Gestational diabetes is a type of diabetes that may occur during pregnancy in patients with no prior diagnosis of diabetes. During pregnancy, levels of certain hormones in your bloodstream increase causing blood glucose levels to rise higher than normal.
Normally, the pancreas produces extra insulin to move the glucose from your bloodstream into your cells. This keeps the blood glucose in a healthy range. Gestational diabetes when your pancreas cannot make enough insulin and the glucose stays in your bloodstream, leading to high blood glucose or hyperglycemia.
Causes of Gestational Diabetes
Gestational diabetes is caused by elevated hormones of pregnancy which cause resistance to the insulin produced by the body. This insulin resistance increases as the pregnancy progresses and the mother, baby, and placenta continue to grow.
Risk Factors and Symptoms for Gestational Diabetes
Risk factors for gestational diabetes include but are not limited to the following:
- Being overweight
- Physical inactivity
- History of gestational diabetes in a previous pregnancy
- History of 9 lb baby from a previous pregnancy
- High blood pressure
- History of heart disease
- History of polycystic ovarian syndrome (PCOS)
- African American, Asian American, Hispanic, Native American, or Pacific Island background
Most commonly, individuals with gestational diabetes experience no symptoms or only very mild ones. As glucose levels rise, symptoms can mimic those of type 2 diabetes. These include but are not limited to:
- Increased thirst
- Frequent urination
- Frequent bladder or skin infections
- Blurred vision
- Weakness and fatigue
Effects of Gestational Diabetes
Because of high blood sugar levels in a mother, the fetus also experiences these levels. This can lead to high insulin levels and excessive weight gain of the fetus. A larger baby can lead to complications with delivery for the mother such as labor difficulties, increased need for cesarean section, heavy bleeding with delivery, and vaginal tears during normal delivery.
Mothers with gestational diabetes also have higher rates of hypertension (high blood pressure) and preeclampsia which can lead to preterm labor and premature delivery.
Screening for Gestational Diabetes
All women are screened for gestational diabetes by 24-28 weeks of pregnancy with a glucose tolerance test or sooner if certain risk factors are present.
Managing Your Gestational Diabetes
If you have gestational diabetes it is important to follow up closely with your obstetrician and possibly an endocrinologist or maternal-fetal medicine specialist.
You will need to monitor your blood glucose levels using a finger-stick glucometer and work on your diet and exercise program and control your weight gain during pregnancy. You should eat 3 small meals and 2-3 small snacks throughout the day to keep blood glucose levels stable.
You should try to exercise for 150 minutes per week. For some, a good way to do this is to walk for 10-15 minutes after each meal.
If you require medication for gestational diabetes to achieve your blood glucose targets, insulin is the safest option for both mother and baby. You should talk to your doctor about the type and dosing that is best for you.
