Up to 10% of American women get diagnosed with gestational diabetes in their pregnancy, and one fourth of them go on to develop diabetes later in life. Find out what gestational diabetes is and how its screened. Plus learn about its complications and treatment strategies. Along with a bundle of joy, pregnancy brings with it a bag of mixed, novel emotions – excitement, anxiety, potential financial stressors, rearrangement of our career plans, home, and social life, and much more. The last thing we want to hear is that there could be possibly be something wrong with the pregnancy itself.
Being diagnosed with a pregnancy complication like gestational diabetes can be quite distressing in an already anxiety-provoking situation. Gestational diabetes may not be the best news to get during pregnancy, but it certainly isn’t the worst either. In fact, it’s often manageable, especially if caught in time and treated properly. Let’s learn more about it..
What Is Gestational Diabetes?
Up to 10% of women in the U.S. are diagnosed with gestational diabetes during pregnancy. It occurs when the pancreas is unable to produce enough insulin in order to process glucose (or sugar) that you take in every day. Blood glucose levels then subsequently rise and cause various complications. Women who have gestational diabetes have a 25% chance of developing diabetes later in their lives, and therefore should have their sugar levels screened after delivery as well. Gestational diabetes can happen to anyone, and that is why we screen all pregnant women for it. Hormonal changes unique to the pregnancy itself also weaken the receptors that insulin binds to in order to metabolize sugar. And if insulin can’t bind, the body can’t process the sugar, and sugar levels in the bloodstream subsequently increase.
Who Gets Gestational Diabetes: Risk Factors
Even though gestational diabetes can happen in any pregnancy, women who already have a risk factor for diabetes before their pregnancy tend to be at a higher risk of developing it: If you have any of the following, you are at a higher risk for developing this complication during pregnancy:
- Family history of diabetes (especially a first-degree relative, like parents or siblings)
- Gestational diabetes in a previous pregnancy
- Overweight prior to pregnancy
- Over the age of 25 during pregnancy
- Women of the following ethnicities:
- Native American,
- South or East Asian, and
- Pacific Islander Women with Polycystic Ovarian Syndrome (PCOS)
- Prediabetes prior to pregnancy Pregnancy with twins or multiples
How Is Gestational Diabetes Diagnosed: Screening
Patients with diabetes are often without any symptoms (pregnant or not). Therefore, it’s important to screen for gestational diabetes in pregnancy. This is done typically sometime between 24 and 28 weeks of pregnancy. However, for those with risk factors for gestational diabetes, screening should begin even earlier (preferably in the first trimester). So if you suffer from any of the previously mentioned risk factors, make sure your doctor is aware of it as early on as possible.
There are two ways to screen for this condition:
A super sweet 50g carb cola or orange drink is consumed in a non-fasting state. An hour later, blood is drawn to test for glucose content. If it’s elevated, the woman must return for a second test. If the results are within normal range, there’s no need for the second test and you’re in the clear. If the results are above normal, the woman must come in for what’s known as a 3-Hour Glucose Tolerance Test. Blood is drawn in a fasted state, then another even sweeter 100g carb cola or orange drink is consumed, and blood glucose levels are tested 1, 2, and 3 hours after drinking it. Diagnosis is made if there are 2 or more abnormal values.
This is a less common method of screening used by doctors. Fasting blood glucose is drawn at the lab, then a 75g carb drink is consumed, and blood glucose is tested 1 and 2 hours after the drink. Diagnosis of gestational diabetes is made if 1 or more abnormal values are obtained.
Complications of Gestational Diabetes
Even though gestational diabetes often resolves after delivery, it can cause some serious complications during the pregnancy itself and is, therefore, vital to treat. Here are some of the potential complications of gestational diabetes:
Having a large baby (over 9 pounds)
More difficult delivery, with higher risk of maternal or infant trauma H
aving a C-section
Fetal cardiac or gastrointestinal deformities
Neonatal respiratory problems
Neonatal hypoglycemia (low blood sugar)
How to Prevent Gestational Diabetes Once diagnosed with gestational diabetes, the treatment is often some diet restrictions, along with close monitoring of both the mommy and baby. However, about 15% of gestational diabetics also require daily insulin injections. They may also require closer observation and testing of the baby throughout the rest of the pregnancy.
Therefore, if you have any risk factors for gestational diabetes, it would be helpful to do everything you can to prevent it before you even get pregnant. Unfortunately, there’s no magic potion. The only thing we can do is strive to be in the best physical health that we can be prior to conception. Here’s what you can do to prevent gestational diabetes in your future pregnancies:
Lose weight: If you are overweight, your plan should include weight management and healthy eating. Studies show that weight loss as little as even 10 pounds in those who are overweight may be beneficial prior to becoming pregnant (not during – do not try to diet and lose weight during your pregnancy). But overall, shoot for a body mass index (BMI) of less than 25 as a goal.
Exercise: Besides aiding in weight management, exercise itself also decreases insulin resistance which is the process by which your body fails to respond well to insulin. Therefore, cardiovascular exercise will help decrease your risk of developing both diabetes and gestational diabetes if done before pregnancy by helping your body to better respond to the insulin that it produces.