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The 411 About Gestational Diabetes

November 01, 2021

Whether you’re pregnant and don’t have a sweet tooth, or if you find your hand in the cookie jar more often than not, you should learn about gestational diabetes. Nearly every pregnant woman is at risk of developing gestational diabetes and it has nothing to do with the amount of sweets you consume. Gestational diabetes affects approximately 18% of all pregnancies, so it is a condition you need to understand and how it can affect your body and potentially your baby. 

Gestational diabetes occurs when the body cannot produce and properly use all the insulin it needs for pregnancy. Glucose and insulin work hand in hand to regulate the sugar levels in the bloodstream.  An imbalance either way can lead to challenges. Elevated levels of blood sugar are called hyperglycemia. Insulin resistance is when the body makes insulin, but it isn’t working as it should. In pregnancy, hormones from the placenta can make it more difficult for the mother’s insulin to work properly.

Though the root causes are still unclear, many women who develop gestational diabetes will have no known risk factors. For others, some risk factors have been shown to correlate with gestational diabetes. These include a family history of diabetes, obesity prior to pregnancy and previous pregnancies with gestational diabetes. Some ethnic backgrounds have a higher prevalence of gestational diabetes. These include Hispanic, Black, Asian, and Native American ethnicities.

High blood sugar throughout pregnancy can cause all kinds of issues for both mom and baby. If blood sugars remain too high over a long period, it can cause the baby to get too big. This condition is called macrosomia which increases the risk of complications at delivery. Macrosomia also has been shown to increase the risk of the baby developing childhood obesity. Additionally, when a mom has high blood sugar the baby’s pancreas has to pick up the slack which increases the baby’s chance of developing diabetes later in life.  Also, high blood sugar can limit the amount of oxygen the baby receives. 

The good news is that every pregnant woman gets tested for gestational diabetes at 24-28 weeks of pregnancy. This test challenges your body’s ability to manage a controlled amount of glucose. The most common test is the One Hour glucose screening test.  The patient drinks a 50gm glucose drink which is similar to drinking two sodas back-to-back, then has their blood tested an hour later. This test allows the doctor to see if your body can bring your blood sugar levels down to normal.  If your blood sugar levels are below the cut-off number, then you “pass”. 

However, if you don’t pass, your provider will ask you to follow up with a diagnostic test called the Three-Hour glucose screening.  You will be required to fast for eight hours and get your blood drawn.  Then you will drink a 100 gm glucose drink and have your blood tested at one, two, and three hours.  If you fail two or more of the cut-offs, you will be diagnosed with gestational diabetes.

What do you do if you develop it? Don’t panic. Just because you’ve developed gestational diabetes doesn’t mean your baby will. For the sweet tooth in the house, know that you can still eat small amounts of sweet things. Light exercise, such as walking after meals, is often recommended to promote glucose control. You may be referred to a Certified Diabetes Educator (CDE), who will teach you about monitoring your blood sugar as well as diet strategies to promote optimal glucose control. Know that you’ll have to monitor your blood sugar daily and that you may even need regular insulin injections. 

Though gestational diabetes is an autoimmune disease, there are simple ways that you can try to avoid having it. Eat well, drink lots of water, keep your carbs in check and exercise regularly. The good news is that most mothers who develop gestational diabetes will find that it goes away after birth. In some cases, mothers will develop type 2 diabetes later. That’s why doctors must continue to monitor anyone with gestational diabetes even years after they’ve had it. 

If you are pregnant and concerned about your risk for gestational diabetes, West Tennessee Medical Group Women’s Health providers can help.