Seven Things You Should Know About Gestational Diabetes

Diabetes is a disease that affects 29 million Americans, and the great majority of people with diabetes suffer from either Type 1 (juvenile) or Type 2 (adult onset), but there is a third type that all woman that are pregnant or thinking about becoming pregnant need to be aware of: gestational.

What is it? Gestational diabetes can only happen during pregnancy and occurs when the placenta produces hormones that create a buildup of sugar (also called glucose) in the blood stream. This buildup occurs in all pregnancies, and your body should create additional insulin (a hormone that helps the body breakdown and use sugar) to compensate for the extra sugar. When your body is unable to make the extra insulin, your blood sugar rises, causing gestational diabetes.

Are you at risk? Gestational diabetes can happen to any woman during pregnancy, but you are at a higher risk of developing it if:

• You have a family history of diabetes
• You’ve had gestational diabetes with previous pregnancies
• You were overweight prior to becoming pregnant
• You are African-American, Asian, Hispanic, or Native American
• Your blood sugar levels were high before becoming pregnant, but not high enough to be diabetes
• You are over the age of 30
• You had previously given birth to a baby who weighed more than 9 1/2 pounds

What are the symptoms? 

For most women, there are no noticeable symptoms of gestational diabetes.

Once your pregnancy is confirmed, your doctor will ask you some questions to determine your risk for developing the disease.

How do you diagnose it? Gestational diabetes is diagnosed with a blood sugar test, which involves consuming a sugary drink to raise your blood sugar levels. After an hour, you will take a blood test to determine how well your body was able to process the sugar. If the results show that your blood sugar remained high, you will need additional testing to determine if you have gestational diabetes. It’s common for all pregnant women to take a blood sugar test, usually between weeks 24 and 28 of the pregnancy. If your doctor determined early in your pregnancy that you are at risk for gestational diabetes, they will ask you to take the blood sugar test right away and may ask you to repeat the test later in you pregnancy.

How is it treated? If diagnosed, your doctor will recommend more frequent checkups so that they can closely monitor your blood sugar levels and check for complications. They will ask you to follow a sensible diet and exercise plan to help control your blood sugar and you may be required to check your blood sugar levels several times a day (it’s much easier to do than you think, and your doctor will teach you how). If you are unable to control your blood sugar with diet and exercise, you may need to take medication to keep it under control. 

How will this affect me and my baby? The majority of women with gestational diabetes go on to deliver healthy babies, but if the diabetes goes unmanaged, you and the baby are at an increased risk for complications.

The risks for babies include:

• Excessive birth weight (weighing more than 9 pounds)
• Early (preterm) birth
• Low blood sugar (hypoglycemia)

The risks for mothers include:

• High blood pressure
• Preeclampsia
• An increased likelihood of developing type 2 diabetes later in life

If you are diagnosed with gestational diabetes, your doctor will explain all possible complications and will monitor you closely throughout your pregnancy. If any complications arise, they will work with you to keep you and your baby healthy.

Will it go away after I have the baby? For the majority of women, gestational diabetes goes away on its own after the baby is born. Your doctor will do another blood sugar test 6 to 12 weeks after your delivery to determine if the diabetes has gone away. If it has, your doctor will continue to test you for diabetes every one to three years, as you will be at an increased risk of developing Type 2 diabetes later in life. If the diabetes does not go away, you are then considered to have Type 2 diabetes and your doctor will work with you to develop a long-term treatment plan.

If you are concerned about gestational diabetes, the best thing that you can do is talk to your doctor about your risk factors and family history. The sooner you are diagnosed, the sooner your doctor can begin treating you and monitoring for potential complications.

Dr. Shannon Fullerton is an OB/GYN with a practice at The Women’s Center of South Shore Medical Center in Weymouth.

Learn more about Primary Care at South Shore Health.