Diabetes is a condition that affects how your body processes sugars. We usually hear about Type 1 and Type 2 diabetes, in which your body either cannot produce insulin or can’t use it effectively. However, pregnant women are also at risk for a third type: gestational diabetes, also known as gestational diabetes mellitus (GDM).
What Is Gestational Diabetes?
Gestational diabetes only develops during pregnancy. The hormonal changes that occur throughout your body can affect your body’s ability to use insulin, the hormone that regulates the absorption of the sugars in your blood. This is called “insulin resistance.” If you can’t produce enough insulin to overcome the resistance, you may develop GDM. These hormonal changes increase over the course of the pregnancy, so GDM doesn’t typically develop until at least the end of the second trimester, if not later.
This condition doesn’t usually cause many symptoms and is most often diagnosed through routine screenings of your blood. Some women may experience symptoms including fatigue, blurred vision, increased urination, and extreme thirst.
GDM affects anywhere from 3% – 10% of pregnancies. In most cases, your insulin and blood sugar levels will return to normal after the pregnancy. However, there’s a 45% – 65% chance that you’ll develop gestational diabetes in subsequent pregnancies after you’ve had it once.
What Causes Gestational Diabetes?
The natural progression of hormonal changes during pregnancy can affect your insulin sensitivity enough to cause GDM even if you have no other risk factors. However, there are certain factors that increase the risks. For example, women who were overweight before pregnancy are anywhere from 2 – 8 times as likely to develop GDM as those who were not overweight. The risk of GDM also increase with age, especially past the age of 35. You’re more likely to develop gestational diabetes if you have a close family member with Type 2 diabetes or if you’ve already been diagnosed with insulin resistance or pre-diabetes. Non-white women are at a higher risk than white women, as are people with certain genetic mutations.
Signs Of Gestational Diabetes
As mentioned above, most women don’t have any symptoms. If you’re symptom-free and low-risk (under 25, white, with a low BMI and no personal or family history of diabetes), your doctor probably won’t test you for it. Otherwise, you’ll take a glucose challenge test. That involves drinking a sweet liquid (a solution of glucose) and having your blood tested after an hour. If your blood contains healthy levels of glucose at that time, your body is processing the glucose effectively and you don’t have gestational diabetes. If your blood test shows high glucose levels, you’ll have to take a second test to determine whether you’ve developed GDM.
The second test is the glucose tolerance test. Your doctor may ask you to keep to a certain diet for a few days prior to this test, and you’ll have to fast for 14 hours before the test itself. You’ll have your blood drawn right away and then you’ll drink a larger quantity of the sweet liquid. Your blood glucose will be tested every hour for several hours after you drink the liquid and compared to your glucose levels when you arrived. If your blood sugar stays high, that indicates that you have developed gestational diabetes.
How Does Gestational Diabetes Affect The Baby?
Gestational diabetes increases the risk of several serious pregnancy complications. First, babies born to mothers with GDM are more likely to have a high birth weight (macrosomia), which can lead to a difficult delivery. Difficult delivery increases the risk of bone fractures and oxygen deprivation, which can cause brain damage. For that reason, babies born to mothers with GDM are more likely to be delivered by c-section, which has its own risks and leads to a more difficult recovery for the mother. Finally, GDM increases the risk of preeclampsia – dangerously high blood pressure during pregnancy. Preeclampsia can cause fetal distress and may cause strokes in the mother during delivery.
The effects of GDM may also extend after birth. The baby has a higher risk of low blood sugar, or hypoglycemia, shortly after delivery and will need to be carefully monitored. The baby will also have a higher risk of obesity and type 2 diabetes.
Gestational Diabetes Treatment
If left untreated, GDM can cause severe health problems for both mother and child. The good news is that treatment is usually not very demanding. In most cases, gestational diabetes can be treated by adjusting your diet. You’ll be asked to reduce your intake of fats and refined sugars and focus on complex carbohydrates such as whole grains and beans. Pregnancy-friendly exercise can also help keep your blood sugar in check.
If diet and exercise alone aren’t enough to keep your glucose levels in a healthy range, you may need to take insulin to help your body absorb the sugars. That may come in the form of pills or self-administered shots.
If you’re diagnosed with GDM, you’ll need to test your blood sugar several times every day to ensure that it stays within healthy levels. Testing is done by pricking your finger with a test strip and using an insulin meter to measure your blood sugar.
How To Avoid Gestational Diabetes
Because gestational diabetes has no single cause, there’s also no single way to prevent it. However, you can lower your risks by staying as healthy as possible before you get pregnant. For example, you may choose to lose excess weight before pregnancy and to start a healthy diet and exercise regimen.
If you’ve had GDM with a prior pregnancy, have close family members with diabetes, are over 35, or are overweight, talk to your doctor about other steps you can take to reduce your risks for GDM.
Have you had an experience with gestational diabetes? Tell us about it in the comments!