Gestational diabetes

Diabetes brought on by pregnancy is called gestational diabetes. During pregnancy the placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also make it hard for the mother's body to make and use the insulin it needs. She may need up to three times as much insulin. If she cannot get enough insulin, glucose cannot be changed to energy. This results in high levels of glucose in the blood. This high glucose, or sugar, in the blood is called hyperglycemia.

High blood sugar levels during pregnancy can cause these problems:

• the baby may get too big before birth (very large babies tend to have more problems before and after birth)
• the baby might have birth defects such as heart, kidney, or spine problems
• high blood pressure may develop for the mother during the pregnancy, causing problems for both the mother and the baby
• premature labor (before 37 weeks of pregnancy) may occur
• the baby might need to be delivered early because of problems
• after delivery the baby may have low blood sugar problems
• after delivery the baby may have problems breathing because the lungs are not fully developed, or
• the baby could die in the uterus before delivery

Gestational diabetes can occur without noticeable symptoms. For this reason, all pregnant women are screened for diabetes. Urine checks for diabetes are done during prenatal visits. A blood test may also be done around the 28th week of pregnancy or anytime the urine test is abnormal.

Women have higher risk of diabetes during pregnancy if they:

• had high blood sugar levels during a previous pregnancy
• had a previous baby that weighed more than 9 pounds at birth
• are overweight, especially if 200 pounds or more
• have a family history of diabetes
• had a previous baby born dead
• had previous miscarriages
• a previous baby with birth defects, or
• are over 35 years of age

If diabetes develops during pregnancy, blood sugar levels may be controlled by checking blood sugar levels at home. The woman will also need to make sure she is eating a healthy, well-balanced diet. Foods should be low in fat and sugar. High fiber foods like whole grain breads, bran cereals, cooked beans and peas, vegetables, and fruits should be eaten. Avoid foods that increase blood sugar levels like sugar, cakes, cookies, candy, soft drinks, fruit packed in syrup, donuts, and ice cream. Limit fat intake to 30 percent or less of daily calories and monitor the size of portions at meals. A healthcare provider or registered dietician can help plan a diet program.

Regular exercise is also important. It helps to keep the blood sugar levels normal. Walking, swimming, or stationary bicycling are good exercises for a pregnant woman. If these do not work, the provider can recommend other activities that would be safe. An exercise program should begin slowly and increase as the woman gains more stamina.

Hopefully blood sugar levels will be controlled with just diet and exercise. But if not, it may be necessary to take insulin shots. Oral medicine for diabetes should not be taken during pregnancy because it could be harmful to the baby.

Gestational diabetes usually goes away within a few weeks after birth. To make sure, a special test will be done 1 to 2 months later to check.

A woman who has had gestational diabetes is more likely to get it again during another pregnancy. She is also more likely to develop Type 2 diabetes later in life. Eating right, continuing to exercise, and keeping her weight down may keep her from getting diabetes as she gets older.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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