Rates of gestational diabetes are increasing among women of all racial and ethnic subgroups in the U.S. Gestational diabetes is relatively common and affects 2% to 10% of pregnancies – but can be connected to short- and long-term risks for women and their babies.
The good news is for most pregnant women is gestational diabetes is transient and can be safely managed under the care of a provider. However, left untreated, gestational diabetes can have devastating impacts during a pregnancy and in some cases can lead to type 2 diabetes with potential complications including chronic kidney disease. It is critical for pregnant women to regularly see a health care provider throughout their pregnancy, as gestational diabetes often carries no symptoms.
Understanding gestational diabetes
During pregnancy, a woman’s metabolism changes temporarily. Their cells become slightly more resistant to insulin, causing the amount of sugar, or glucose, in their blood, to rise. This extra sugar helps the woman’s body provide more nutrients to the baby.
However, if a pregnant woman’s cells become too resistant to insulin, they stop absorbing the glucose and blood sugar spikes. Once a certain blood sugar level is reached, it is considered gestational diabetes.
Risk factors for gestational diabetes
What causes some women to get gestational diabetes and others to avoid it is not well understood. There are some risk factors:
- Being overweight
- Not physically active
- Having prediabetes
- Previously having gestational diabetes
- Having polycystic ovary syndrome
- Having a relative with diabetes in the immediate family
- Previously delivering a baby weighing more than nine pounds
However, women without these risk factors can also develop gestational diabetes.
Gestational diabetes testing
It is important for pregnant women to see a health care provider throughout their pregnancy. One of the routine appointments, typically between weeks 24 and 28 of pregnancy, includes a screening for gestational diabetes. Individuals at a higher risk may be screened earlier in their pregnancy.
The initial test is a glucose screening test. Individuals drink a syrupy solution, wait an hour, and then have their blood drawn. The blood is tested to measure blood sugar levels. Based on the result, the health care provider will make a recommendation. If the blood sugar level is higher than a certain threshold, an additional glucose screening test will be ordered to determine if gestational diabetes is present or not.
Left untreated, gestational diabetes can pose a risk to the health of the mother and baby:
- The baby may grow larger, increasing the likelihood of a preterm birth or the need for a C-section
- There’s an increased risk of risk of stillbirth
- The baby has an increased risk for low blood sugar shortly after birth which could cause seizures
Additionally, pregnant women with gestational diabetes are at an increased risk for high blood pressure and preeclampsia during their pregnancy. Gestational diabetes goes away for most women after delivery. However, women with a history of gestational diabetes are 10 times more likely to develop type 2 diabetes later in life.
After delivering their child, women should get tested for diabetes six to 12 weeks later, and then every one to three years afterwards.
Managing gestational diabetes
After issuing a diagnosis of gestational diabetes to a pregnant woman, a provider will likely recommend that they adopt a diabetes diet and incorporate safe exercise.
Pregnant women may also have to regularly check their blood sugar and may need to take insulin.
Gestational diabetes prevention
The best thing women can do for themselves, and their babies is to start healthy habits as soon as possible – even before getting pregnant. While there is no one way to prevent gestational diabetes, starting from a place of health can help women and their health care providers navigate the pregnancy journey ahead. Here are some health tips:
- Exercise regularly: Staying active is important for pregnant women. Talk with a health care provider about the types of activity that are safe during pregnancy. Low-impact, moderate activity like walking and yoga are great to incorporate, as well as finding small ways to move more during the day.
- Eat a balanced diet: Pregnancy can bring both food cravings and aversions, especially during the first trimester. Strive to incorporate a variety of food when you can. High-fiber foods including fruits, vegetables and whole grains – as well as healthy fats and proteins – will help the body through the changes of pregnancy.
- Talk about weight gain with a provider: Gaining weight during pregnancy is healthy and normal. Talk with a health care provider about how much weight gain is appropriate.
- Keep up with routine doctor’s visits: Do not skip wellness visits during pregnancy. Sometimes issues with blood sugar and blood pressure can arise without showing noticeable symptoms.
Patricia Ferguson, M.D., is medical director atSenior Health Services, Emergent Holdings. Emergent Holdings is a separate entity contracted by Blue Cross Blue Shield of Michigan to perform administrative services for Blue Cross’ Medicare Advantage program.
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