Many pregnant women are familiar with the usually-dreaded glucose drink — a syrupy solution that’s used during the glucose challenge test to help determine a woman’s glucose tolerance during pregnancy. While it may not be a pleasant experience for some, it is necessary to determine if you have gestational diabetes.
What is gestational diabetes?
Gestational diabetes is high blood sugar that occurs during pregnancy for women who have never had high blood sugar before. Pregnant women who do not have pre-existing diabetes are screened for gestational diabetes between 24-28 weeks. The screening is a 1-hour glucola test that includes drinking a syrupy glucose solution. If blood sugar levels are elevated, the next step is to take a 3-hour test, which will be used to make a diagnosis.
Alternatively, there is a 2-hour glucola test that does not require another test for diagnosis. This choice depends on your OB/GYN’s preference. Both types of tests are equally adequate in diagnosing gestational diabetes.
If you have any of the following risk factors, we recommend an early glucola test prior to 24 weeks gestation:
- History of Polycystic Ovary Syndrome (PCOS)
- Family history of diabetes
- History of gestational diabetes in prior pregnancy
- History of previous microsomic infant
What causes gestational diabetes?
Gestational diabetes is caused by pregnancy hormones in your placenta. These hormones cause insulin resistance. When you eat food, it turns into glucose. Your body makes insulin to break down the glucose so your body can use it as fuel. With gestational diabetes, your body cannot make enough insulin to break down the glucose, so the glucose stays in your blood stream instead of moving to your cells for energy. This causes high blood sugar levels that are detected by glucose screenings.
How common is gestational diabetes?
About 2-10% of pregnant women with no previous risk factors will develop gestational diabetes. This percentage increases with risk factors such as:
- History of gestational diabetes
- Previously delivering a baby weighing more than 9 pounds
- Being overweight or obese
- Being over 25 years old
- A lack of physical activity
- Polycystic Ovary Syndrome (PCOS)
- Diabetes in an immediate family member
- Race — Women who are Hispanic, Asian American, African American, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander are at higher risk of developing gestational diabetes
Can you prevent gestational diabetes?
If you are overweight, losing weight before pregnancy may help prevent gestational diabetes. Eating healthy and regular physical activity also contribute to an overall healthier pregnancy.
Eating healthy includes non-starchy vegetables and lean or low-fat protein balanced with appropriate portions of carbs. Avoiding sugary beverages and drinking plenty of water are important for a healthy lifestyle as well.
Regular physical activity includes 30 minutes or more of walking every day. Please consult your doctor before beginning a new exercise regimen, especially if you are pregnant.
How is gestational diabetes treated?
Gestational diabetes is treated with diet (watching carbohydrates), exercise, and medication. Medication is recommended when diet and exercise alone are not enough. The method of evaluation of blood sugar control is done by both a glucose check — either through finger sticks or continuous glucose meter — and information obtained from an ultrasound.
When medication is recommended, insulin is the gold standard because of its safety. Insulin does not cross the placenta, while oral medication does. Taking insulin has come a long way thanks to technological advancements over the last hundred years. It now comes in an insulin pen, which increases ease-of-use and convenience, and the needle tip is only 4mm long to maximize comfort.
Once the baby is born, medication is usually no longer needed.
Does gestational diabetes go away?
Yes. Gestational diabetes usually resolves on its own after the baby is born. This is confirmed by a glucose test at 4-12 weeks postpartum. However, 33-66% of women who develop gestational diabetes are at risk of developing it in later pregnancies. They may also be at risk for:
- Prediabetes – A condition where a person’s blood sugar level is higher than it should be, but not high enough to be diagnosed as type 2 diabetes. 30% of women who have had gestational diabetes may develop prediabetes.
- Overt diabetes – A more advanced type of gestational diabetes that is often diagnosed at the first prenatal visit. The risk of developing overt diabetes increases 10 times after having gestational diabetes.
- Metabolic syndrome – A cluster of conditions that increase the risk of heart disease, stroke and diabetes. 30% of women who have had gestational diabetes may develop MetS in 5-10 years.
- Cardiovascular disease
It’s important to take the warning signs of having gestational seriously and to modify behavior to protect your health. This includes weight loss (if needed), regular exercise, a balanced diet, and regular follow-up care.
If you have been diagnosed with gestational diabetes or are concerned about your risk of developing it, we encourage you to contact us today. Our maternal-fetal medicine specialists will work with you and your OB/GYN to help you determine the best course of action. To schedule an appointment, call 702-848-3134 or fill out an online form.