Understanding gestational diabetesBy Garrett K. Lam, MD, Chief of OB-GYN
What is it?
Gestational diabetes is a temporary form of diabetes that develops in some women during pregnancy (gestation). Like other forms of diabetes, gestational diabetes affects how cells absorb sugar, causing your blood sugar to increase — putting you and your baby’s health at risk.
How does it develop?
While there is still some uncertainty as to what exactly causes gestational diabetes, researchers do have some clues. To best understand how it develops, it’s helpful to first learn how pregnancy affects your body’s glucose levels.
What does this mean for you and your baby?
When your body digests food, it produces sugar (glucose) that enters your bloodstream. Your pancreas responds by producing insulin, a hormone that allows glucose to enter your body’s cells. That glucose is then used as energy for your cells.
During pregnancy, the placenta — which supports the baby as it grows — produces high levels of hormones that can impair the insulin’s ability to allow sugar into cells. This forces the sugar to remain in the blood stream, increasing the overall blood sugar level. The bigger the baby gets, the more hormones are produced by the placenta. For this reason, most women develop gestational diabetes during the second half of their pregnancy.
What can it do to you and your baby?
Since gestational diabetes usually affects the mother in late pregnancy — after the baby has had some time to develop — it doesn’t typically cause the birth defects seen in babies whose mothers had diabetes before pregnancy. In fact, most women with gestational diabetes deliver healthy babies.
However, ignoring gestational diabetes altogether can hurt mother and baby. Here are just a few possible complications.
- Future diabetes. Women who develop gestational diabetes during pregnancy are more likely to get it again with future pregnancies. It also increases the risk of developing type 2 diabetes later in life.
- High blood pressure. Gestational diabetes can also raise your risk of high blood pressure or preeclampsia.
- High birth weight. The additional sugar in your bloodstream can cross through the placenta, triggering your baby’s pancreas to increase insulin production. This can cause your baby to grow too big, leading to possible birthing injuries.
- Low blood sugar. Sometimes, due to high insulin production, babies of mothers with gestational diabetes develop low blood sugar shortly after birth.
- Type 2 diabetes. Babies of mothers with gestational diabetes have a higher risk of becoming obese and developing type 2 diabetes later in life.
How do you know if you have it?
Unfortunately, it can be hard to tell if you have gestational diabetes, because most women don’t experience any noticeable signs or symptoms.
So, what can you do?
It is recommended you see a doctor when you start thinking about getting pregnant — or right when you become pregnant — so your doctor can evaluate your risk of developing gestational diabetes.
What are your risk factors?
If you’re overweight, have high blood pressure, or a family history of diabetes, you have a higher risk of developing diabetes. Because of this, you may want to get tested during the early stages of your pregnancy.
All women, even those that aren’t at risk, should be screened after 24–28 weeks of pregnancy.
How can you treat it?
It is very important for women to manage their blood sugar levels during pregnancy to help reduce the risks of complications. Usually, two lifestyle changes are the first recommendations you’ll receive from your doctor:
- Eat healthier
- Exercise frequently
Though for about 10% of women, lifestyle changes only won’t stabilize blood sugar levels. These women may need insulin injections to help lower their blood sugar.
If you are pregnant or may become pregnant, ask your doctor about your risk for gestational diabetes. Need a doctor? Find one here.