Gestational Diabetes: Risk Factors, Complications, and Treatment

According to the CDC, between two and ten percent of pregnant women in the United States develop gestational diabetes every year. The condition can lead to serious complications during pregnancy and childbirth. For this reason, screening is a regular part of prenatal testing. Once identified, gestational diabetes is generally easy to control. It can also be prevented by instilling good diet and exercise habits prior to conception. Gestational diabetes resolves on its own after birth but can affect the future health of both the mother and baby.

Gestational Diabetes vs. Diabetes

Like type 1 and type 2 diabetes, gestational diabetes affects how cells in the body use glucose. The only difference is that gestational diabetes occurs only during pregnancy. It resolves after the birth, but a mother diagnosed with gestational diabetes has a higher chance of developing type 2 diabetes later in life.

Causes

It is not clear why some women develop gestational diabetes and others do not. During pregnancy, the placenta produces various hormones that can alter the effects of insulin. As the baby grows, the placenta makes more and more of these hormones. As such, gestational diabetes is more likely to occur in the second and third trimesters.

Risks

Gestational diabetes is more prominent in women over 25. Other risk factors include a personal history of pre-diabetes, a family history of type 2 diabetes, or a BMI over 30. Black, Hispanic, Asian, and American Indian women are at higher risk than Caucasian women. Women who develop gestational diabetes during one pregnancy are more likely to develop it again. Women who have a baby weighing more than nine pounds are also more likely to have gestational diabetes with future pregnancies.

Signs and Symptoms

Most women with gestational diabetes have no noticeable signs or symptoms. They may experience increased thirst or have to urinate more frequently, but these changes can happen in pregnant women without the condition, as well. Gestational diabetes can be difficult to detect. This is the main reason that screening is a part of routine prenatal care.

Diagnosis

Screening for gestational diabetes is typically done between 24 and 28 weeks. The first of two tests a woman will undergo is a glucose challenge test. The mother-to-be drinks a liquid that contains a lot of glucose. After one hour, a blood test determines blood sugar levels. If the result is 200 or greater, gestational diabetes is likely. If it is 140 or higher, the woman faces an increased risk. A second test, called an oral glucose tolerance test, can confirm the diagnosis. In this fasting test, blood is drawn initially for a baseline blood sugar level. Next, the pregnant woman drinks a sugary liquid. Blood draws are done two or three more times, an hour apart, to indicate how well the woman’s body is managing blood sugar.

Treatment

Most women can control gestational diabetes by changing their diet or increasing their activity. It is important to discuss the best approach with a doctor. Some pregnant women must check their blood sugar levels multiple times a day. Excess glucose can produce ketones in the urine, which can also be tested. If lifestyle changes are not enough, a woman may require insulin injections.

Complications for Mom

Women diagnosed with gestational diabetes are at greater risk for high blood pressure. They are also more likely to develop preeclampsia, a life-threatening condition that affects pregnancy and birth. As mentioned, women with gestational diabetes are at higher risk of developing type 2 diabetes later in life. It also increases the risk of complications for the baby, which has a direct effect on the mother’s health.

Complications for Baby

Babies born to mothers with gestational diabetes often have a birth weight over more than nine pounds. This increases the chance of complications during labor and the chance that the mother will require a C-section birth. Early labor is also a risk. Babies born pre-term often have respiratory issues and other complications. Additionally, newborns could develop hypoglycemia. Increased glucose from the mother stimulates the baby’s pancreas to make more insulin while still in the womb. After delivery, the baby is no longer receiving excess glucose, and the increased insulin can cause the blood sugar to fall.

What to Do if You Have Gestational Diabetes

Women with gestational diabetes should make a treatment plan with their doctor and stick to it. This often involves dietary changes and may necessitate working closely with a nutritionist or dietician. Exercise is important, too. Doctors often recommend at least 30 minutes of moderate, low-impact activity a day. They may also need to monitor their blood sugar and administer insulin.

Prevention

The best way to prevent gestational diabetes is to be at a healthy weight before pregnancy. The best time to make lifestyle changes is before getting pregnant; women should not actively try to lose weight during pregnancy. Women with gestational diabetes should also take precautions after the birth of their child, to help prevent the development of type 2 diabetes. According to the CDC, about half of all women with gestational diabetes develop type 2 diabetes eventually. Having healthy diet and exercise habits in place before pregnancy is essential.