What is gestational diabetes?

Gestational diabetes (also called gestational diabetes mellitus or GDM) is a kind of diabetes that some women get during pregnancy. It’s a condition in which your body has too much sugar (called glucose) in the blood. 

When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood. When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood. This can cause serious health problems, like heart disease, kidney failure and blindness. 

Most pregnant women get tested for GDM at 24 to 28 weeks of pregnancy. Most of the time it can be controlled and treated during pregnancy. If it’s not treated, GDM can cause problems for you and your baby. It usually goes away after you have your baby. But if you have GDM, you’re at increased risk of developing diabetes later in life.

In the United States, 7 out of every 100 pregnant women (7 percent) develop gestational diabetes. You’re more likely than other women to have GDM if you’re African-American, Native American, Asian, Hispanic or Pacific Islander.  

Can gestational diabetes cause problems during pregnancy?

Yes. If not treated, GDM can cause pregnancy complications, including: 

• Cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb). You may need to have a c-section if you have complications during pregnancy, like your baby being very large (called macrosomia). Most women with GDM can have a vaginal birth. But they’re more likely to have a c-section than women without GDM.
• High blood pressure and preeclampsia. High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy. Preeclampsia is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Signs of preeclampsia include having protein in the urine, changes in vision and severe headaches. High blood pressure and preeclampsia can increase your risk for premature birth.
• Macrosomia. This means your baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth. Weighing this much makes your baby more likely to get hurt during labor and birth. And you may need to have a c-section to keep you and your baby safe.
• Perinatal depression. This is depression that happens during pregnancy or in the first year after having a baby (also called postpartum depression). Depression is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you feel, think and act and can interfere with your daily life. It needs treatment to get better.
• Premature birth. This is birth before 37 weeks of pregnancy. Most women with GDM have a full-term pregnancy that lasts between 39 and 40 weeks. But if there are complications with your pregnancy, you may need to have your labor induced before your due date. Inducing labor means your provider gives you medicine or breaks your water (amniotic sac) to make your labor begin. 
• Shoulder dystocia or other birth injuries (also called birth trauma). Shoulder dystocia happens when a baby’s shoulders get stuck inside the mother’s pelvis during labor and birth. It often happens when a baby is very large. It can cause serious injury to both mom and baby. Complications for moms caused by shoulder dystocia include postpartum hemorrhage (heavy bleeding). For babies, the most common injuries are fractures to the collarbone and arm and damage to the brachial plexus nerves. These nerves go from the spinal cord in the neck down the arm. They provide feeling and movement in the shoulder, arm and hand.
• Stillbirth. This is the death of a baby in the womb after 20 weeks of pregnancy.

Gestational diabetes also can cause health complications for your baby after birth, including:

• Breathing problems, including respiratory distress syndrome (also called RDS). This is a breathing problem caused when babies don’t have enough surfactant in their lungs. Surfactant is a protein that keeps the small air sacs in the lungs from collapsing.
• Jaundice. This is a medical condition in which a baby’s eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn’t working well.  
• Low blood sugar (also called hypoglycemia)
• Obesity later in life
• Diabetes later in life

Are you at risk for gestational diabetes?

You may be more likely than other women to develop gestational diabetes if:

• You’re older than 25.
• You’re overweight or obese and not physically active.
• You had gestational diabetes or a baby with macrosomia in a past pregnancy.
• You have high blood pressure or you’ve had heart disease.
• You have polycystic ovarian syndrome (also called polycystic ovary syndrome or PCOS). This is a hormone imbalance that can affect a women’s reproductive and overall health.
• You have prediabetes. This means your blood glucose levels are higher than normal but not high enough to be diabetes.
• You have a parent, brother or sister who has diabetes.

Even women without any of these risk factors can develop gestational diabetes. This is why your health care provider tests you for GDM during pregnancy. 

How do you know if you have gestational diabetes?

Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. You get the test at 24 to 28 weeks of pregnancy. If your provider thinks you’re at risk for GDM, you may get the test earlier.

If your glucose screening test comes back positive, you get another test called a glucose tolerance test to see for sure if you have gestational diabetes. 

How is gestational diabetes treated?

If you have GDM, your prenatal care provider wants to see you more often at prenatal care checkups so she can monitor you and your baby closely to help prevent problems. At each checkup, you get tests to make sure you and your baby are doing well. Tests include a nonstress test and a biophysical profile. The nonstress test checks your baby’s heart rate. The biophysical profile is a nonstress test with an ultrasound. An ultrasound uses sound waves and a computer screen to show a picture of your baby in the womb.

Your provider also may ask you to do kick counts (also called fetal movement counts). This is way for you to keep track of how often your baby moves in the womb. Here are two ways to do kick counts:

1. Every day, time how long it takes for your baby to move ten times. If it takes longer than 2 hours, tell your provider.
2. See how many movements you feel in 1 hour. Do this three times each week. If the number changes, tell your provider.

If you have GDM, your provider tells you how often to check your blood sugar, what your levels should be and how to manage them during pregnancy. Blood sugar is affected by pregnancy, what you eat and drink, how much physical activity you get. You may need to eat differently and be more active. You also may need to take insulin shots or other medicines. 

Treatment for GDM can help reduce your risk for pregnancy complications. Your provider begins treatment with monitoring your blood sugar levels, healthy eating and physical activity. If this doesn’t do enough to control your blood sugar, you may need medicine. Insulin is the most common medicine for GDM. It’s safe to take during pregnancy.  

Here’s what you can do to help manage gestational diabetes:

• Go to all your prenatal care checkups, even if you’re feeling fine.
• Follow your provider’s directions about how often to check your blood sugar. Your provider shows you how to check your blood sugar on your own. She tells you how often to check it and what to do if it’s too high. Keep a log that includes your blood sugar level every time you check it. Share the log with your provider at each checkup. Most women can check their blood sugar four times each day: once after fasting (first thing in the morning before you’ve eaten) and again after each meal.
• Eat healthy foods. Eat three regular meals and two to three snacks each day. Have one of the snacks at night. Talk to your provider about the right kinds of foods to eat to help control your blood sugar.
• Do something active every day. Try to get 30 minutes of moderate-intensity activity at least 5 days each week. Talk to your provider about activities that are safe during pregnancy, like walking. Walk for 10 to 15 minutes after each meal to help control your blood sugar.
• If you take medicine for diabetes, take it exactly as your provider tells you to. If you take insulin, your provider teaches you how to give yourself insulin shots. Tell your provider about any medicine you take, even medicine that’s not related to GDM. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby. Don’t start or stop taking any medicine during pregnancy without talking to your provider first.
• Check your weight gain during pregnancy. Gaining too much weight or gaining weight too fast can make it harder to manage your blood sugar. Talk to your provider about the right amount of weight to gain during pregnancy. 

If you have gestational diabetes, how can you help prevent getting diabetes later in life?

For most women, gestational diabetes goes away after giving birth. But having it makes you more likely to develop type 2 diabetes later in life. Type 2 diabetes is the most common kind of diabetes. If you have type 2 diabetes, your pancreas makes too little insulin or your body becomes resistant to it (can’t use it normally).  

Here’s what you can do to help reduce your risk of developing type 2 diabetes after pregnancy:

• Breastfeed. Breastfeeding can help you lose weight after pregnancy. Being overweight makes you more likely to develop type 2 diabetes.
• Get tested for diabetes 4 to 12 weeks after your baby is born. If the test is normal, get tested again every 1 to 3 years.
• Get to and stay at a healthy weight.
• Talk to your provider about medicine that may help prevent type 2 diabetes. 

Last reviewed: April, 2019

 

 

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Category: Pregnancy