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Pregnancy and Gestational Diabetes

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Who Is at Risk for Gestational Diabetes?

The following factors increase the risk of developing gestational diabetes during pregnancy:

  • Being overweight prior to becoming pregnant (if you are 20% or more over your ideal body weight)
  • Being a member of a high risk ethnic group (Hispanic, Black, Native American, or Asian)
  • Having sugar in your urine
  • Impaired glucose tolerance or impaired fasting glucose (blood sugar levels are high, but not high enough to be diabetes)
  • Family history of diabetes (if your parents or siblings have diabetes)
  • Previously giving birth to a baby over 9 pounds
  • Previously giving birth to a stillborn baby
  • Having gestational diabetes with a previous pregnancy
  • Having too much amniotic fluid (a condition called polyhydramnios)

Many women who develop gestational diabetes have no known risk factors.

How Is Gestational Diabetes Diagnosed?

High risk women should be screened for gestational diabetes as early as possible during their pregnancies. All other women will be screened between the 24th and 28th week of pregnancy.

To screen for gestational diabetes, you will take a test called the oral glucose tolerance test. This test involves quickly drinking a sweetened liquid, which contains 50g of sugar. The body absorbs this sugar rapidly, causing blood sugar levels to rise within 30-60 minutes. A blood sample will be taken from a vein in your arm 1 hour after drinking the solution. The blood test measures how the sugar solution was metabolized (processed by the body).

A blood sugar level greater than or equal to 140mg/dL is recognized as abnormal. If your results are abnormal based on the oral glucose tolerance test, another test will be given after fasting for several hours.

In women at high risk of developing gestational diabetes, a normal screening test result is followed up with another screening test at 24-28 weeks for confirmation of the diagnosis.

Learn more about diagnosing diabetes.

How Is Gestational Diabetes Managed?

Gestational diabetes is managed by:

  • Monitoring blood sugar levels four times per day -- before breakfast and 2 hours after meals; monitoring blood sugar before all meals may also become necessary.
  • Monitoring urine for ketones, an acid that indicates your diabetes is not under control
  • Following specific dietary guidelines as instructed by your doctor; you'll be asked to distribute your calories evenly throughout the day.
  • Exercising after obtaining your health care provider's permission
  • Monitoring weight gain
  • Taking insulin or an oral hypoglycemic medication such as glyburide, if necessary
  • Controlling high blood pressure

 

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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