Gestational diabetes can have serious consequences for mother and baby. Fortunately, diagnosis, monitoring and treatment can reduce those consequences.
What is gestational diabetes and who gets it?
High blood sugar that appears during pregnancy is called gestational diabetes. Women who get gestational diabetes usually get it around the middle of their pregnancy, after the 20th week.
The cause of gestational diabetes is not known. Women who have never had high blood sugar can get gestational diabetes during their pregnancy, but some women are at higher risk of developing it.
According to the US National Library of Medicine, the following factors increase a woman's risk of developing gestational diabetes:
- Being older than 25 when pregnant
- Family history of diabetes
- Giving birth to a baby that weighed more than 9 pounds or had a birth defect
- High blood pressure
- Having too much amniotic fluid
- Having had an unexplained miscarriage or stillbirth
- Being overweight before pregnancy
How do you know if you have gestational diabetes?
If you have gestational diabetes, you may show no symptoms. However, your obstetrician may monitor for gestational diabetes during your pregnancy by testing your blood sugar levels.
One test for blood sugar is called a glucose tolerance test. For this test, you will be asked to refrain from eating or drinking anything for eight hours before the test. Then, you will drink a sugar solution, and your blood will be drawn at different time intervals to test how much sugar remains in your blood.
How is gestational diabetes treated?
Untreated gestational diabetes is very serious. It can result in a baby's death either before or shortly after its birth.
The aim of treatment for gestational diabetes is to reduce blood sugar levels, which may be accomplished through diet and exercise. A healthy diet often includes fruits, vegetables and whole grains, but limits sugars, including those in processed foods.
"Patients can lower their risks for gestational diabetes by limiting sugars, juices, carbohydrates and weight gain during pregnancy," said Jennifer Mushtaler, MD, founder of Capital Ob/Gyn Associates of Texas in Austin, Texas. "Don't indulge cravings, indulge your baby's health with healthy choices for both of you."
It is important that a doctor manages the treatment of gestational diabetes because if diet and exercise do not bring the blood sugar levels down to normal, medicine may be prescribed to lower it.
Between 10 and 20 percent of women with gestational diabetes need insulin to control their blood sugar. Insulin helps sugar get into cells where it can be used for energy, thereby decreasing the amount of sugar in the blood.
The use of oral medications, such as metformin (brand name Glucophage), to decrease blood sugar has been used to treat gestational diabetes.
Your baby’s growth and development will be closely monitored by your doctor during your pregnancy. Ultrasounds, in which sound waves are used to create pictures of the baby in the womb, can be used to look at organ, skeletal and other developmental features of the baby, and can provide an estimate of the baby's size.
Monitoring the baby's size is important for planning delivery methods and anticipating other situations that can occur with the vaginal birth of a large baby, such as broken collarbones.
Some mothers with gestational diabetes may be given a non-stress test, also called fetal heart rate monitoring. Fetal heart rate monitoring allows the doctor to see how the baby’s heart responds to the baby's movements.
During the non-stress test, the baby's heart rate will be measured. Later in pregnancy, a baby’s heart typically beats faster if the baby is active. If the baby's heart does not beat faster when the baby is active, it may mean that the mother's gestational diabetes is affecting the baby's health. In this case, your doctor will decide whether further testing is needed or if the baby should be delivered early.
What are the consequences of gestational diabetes to mother and baby?
Gestational diabetes can affect both the mother and the baby. Pregnant women with gestational diabetes are at increased risk for developing high blood pressure and preeclampsia during their pregnancy.
Preeclampsia is a condition during pregnancy in which the mother has high blood pressure and protein in her urine. This is a very serious condition that can be life-threatening for both the mother and baby.
Women who have had gestational diabetes are more likely to get it again during a future pregnancy.
Your doctor may recommend that your blood sugar be monitored regularly after delivery because women who have had gestational diabetes are at increased risk for getting type 2 diabetes, a type of diabetes in which the body’s insulin does not effectively lower the blood sugar.
Building a healthy diet and exercise routine into your lifestyle after your baby’s birth may lower your risk of developing type 2 diabetes.
The Mayo Clinic estimates that less than one in four women who have had gestational diabetes and reach their ideal body weight after their baby’s birth will develop type 2 diabetes.
If a pregnant woman has gestational diabetes, her baby is at an increased risk for weighing over nine pounds. Heavier babies may lead to complications during delivery that require a Cesarean section (C section).
High blood sugar in the mother may cause early labor and delivery. If that happens, the baby is at risk for respiratory distress syndrome, a condition in which the baby has difficulty breathing. Even babies not born early can develop respiratory distress if the mother has gestational diabetes.
The blood sugar of babies born to mothers with gestational diabetes will be tested because they may develop low blood sugar shortly after they are born. This low blood sugar can result in seizures and can be treated with feeding or by giving the baby a sugar solution through an IV.