What is Gestational Diabetes?

Gestational Diabetes is high blood sugar (glucose) during pregnancy. It begins in pregnancy and often goes away after the baby is born.

How is Gestational Diabetes Diagnosed?

Each time a woman is pregnant, at 24-28 weeks of pregnancy, a glucose tolerance test (GTT) is done. This is a set of three blood tests that are taken before and after the woman has been given an oral glucose solution to drink. This test may also be ordered earlier in the pregnancy for patients at risk for gestational diabetes.

What causes Gestational Diabetes?

Blood glucose levels are regulated by a hormone called insulin. Insulin moves the glucose from the blood to the cells. During pregnancy, women’s cells become more resistant to insulin so that more nutrients will be available to the baby. As a result, women make more insulin to keep sugars normal. Some women cannot make enough insulin to keep glucose at a normal range. This results in gestational diabetes.

What will happen if blood glucose levels are too high?

High blood glucose during pregnancy can cause:

• A large baby which makes delivery more difficult and could slow lung development.
• Birth defects in the baby if levels are high during early pregnancy.
• Elevated blood pressures during the second half of pregnancy (preeclampsia.)
• After the head comes out at delivery, there can be trouble with the delivery of the shoulder and birth trauma.
• Patients with uncontrolled diabetes are at increased risk for intrauterine fetal death.
• Low blood sugar in the baby during the first few hours or days after birth (Hypoglycemia can be checked by frequent tests of the baby’s blood glucose after birth).
• The baby may have breathing difficulty and jaundice.

What can I do to keep my blood glucose under control?

You can help keep your blood glucose under control by:

• Following the recommended diet.
• Doing moderate exercises.
• Checking your blood glucose at home and in the prenatal clinic.

What kind of a diet will I need to be on?

Following a diet is often the most important way to keep your blood glucose level in the normal range. Your doctor, nurse or dietitian will help you to determine a diet that will be best for you and your baby.

Will I need to use medicine

Sometimes diet is not enough. When diet is not enough, either oral medicine or insulin is recommended depending on each individual patient’s risk. If oral medication fails, insulin injections are needed to control blood glucose levels. Insulin cannot be taken as a pill. It must be taken as a shot.

If you need insulin, your nurse will also show you:

• How to prepare and give your own shot.
• How to recognize the signs and symptoms of high blood glucose and/or low blood glucose.

How do I check my blood glucose?

Self blood glucose monitoring is used to check your blood glucose. The test is done by sticking your finger for a drop of blood. The drop of blood is put on a special chemically treated strip. The nurse will show you how this is done. Your physician will let you know how often to check your blood sugar and give you a chart to record the values.

Will I need any special testing?

If you get to the point that you need medication, you will also be scheduled for special testing for your baby. This may include ultrasounds or monitoring the heart rate of the baby for 20-30 minutes. This testing will start at 32 weeks. You will also be scheduled for more frequent clinic visits to monitor the sugars.

What are the chances my baby will have diabetes?

The chances of your baby having diabetes at birth are very small. Those who do develop diabetes usually do so later in life.

What are my chances of developing diabetes?

If you become pregnant again, there is a 90% chance of you having gestational diabetes. There is also a 50-60 % chance that you will develop Type 2 diabetes later in life if you had gestational diabetes. You can reduce your risks of later developing diabetes by staying at a healthy weight after delivery. If you are overweight it is very important to lose weight. You will be checked for diabetes six weeks after the delivery of your baby. You should be checked yearly after delivery. Your doctor will discuss this with you.

Can I breastfeed my baby?

Yes! Most mothers with Gestational Diabetes have normal blood glucose levels soon after delivery. Your doctor will discuss your condition with you after the birth of your baby. You should be able to breastfeed even if diabetes is present. You may need more calories than before pregnancy to help you make milk for the baby. A dietitian will help you plan changes in your diet. Your doctor will make changes in your insulin if it is still needed. These changes are important for you and your baby’s health.

What does all this mean for me?

The more you know about Gestational Diabetes, the easier it will be to control your glucose levels and prevent problems for you and your baby. There are many health professionals to help you, but you are responsible for your care each day. If you take good care of yourself, you will increase your chances of having a healthy, normal baby.