Gestational diabetes is a condition in which women develop diabetes for the first time during pregnancy. This is becoming more frequent in the United States, and it currently affects nearly 10% of all pregnant women, according to the American Diabetes Association. Years ago, it was only 2-3% of all pregnancies. Gestational diabetes can cause high blood sugar levels and often goes undetected. This is why it’s important to get your blood sugar levels checked during prenatal appointments, as it can lead to unintended side effects for both the mother and the baby.
Fortunately, gestational diabetes is treatable and easily diagnosable, meaning you can get the care you need at Maternal Fetal Medicine Associates to prevent your risk for developing more serious health risks to you or your baby.
Signs and Symptoms of Gestational Diabetes During Pregnancy
There are several signs of gestational diabetes during pregnancy. Perhaps the most well-known sign of diabetes (both gestational and types 1 and 2) is constant thirst and frequent urination. This is because the process that is normally responsible for controlling blood sugar is no longer working, leading to high levels of blood sugar. The body needs to maintain a balance between sugars and water, leading to an ultimately ineffective solution of simply signaling to drink more water.
However, this symptom may not be caused by diabetes, which is why this condition must be diagnosed by a medical professional. During a professionally administered blood test, we can determine whether you have developed gestational diabetes.
Effects and Risks of Gestational Diabetes
Elevated blood sugar in the mother’s blood translates into higher blood sugars in the baby’s blood. High blood sugars in the fetus’ blood can cause a number of problems. One of the most common problems is that these babies can be much bigger in size at birth, the medical term for this being macrosomia.
High blood sugar can also lead to early labor and delivery, or be recommended due to the size of the baby. Gestational diabetes can also lead to low blood sugar, which can be dangerous for infants born with low blood sugar, as they are at risk for seizures. Untreated gestational diabetes has also been linked to stillbirths. Respiratory distress syndrome affects some newborns, a condition in which the baby has difficulty breathing.
On the mother’s side, women with gestational diabetes can have a greater risk for having type 2 diabetes later in life, or gestational diabetes in future pregnancies. Additionally, it can increase your risk for high blood pressure, which poses a serious risk to your health and the health of your baby during delivery. Mothers with gestational diabetes more frequently need a C-section to avoid the risks of a vaginal birth.
Causes and Risk Factors of Gestational Diabetes
Doctors are still unsure about what causes gestational diabetes. However, women who are pregnant are more likely to develop diabetes due to the many hormonal changes caused by pregnancy. As fetuses have a constant need for sugar, the placenta actually makes a hormone to raise the amount of sugar in the mother’s blood. This hormone blocks the action of insulin that we normally make to control blood sugar levels. To counteract this process, pregnant women normally make more insulin than they did when they weren’t pregnant. About 6-9% of pregnant women cannot make the extra insulin required, and therefore become diabetic.
Women with a history of diabetes in their family also have an increased risk of developing gestational diabetes, as are women of color and those who have had previous gestational diabetes.
Gestational Diabetes and Pregnancy Complications
In some cases, gestational diabetes affects the size of a baby, leading to a macrosomic birth. The vaginal birth of a macrosomic baby (a baby over 8 pounds 13 ounces) is at higher risk of traumatic birth injury or being injured during the birth process, which is why these babies frequently require cesarean sections. A few common injuries that can occur during vaginal birth of a macrosomic fetus are broken bones, as well as injury to nerves in the shoulder and arms from shoulder dystocia. Shoulder dystocia is where the baby’s head comes out but the shoulders get stuck and can lead to a syndrome where the baby can lose the function of an arm. This syndrome is called Erb’s palsy.
A few other complications can occur after the baby is born. They include the baby’s blood sugar being too low or having jaundice, a condition where there is a yellow tint in the newborn’s skin and eyes, both of which can require the baby to stay in the Neonatal Intensive Care Unit (NICU).
Gestational Diabetes Diagnosis
At Maternal Fetal Medicine Associates, we take rigorous efforts to make sure that blood glucose levels are in a normal range for all pregnant women with diabetes. Typically, we administer blood sugar screening early in the third trimester (between 24 and 28 weeks) to ensure our patients deliver healthy babies when it’s time.
This screening test involves giving patients a sugary drink, waiting an hour, then testing their blood sugar to see if their system has adequately processed the dump of glucose. If it is too high, we move on to a more definitive three-hour test, during which we will check blood glucose levels four times.
Based on the results of the three-hour test, we can determine whether someone has gestational diabetes.
Treating Gestational Diabetes
If the results of our test show that patients have gestational diabetes mellitus, we put them on a special diabetic diet to manage their carbohydrate intake. It’s a simple and healthy diet to help people not overeat while eating the right foods to prevent their blood sugar levels from rising too high.
The diet we recommend is important for a safe and healthy pregnancy. It includes removing or limiting foods that are high in carbohydrates like sodas, ice cream, cake, bread, rice, and pasta.
We understand this can be hard for many mothers. However, we assist patients through this process via regular meetings with our MFM physicians and diabetic counselors. In some cases, diet alone is not enough to control blood sugar, and we have to treat the mother with medication. The medication we use is either a pill that helps lower blood sugar levels or in some cases, we provide insulin therapy.
Treatment for gestational diabetes usually requires more frequent appointments and check-ups to ensure both the baby’s health as well as the health of the mother is good and stable. This is more important in the last trimester, and our doctors will closely monitor both your blood sugar level and blood pressure, among other vitals.
Preventing Gestational Diabetes
There are no guaranteed ways to prevent gestational diabetes 100% of the time. However, recommendations for avoiding this condition include practicing healthy habits, such as maintaining a healthy weight and getting plenty of exercise prior to becoming pregnant.
Although we know many women experience cravings for specific, sometimes non-nutritious, foods during pregnancy, it’s important to eat balanced meals with healthy foods when possible. One way to reduce the risk that you’ll develop gestational diabetes is to not gain too much weight too quickly during pregnancy.
Gestational Diabetes After Delivery
In most cases, women with gestational diabetes see their blood sugar levels return to normal after giving birth. However, the increased risk for developing type 2 diabetes means it’s important for women to be tested regularly after giving birth to monitor glucose levels and have diabetes diagnosed by a medical professional if and when your symptoms return.
Gestational diabetes has also been linked to an increased likelihood of post-partum depression, so moms with this condition may want to preemptively create a healthy mental health strategy to handle this potential development.
Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!