Gestational diabetes is a type of diabetes that develops during the second trimester of pregnancy. In healthy women, the stomach and intestines digest carbohydrates from the food in order to form glucose. But for the body to utilize glucose properly, insulin is needed so that it can move from the blood to the cells in order to be used as energy. In women with gestational diabetes, the body is either unable to produce enough insulin or the cells are using glucose inappropriately thereby leading to elevated blood sugar levels.

What are the risk factors?

The incidence tends to be higher in Hispanic, African American, Native American, or Asian women. The risk of developing the disease also tends to increase in women who are older than 30 years old, or those with a family history of diabetes. A woman who had gestational diabetes during her previous pregnancy may also have a higher risk of having it again. Likewise, a woman with a history of giving birth to a 9 pound baby or heavier may also have an increased chance of developing the condition.

How is it diagnosed?

Health care providers usually test women with average risk during the 24th to the 28th week of pregnancy. However, for women who are considered high-risk or those who have two or more risk factors mentioned above, the doctor will order for an oral glucose tolerance test as early as possible. The test will require a woman to fast for at least 8 hours prior to the test. Blood is then drawn to determine a woman’s fasting blood glucose level.  She is then asked to drink a sweetened liquid containing the specified amount of glucose as ordered by the doctor.

Blood is drawn an hour after drinking the solution in order to determine how the body processed the sweetened drink. A result of 140 mg/dl is considered as abnormal, and a health care provider may order for subsequent tests after more hours of fasting. For women having normal results, a repeat test may be ordered during the 24th to 28th week of pregnancy.

How is it managed?

Women with gestational diabetes are asked to monitor their blood sugar levels usually before breakfast and 2 hours after meals. In certain cases, a doctor may order blood sugar monitoring more frequently in order to better manage the condition. Knowing one’s glucose levels at different times during the day is crucial because it can serve as guidelines as to when to eat, and even how much food is recommended at a particular time period.  It is also through glucose monitoring that one can determine whether activities like exercise and other physically taxing tasks are allowed.

A healthy diet is vital in managing gestational diabetes so women are usually asked to follow a strict diet plan with emphasis on limiting the intake of carbohydrates. A diet high in carbohydrates can greatly affect glucose levels so women are advised to follow recommended portions. Exercise is also part of the treatment plan because it can keep glucose levels controlled. For women with this condition, it is never safe to exercise or to do moderate physical activity without having any guidelines. Strict weight monitoring may also be ordered to prevent any complications.

To determine if a treatment plan is working, pregnant women are also asked to keep a record of their glucose levels along with their corresponding activities throughout the day. To add to that, pregnant women are also asked to make a list of the foods they ate during the day including the corresponding time of those meals. This record is a very helpful tool that can guide doctors whether the current treatment approach is working. If blood sugar levels remain uncontrolled, insulin may already be ordered.

What are the complications with poor management?

With uncontrolled gestational diabetes, it is very probable that vaginal delivery may no longer be an option because the condition can lead to larger babies or macrosomia. At birth, it can cause blood sugar problems for the baby, respiratory distress syndrome, jaundice and low levels of calcium and magnesium in the blood. There is also a chance that this condition can lead to preeclampsia or a serious condition related to blood pressure increase during the latter stage of pregnancy.

What happens after delivery?

Six weeks after delivery, blood sugar levels are expected to return to normal but doctors usually order a test still just to make sure. Future screenings for diabetes may also be ordered because women with gestational diabetes have a 60% higher risk of getting Type 2 diabetes later in life.

If you had gestational diabetes during your pregnancy, how were you able to manage your glucose levels? What lifestyle changes have you made in order to avoid long term complications such as Type 2 Diabetes Mellitus?