Diabetes in Pregnancy

What is gestational diabetes? — Gestational diabetes, like “regular” diabetes, is a disorder that disrupts the way your body uses sugar.

All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. If there is not enough insulin, or if the body stops responding to insulin, sugar builds up in the blood. That is what happens to people with diabetes.

Gestational diabetes is a form of diabetes that affects some women when they are pregnant. It happens because pregnancy increases the body’s need for insulin, but the body cannot always make enough.

What does gestational diabetes do to a woman and her baby? — It can make the baby get too big (heavier than 9 pounds). That is a problem, because a big baby can get hurt if it cannot fit easily through the vagina. A big baby can also damage his or her mother’s body during delivery. Sometimes, the baby will not fit and the mother has to have a c-section (surgery to get the baby out).

Gestational diabetes also increases the risk that a woman will have a life-threatening problem during pregnancy called preeclampsia. (Preeclampsia causes high blood pressure, among other things.)

Will I get gestational diabetes during my pregnancy? — It is hard to predict which women will get gestational diabetes. But some women are more likely to get it than others. You are more likely to get gestational diabetes if you:

●Had it before

●Are overweight

●Have diabetes in your family

●Are older than 25

Some habits might reduce your risk of gestational diabetes. These include eating a healthy diet, exercising regularly, and not smoking.

Will I be tested for gestational diabetes? — Yes. All pregnant women are tested for gestational diabetes.

Most women should be tested when they are about 6 or 7 months pregnant. (That’s the same as 24 to 28 weeks pregnant.) But women at high risk for diabetes might need to be tested earlier in pregnancy.

There are a few ways to test for diabetes. A common way is to have you drink a special, sweet drink. Then, an hour or more later, your doctor or nurse will take some blood. That way he or she can see how high your blood sugar gets after you eat sugar.

How is gestational diabetes treated? — To treat your gestational diabetes, you will need to check your blood sugar often. This is something you can learn how to do on your own with an easy-to-use machine. Most women can control their blood sugar level by changing their diet. Some women also need insulin shots or other diabetes medicines.

How should I change my diet? — A registered dietitian can tell you how to change your diet. Each woman is a little different, so there is no single diet that is right for everyone. Even so, most women should:

●Avoid sweets and fatty foods

●Choose bread and rice made with whole grains

Should I exercise? — You do not need to exercise to treat gestational diabetes. But being active will help control your blood sugar. If you already exercise, keep doing what you have been doing. If you have not been exercising and want to start, ask your doctor or nurse what kind of activity is safe for you.

How often do I need to see the doctor or nurse? — Women with gestational diabetes need to see the doctor or nurse more often than other pregnant women. How often you go will depend on how you are doing at each visit, and on whether you use insulin. During these visits, the doctor or nurse will:

●Check on your baby

●Ask about your diet

●Make sure your blood sugar levels are where they should be

●Adjust your dose of insulin (if you use insulin)

Can I have a normal delivery? — If your blood sugar levels have been close to normal, chances are good that you will have a normal delivery. During delivery, your doctor or nurse will check your blood sugar to make sure that it is not too high.

What happens after I give birth? — Your diabetes will probably go away and your blood sugar will probably go back to normal. If you were taking insulin, you probably will not need it anymore. Even so, your doctor or nurse should check your blood sugar to make sure your levels get back to normal and stay that way. Women who have gestational diabetes are at very high risk of getting “regular” diabetes later in life. You should get checked for diabetes 2 or 3 months after you give birth, then every few years for the rest of your life.

Content adapted from UpToDate Patient Information.