
- Tests and diagnosis for gestational diabetes
- When should I do the test?
- What should I do if I am diagnosed with gestational diabetes?
- Blood sugar test after giving birth
- Treatment and medicine
Medical Video: What is Gestational Diabetes?
Gestational diabetes is diabetes that develops during pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar which can affect your baby's pregnancy and health.
Every pregnancy complication must make you worry, but there is good news. Pregnant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and make you and your baby healthy.
In gestational diabetes, blood sugar will return to normal soon after giving birth. But if you have had gestational diabetes, you are at risk of developing type 2 diabetes in the future. You should continue to see your doctor to monitor and manage your blood sugar, because for most women, gestational diabetes does not cause real signs or symptoms.
When you have gestational diabetes, you need to regularly check your blood sugar levels. The frequency of blood sugar testing will depend on the results of the test after you give birth to your baby.
What causes gestational diabetes?
Researchers don't know why some women have gestational diabetes. By understanding how gestational diabetes occurs, you can also understand how pregnancy affects the process of glucose in your body.
Your body digests the food you eat to produce sugar (glucose) that enters your bloodstream. Then, the pancreas — the large gland behind your stomach — produces insulin. Insulin is a hormone that helps glucose move from the bloodstream into your body's cells, which is then used as energy.
During pregnancy, the placenta, which connects your baby to your blood supply, will produce a variety of other high-level hormones. Almost all of them prevent the action of insulin in your cells and increase your blood sugar. Moderate increases in blood sugar after meals are normal during pregnancy.
When your baby grows, the placenta produces more insulin barrier hormones. In gestational diabetes, placental hormones trigger an increase in blood sugar to levels that can affect the growth and well-being of your baby. Gestational diabetes usually develops during the last half of pregnancy — sometimes the initial 20th week, but generally no more than that.
What are the factors that can make me at risk for gestational diabetes?
Gestational diabetes can develop in every woman, but some women have a higher risk. Risk factors for gestational diabetes include:
- Age more than 25 year. Women over the age of 25 are more likely to develop gestational diabetes
- Family or personal health history. The risk of gestational diabetes increases when you have prediabetes — a slight increase in blood sugar that might be a clue to type 2 diabetes — or if a family member, such as a parent or sibling, has type 2 diabetes. You are likely to get gestational diabetes if you have this diabetes, or if you give birth to a baby who weighs more than 4.1 kilograms, or if you have a stillbirth without explanation
- Excess weight. You are likely to get gestational diabetes if you are significantly overweight with a body mass index of 30 or more.
- Not a white race. For no apparent reason, Negro women, Hispanics, Americans-Indians, or Asians are more likely to develop gestational diabetes.
Tests and diagnosis for gestational diabetes
Medical experts have not agreed on a set of guidelines for screening for gestational diabetes. It is still questionable whether gestational diabetes screening is needed if you are younger than 25 and do not have risk factors. Others say that all pregnant women need screening to identify all cases of gestational diabetes.
When should I do the test?
Your doctor may evaluate your risk factors for gestational diabetes early in your pregnancy.
If you are at high risk for gestational diabetes - for example, your body mass index (BMI) before pregnancy is 30 or higher or you have a mother, father, sibling or child with diabetes - your doctor may test for diabetes at the start of your prenatal visit.
If you are at an average risk for gestational diabetes, you may be tested for screening during the second trimester — between the 24th and 28th weeks of pregnancy.
What should I do if I am diagnosed with gestational diabetes?
Your doctor may often recommend a check-up, especially as long as you are in the last three months of pregnancy. During this examination, the doctor will monitor your blood sugar. Your doctor may also ask you to monitor your own blood sugar as part of a treatment plan.
If you have difficulty controlling your blood sugar, you may need to use insulin. If you have other pregnancy complications, you may need additional tests to evaluate your baby's health. This test will assess the function of the placenta, the organ that provides oxygen and nutrients to your baby by connecting the baby's blood supply with you.
If your gestational diabetes is difficult to control, it can affect the placenta and endanger the delivery of oxygen and nutrients to the baby.
Your doctor will also do a test to monitor your baby during pregnancy.
Blood sugar test after giving birth
Your doctor will check your blood sugar after giving birth and then within six to 12 weeks to ensure that your blood sugar level has returned to normal. If your test is normal, you should check your diabetes risk at least every three years.
If future tests show diabetes or prediabetes - a condition where your blood sugar is higher than normal, but not high enough to be considered diabetes - talk to your doctor about increasing prevention efforts or starting a diabetes management plan.
Treatment and medicine
It is important to monitor and control your blood sugar to keep your baby healthy and avoid complications during pregnancy and childbirth.
You also need to monitor your blood sugar level in the future. Your treatment strategies might include:
Monitor your blood sugar. When you are pregnant, your health care team may ask you to check your blood sugar 4-5 times a day — first in the morning and after meals — to ensure that your blood sugar level is in a healthy range. This may sound uncomfortable and difficult, but it will be easier when practiced.
To test your blood sugar, take a drop of blood from your finger using a small needle (lancet), then place blood on the test strip and put it in the blood glucose meter - a device that measures and displays your blood sugar level.
Your health care team will monitor and manage your blood sugar during labor and delivery. If your blood sugar rises, your baby's pancreas can release high levels of insulin - which can cause low blood sugar in your baby after birth.
Follow-up examination of blood sugar is also important. Having gestational diabetes increases your risk of developing type 2 diabetes later in life. Check your doctor regularly to monitor your blood sugar level. Maintaining healthy lifestyle habits, such as a healthy diet and regular exercise, can help reduce your risk.
Healthy diet. Eating the right type of food in a healthy portion is one of the best ways to control blood sugar and prevent too much weight gain, which can put you at a higher risk of complications. Doctors do not recommend losing weight during pregnancy because your body works hard to support your baby's growth. But your doctor can help you set weight goals based on your weight before becoming pregnant.
Sports. Regular physical activity plays a key role in every woman's health plan before, during, and after pregnancy. Exercise lowers your blood sugar by stimulating your body to move glucose into your cells, which will be used as energy. Exercise also increases the sensitivity of your cells to insulin, which means your body will need to produce a little insulin to transport sugar.
As an added bonus, regular exercise can help alleviate some of the common discomforts during pregnancy, including back pain, muscle cramps, swelling, constipation, and difficulty sleeping. Exercise can also help you stay healthy during labor.
Drugs. If your diet and exercise are not enough, you might need an injection of insulin to lower your blood sugar. Between 10 and 20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors prescribe oral blood sugar control drugs, while others believe that more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin for controlling gestational diabetes.
Monitor your baby. An important part of your treatment plan is your baby's observation. Your doctor can monitor the growth and development of your baby with recurrent ultrasound or other tests. If you have not given birth at the appointed time — or sometimes earlier — the doctor may induce labor. Giving birth after the prescribed time limit can increase the risk of complications for you and your baby.
