When you are pregnant, your cells become slightly more resistant to insulin. That raises the amount of sugar in your blood, which helps make more nutrients available to your baby. But if the level of glucose becomes too high, it can cause problems for you and your baby.
Gestational diabetes, also known as GDM, will raise the odds of pregnancy complications. Most women with gestational diabetes have healthy pregnancies and healthy babies. Getting good treatment makes all the difference.
How Will I Know I Have It?
You can expect your doctor to assess your risk for GDM at your first prenatal visit.
If you are at high risk, you'll have a blood test for GDM as soon as possible. If your test is negative, you'll repeat the test about week 24-28.
If you are not at high risk, you should also get screened about week 24-28.
To test for gestational diabetes, your doctor may order a test known as the glucose challenge test. You do not need to fast for this. If you fail the test, you will have an oral glucose tolerance test. You will fast for a certain period beforehand (your doctor will tell you for how long). This two-step approach is commonly used.
After you're diagnosed, your doctor or midwife will want to watch your health and your baby's health closely for the rest of your pregnancy.
How Will It Affect My Baby?
Your higher blood sugar affects your baby, too, since they gets nutrients from your blood. Your baby stores that extra sugar as fat, which can make them grow larger than normal. They're more likely to have certain complications:
- Injuries during delivery because of their size
- Low blood sugar and mineral levels when they're born
- Jaundice, a treatable condition that makes the skin yellowish
- Pre-term birth
- Temporary breathing problems
Later in life, your baby might have a greater chance of obesity and diabetes. So help your child live a healthy lifestyle -- it can lower their odds for these problems.
How Will It Affect Me?
You might have:
- A higher chance of needing a C-section
- High blood pressure or preeclampsia
- Pre-term birth
Your blood sugar will probably return to normal after you give birth. But you'll have a higher risk of developing type 2 diabetes later or gestational diabetes again with another pregnancy. A healthy lifestyle can lower the odds of that happening. Just as you can help your child, you can lower your own chances of obesity and diabetes.
Although you may need a C-section, many women with gestational diabetes have regular vaginal births. Talk to your doctor or midwife about your delivery options:
- Does my baby need to be delivered by C-section?
- How accurate are birth-weight estimates? Could my baby be smaller than you think?
- What are the risks to my baby and I if I don’t have a C-section?
- What are the risks to us if I do?
What You Can Do: Step by Step
Eat healthy. Work with a dietitian or diabetes educator to plan meals and snacks that keep your blood sugar in a healthy range. You'll need to limit how many carbohydrates you eat and drink, because they can cause your blood sugar to spike. Avoid high-sugar foods such as soda and pastries.
Include fiber in your meals. This can come from vegetables, fruits, whole-grain breads, whole-grain crackers, and cereals. One large study looked at diets of women before they got pregnant. Each daily increase in fiber by 10 grams reduced their risk of gestational diabetes by 26%.
Exercise. Get some physical activity every day to help manage blood sugar. Make your goal 30 minutes of moderate activity each day, unless your doctor or midwife recommends something different. For gentle exercise, try walking or swimming.
In one study, researchers found that women who were physically active before and during their pregnancy -- about 4 hours a week -- lowered their risk of gestational diabetes by about 70% or even more.
Check with your doctor about how much and how often you should exercise. It depends upon your overall health.
After your babies are born, follow the same healthy diet and exercise plan.
Getting back to a healthy weight will also lower your risk. But you don't have to worry about fitting into your "skinny jeans" again right away. When you're overweight, losing 5% to 7% of your body weight helps: If you weigh 180 pounds, losing just 9 pounds makes a difference.
Keep your medical appointments. Skipping check-ups could put your health and your baby's at risk. You may need to get your baby checked regularly in the doctor's office with ultrasounds or non-stress tests.
Test your blood sugar. It can be a key way to watch your health. You may have to check it several times a day.
Take prescribed medication. Some women need insulin or other medications to help manage their blood sugar. Follow your doctor's or midwife’s recommendations. Make sure you understand how and when to use your medicine.
Watch for signs of blood sugar changes. Make sure you know what to do when you notice symptoms or your test shows low or high levels.
When to Call Your Doctor or Midwife
When you have gestational diabetes, part of your job is to pay close attention to your health. Check in with your doctor when:
- You get sick and can't follow your eating plan.
- You have symptoms of high blood sugar: trouble concentrating, headaches, increased thirst, blurred vision, or weight loss.
- You have symptoms of low blood sugar: anxiety, confusion, dizziness, headaches, hunger, racing pulse or pounding heart, feeling shaky or trembling, pale skin, sweating, or weakness.
- You tested your blood sugar at home, and it’s above or below your target range.