What is Gestational Diabetes?

Gestational diabetes is a kind of type 2 diabetes that develops during pregnancy due to the stress of pregnancy on the body. What seems to happen is that the pregnancy hormones prevent the body from using insulin normally. This kind of diabetes can be called pregnancy diabetes.

Diabetes in Pregnancy

When a pregnant woman is diagnosed with diabetes, she is given instruction on blood sugar control. This includes how to perform finger stick blood sugar properly and use glucometer to check for blood sugar levels. She is given instruction on the self-injection of insulin.

  • Patient teaching is very important. The patient is taught the use of proper diet and exercise. Good exercise choices in pregnancy can be walking and stretching exercises. The patient is taught how to recognize abnormal blood sugar levels. High blood sugar or hyperglycemia occurs when the blood sugar is above 200mg/dl. The patient may experience:
  • Increase thirst, called polydipsia
  • Increased urination, called polyuria
  • Dry skin 
  • Skin may feel warm to touch.

Hyperglycemia and hypoglycemia are medical emergencies. Take blood sugar and call the doctor right away. If the blood sugar is low and the patient is conscious, give the patient some sugar by mouth. If blood sugar is high, but not to the level of coma, the patient may be given insulin if any is ordered to be used as needed.

Causes of Gestational Diabetes

This is type 2 diabetes that is caused by the stress of pregnancy on the body. The pregnancy hormones cause the body to become insulin resistant. The risk factors for diabetes in pregnancy include family history of type 2 diabetes, maternal age of over 25 years, previous pregnancy diabetes, and previous birth of a baby that is over 9 pounds.

Symptoms of Gestational Diabetes

The symptoms could be subtle or not there at all at the early part of the disease. As both disease and pregnancy progress, the pregnant woman stops gaining weight as expected, and may even start to lose weight. This is because when the body is not sensing the sugar in the blood, it breaks down fats and muscle to release more sugar into the blood. This causes blood sugar to rise even higher. The baby’s weight continues to increase because the baby’s body uses the baby’s insulin to convert the excess sugar in the mother’s blood into the baby’s body fat. Baby birth weight of over 9 pounds is one of the signs of diabetes in pregnancy.

Diagnosing Diabetes in Pregnancy

Pregnancy diabetes is diagnosed by the use of glucose tolerance test. The normal pregnancy screening includes screening for elevated blood sugar. When high blood glucose is detected, the doctor does further test in order to determine if the patient is developing diabetes. This is usually done by glucose tolerance test. The patient is given sugar drink after initial fasting blood glucose has been drawn. The patient’s blood glucose is then tested hourly. Blood sugar of 180mg/dl or above can rule the person in for diabetes.

Hemoglobin A1c is not always useful for detecting this diabetes. This is because hemoglobin A1c measures the average blood sugar for the past three months. Diabetes needs to be diagnosed before three months of onset during pregnancy. Hemoglobin A1c will not be accurate because it will include the period when the patient had not yet developed the disease.

REMEMBER: Only a physician can make a medical diagnosis.

Treatment of Gestational Diabetes

This kind of diabetes is usually treated by the use of insulin. This is because many of the oral medications that are taken by mouth may not be safe for the baby. The goal of the treatment is to keep the blood sugar levels normal to reduce stress on the baby and mother.

Gestational Diabetes Diet

Diabetes diet in pregnancy is similar to type 2 diabetes diet, or diabetes diet in general. When a pregnant woman is diagnosed with diabetes, the doctor usually refers her to a dietician. The dietician meets with her and reviews food pyramid and portions and diabetes exchange diet lists.

Cure of Gestational Diabetes

There is no cure for diabetes. This kind of diabetes usually resolves after pregnancy. In a few cases, it continues as a chronic condition after the birth of the baby. Many women who have had diabetes in pregnancy develop type 2 diabetes later in life.

Complications of Gestational diabetes

Diabetes places a woman at an increased risk for preeclampsia, which is increased protein in urine and increased blood pressure. Diabetes also weakens the uterus ability to supply nutrients to the baby. Increased blood sugar by itself is a stress on the fetus. When a pregnant woman is diagnosed with diabetes, the doctor plans for periodic non-stress test, to measure how the baby is doing, by measuring the fetal heart rate. If the response is weak, the doctor may plan a caesarian section to remove the baby from the unfavorable uterine conditions. Some of the complications of gestational diabetes are C-section and premature birth. 

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