Gestational Diabetes is a complication of pregnancy, occurring in a small percentage of expectant mothers. The condition usually goes away after the baby is born, but during pregnancy it can cause problems for both mother and baby if not diagnosed and treated. That’s why screening for gestational diabetes is a routine part of prenatal care.
When you’re pregnant, certain hormones you produce can counteract the effects of insulin, which is a hormone that helps your body convert glucose from the food you eat into energy. If pregnancy hormones prevent insulin from breaking down glucose, it can build up in your bloodstream, cross the placenta and lead to problems for both you and your baby.
Complications you might experience include:
- Higher likelihood of having a c-section delivery
- High blood pressure
- Increased risk of developing Type 2 Diabetes later in life
- Pre-eclampsia
Complications for the baby both in utero and after birth include:
- Macrosomia (oversized baby)
- Respiratory distress syndrome immediately after delivery
- Hypoglycemia (low blood sugar) after delivery
- Increased risk of being stillborn
- Increased likelihood of obesity as the baby matures, which increases the chance of developing Type 2 Diabetes
Risk Factors for Gestational Diabetes
Your doctor will typically test for gestational diabetes when you are between 24 and 28 weeks gestation. However, if you are at high risk for developing gestational diabetes, your doctor should screen you as soon as possible. Risk factors for gestational diabetes include:
- You are overweight or obese
- You had gestational diabetes in a previous pregnancy
- You have a family history of Type 2 Diabetes
- You are pregnant with more than one baby
- You are African-American, Hispanic-American, Asian-American, Native American or Pacific Islander
Screening Tests for Gestational Diabetes
Two tests may be administered between weeks 24 and 28 of your pregnancy to screen for gestational diabetes. The first is an oral glucose tolerance test (or glucose challenge test), in which you drink a sugary beverage containing 50 grams of glucose. One hour after your drink it, your doctor will take blood and test it for glucose levels. You do not need to fast for the oral glucose tolerance test.
If your one-hour blood sugar level is less than 130 milligrams per deciliter of blood (mg/dL), you most likely do not have gestational diabetes and do not need any more tests. However, if your blood sugar level is above 130 mg/dL, you may have gestational diabetes and your doctor will probably conduct another test to confirm or rule out a diagnosis.
This second test is called the 3-hour glucose tolerance test. You will need to fast for 10 to 14 hours prior to the test. Your doctor will first draw blood to measure your fasting glucose level. Afterward, you will drink a sugary-sweet liquid containing 100 grams of glucose and have blood samples taken at 1 hour, 2 hours and 3 hours after finishing the drink.
If two or more of these values are greater than the following levels of glucose, your doctor will confirm a diagnosis of gestational diabetes:
- Fasting = 95 mg/dL
- One hour = 180 mg/dL
- Two hours = 155 mg/dL
- Three hours = 140 mg/dL
What Now? Treating Gestational Diabetes
If you are diagnosed with gestational diabetes, it is vitally important to maintain good control of your blood glucose levels during pregnancy to decrease the likelihood of complications to you and to your baby. This means your doctor may recommend any or all of the following:
- Changing your diet to achieve a healthy weight
- Getting regular exercise that is safe for you and your fetus
- Taking insulin
- Monitoring your glucose levels throughout the day
As always, your doctor is the person best able to diagnose and treat your condition. Regular visits are essential to ensure the best possible care for you and your baby. Your doctor will likely order additional tests as your pregnancy progresses to ensure the baby is healthy and developing normally.
SUPPORTER