Gestational Diabetes

What Is Gestational Diabetes?

Gestational diabetes is a condition in which your blood sugar levels become high during pregnancy. It affects up to 10% of women who are pregnant in the U.S. each year. It affects pregnant women who haven’t ever been diagnosed with diabetes.

There are two classes of gestational diabetes. Women with class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medications.

Gestational diabetes goes away after you give birth. But it can affect your baby’s health, and it raises your risk of getting type 2 diabetes later in life. You can take steps so you and your baby stay healthy.

Gestational Diabetes Symptoms

Women with gestational diabetes usually don’t have symptoms or may chalk them up to pregnancy. Most find out that they have it during a routine screening.
You may notice that:

  • You’re thirstier than usual
  • You’re hungrier and eat more than usual
  • You pee more than usual

Gestational Diabetes Causes

When you eat, your pancreas releases insulin, a hormone that helps move a sugar called glucose from your blood to your cells, which use it for energy.

During pregnancy, your placenta makes hormones that cause glucose to build up in your blood. Usually, your pancreas can send out enough insulin to handle it. But if your body can’t make enough insulin or stops using insulin as it should, your blood sugar levels rise, and you get gestational diabetes.

Gestational Diabetes Risk Factors

You’re more likely to get gestational diabetes if you:

  • Were overweight before you got pregnant
  • Are African-American, Asian, Hispanic, Alaska Native, Pacific Islander, or Native American
  • Have blood sugar levels that are higher than they should be but not high enough to be diabetes (this is called prediabetes)
  • Have a family member with diabetes
  • Have had gestational diabetes before
  • Have polycystic ovary syndrome (PCOS) or another health condition linked to problems with insulin
  • Have high blood pressure, high cholesterol, heart disease, or other medical complications
  • Have given birth to a large baby (weighing more than 9 pounds)
  • Have had a miscarriage
  • Have given birth to a baby who was stillborn or had certain birth defects
  • Are older than 25

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Gestational Diabetes Tests and Diagnosis

Gestational diabetes usually happens in the second half of pregnancy. Your doctor will check for it between weeks 24 and 28, or sooner if you're at high risk.

Your doctor will give you a glucose tolerance test: You’ll drink 50 grams of glucose in a sweet drink, which will raise your blood sugar. An hour later, you’ll take a blood glucose test to see how your body handled all that sugar. If the results show that your blood sugar is higher than a certain level, you’ll need a 3-hour oral glucose tolerance test, meaning you’ll get a blood glucose test 3 hours after you drink a 100-gram glucose drink. Your doctor can also test you by having you fast for 12 hours, then giving you a 75-gram glucose drink and a 2-hour blood glucose test.

If you’re at high risk but your test results are normal, your doctor might test you again later in your pregnancy to make sure you still don’t have it.

Gestational Diabetes Treatment

If you have gestational diabetes, you’ll need treatment as soon as possible to keep yourself and your baby healthy during your pregnancy and delivery. Your doctor will ask you to:

  • Check your blood sugar levels four or more times a day
  • Check your urine for ketones, chemicals that mean that your diabetes isn’t under control
  • Eat a healthy diet
  • Make exercise a habit

Your doctor will keep track of your weight and your baby’s development. They might give you insulin or another medicine to keep your blood sugar under control.

Target Blood Sugar Levels for Women During Pregnancy

The American Diabetes Association recommends these targets for pregnant women who test their blood sugar:

  • Before a meal: 95 mg/dL or less
  • An hour after a meal: 140 mg/dL or less
  • Two hours after a meal: 120 mg/dL or less

Diet and Exercise for Gestational Diabetes

Take these simple steps to stay healthy:

Eat a healthy, low-sugar diet. Talk to your doctor to be sure you’re getting the nutrition you need. Follow a meal plan made for someone with diabetes:

  • Trade sugary snacks like cookies, candy, and ice cream for natural sugars like fruits, carrots, and raisins. Add vegetables and whole grains, and watch your portion sizes.
  • Have three small meals along with two or three snacks about the same times every day.
  • Get 40% of your daily calories from carbs and 20% from protein. Fifty percent of the carbs should be complex, high-fiber carbs, with fat being between 25% and 30%.
  • Aim for 20-35 grams of fiber a day. Foods such as whole-grain breads, cereals, and pasta; brown or wild rice; oatmeal; and vegetables and fruits will help get you there.
  • Limit your total fat to less than 40% of your daily calories. Saturated fat should be less than 10% of all the fat you eat.
  • Eat a variety of foods to make sure you get enough vitamins and minerals. You may need to take a supplement to cover your bases. Ask your doctor if they think you should take one.

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Exercise throughout your pregnancy. You can exercise when you have gestational diabetes as long as your doctor says it’s OK. Being active is a good way to help manage your blood sugar. Staying fit during pregnancy is also good for your posture and can curb some common problems, like backaches and fatigue.

  • Get active as soon as possible. Aim for 30 minutes of moderate activity most days of the week. Running, walking, swimming, and biking are good options.
  • Was there a workout that you were doing before you found out you were pregnant? Do you have an activity that you love? Check with your doctor to see if you can keep it up, if you should make some changes, or if it's better to try something else.
  • Exercise can lower your blood sugar. So when you work out, always have a form of quick sugar with you, such as glucose tablets or hard candy.

Get the right prenatal care: Not only can your doctor screen you for this condition; they can offer advice on food, activity, and weight loss. They can also point you to other health professionals, like nutritionists, that can help.

If you have morning sickness, eat small snacks. Nibble on crackers, cereal, or pretzels before you get out of bed. As you go through your day, have small meals often and avoid fatty, fried, and greasy foods.

If you take insulin, make sure you've got a plan to deal with low blood sugar. Throwing up can make your glucose level drop. Talk to your doctor if you're not sure what to do.

Gestational Diabetes Prevention

You can lower your risk before you get pregnant by:

  • Eating a healthy diet
  • Staying active
  • Losing extra weight

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Will Gestational Diabetes Affect My Baby?

Your baby will probably be healthy, if you and your doctor manage your blood sugar while you have gestational diabetes.

Right after you give birth, doctors will check your newborn's blood sugar level. If it’s low, they may need to get glucose through an IV until it comes back up to normal.

Gestational diabetes raises the chance that you will have a baby who is larger than normal. It's also linked to jaundice, in which the skin looks yellowish. Jaundice generally fades quickly with treatment.

Although your child will be more likely than other kids to get type 2 diabetes later on, a healthy lifestyle (including a good diet and lots of physical activity) can cut that risk.

Will I Get Type 2 Diabetes?

Because you had gestational diabetes, you have a greater chance of having type 2 diabetes. But it won’t definitely happen, and you can take action to prevent that.

Your blood sugar levels will likely return to normal about 6 weeks after childbirth. (Your doctor will check on that.) If it does, you should get follow-up tests every 3 years.

To lower your risk:

  • Try to keep your weight in a healthy range. Not sure what that is? Ask your doctor.
  • Eat a good diet that includes lots of vegetables, whole grains, fruits, and lean protein.
  • Make exercise a habit.

If you plan to have another baby, keep in mind that you are more likely to get gestational diabetes again. Ask your doctor if there are any lifestyle changes that would help you avoid that.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on December 13, 2019

Sources

SOURCES:

American Diabetes Association: "Gestational Diabetes," “What is Gestational Diabetes?”

Agency for Healthcare Research and Quality: "Gestational Diabetes: A Guide for Pregnant Women."

American College of Nurse Midwives: "Gestational Diabetes."

Ohio State University Medical Center.

University of San Francisco Medical Center: “Diabetes in Pregnancy.”

Mayo Clinic: “Gestational diabetes.”

CDC: “Gestational Diabetes and Pregnancy,” “Gestational Diabetes.”

American Academy of Family Physicians: “Gestational Diabetes.”

UpToDate: “Gestational diabetes mellitus: Obstetric issues and management.”

Diabetes Care: “Gestational Diabetes Mellitus.”

National Diabetes Education Program: “Did You Have Gestational Diabetes When You Were Pregnant? What You Need to Know.”

WebMD Medical Reference: "Pregnancy: Gestational Diabetes."

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