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Gestational diabetes and pregnancy

How to know if you are at risk for gestational diabetes


If you’re expecting or planning to become pregnant in the near future, you may have questions about gestational diabetes and the related health risks.

Gestational diabetes occurs in as many as 9.2 percent of pregnancies, but can be controlled by eating healthy foods, exercising and, if necessary, using medication. Women who develop gestational diabetes did not have diabetes before becoming pregnant.

Doctors often test for gestational diabetes with a glucose screening and blood test between 24 and 28 weeks of pregnancy, as it usually shows up in the middle of pregnancy with few symptoms. Some women have more than one pregnancy affected by gestational diabetes.

“We routinely screen patients at 28 weeks, regardless if they are at risk,” said Dr. Sarah Morris of Novant Health Carmel OB/GYN. “We have patients drink a very sweet drink that tastes a bit like flat orange soda. The drink has a high sugar load that most women’s bodies should be able to handle. If a patient’s blood sugar levels spike, a more detailed glucose test will be performed. A woman’s blood glucose levels are tested four times and if she fails two or more times, she is considered to have gestational diabetes.”

Risk factors for gestational diabetes

There are several risk factors that can increase one’s chances of having gestational diabetes, including if you are:

  • Over age 25. A recent study shows that the average age of first-time mothers continues to increase. With older maternal age, women have a higher chance of developing gestational diabetes.
  • Prediabetic or have a family health history of diabetes. A woman’s risk increases if she has prediabetes or if a close family member, such as a parent or sibling, has Type 2 diabetes. Women are also more likely to develop gestational diabetes if they had it during a previous pregnancy, if they delivered a baby who weighed more than 9 pounds or if they had an unexplained stillbirth.
  • Overweight. Women are more likely to develop gestational diabetes if they are significantly overweight with a body mass index (BMI) of 30 or higher.
  • Nonwhite race. For unexplained reasons, women who are black, Latino, American Indian or Asian are more likely to develop gestational diabetes.

Even if a woman is at risk for gestational diabetes, there are some lifestyle changes she can make to minimize her chances of developing it.

Dr. Alyssa Mills of Novant Health Maternal-Fetal Medicine said her biggest recommendation is to lose weight before pregnancy either through diet and exercise, or if recommended, weight loss surgery. She also said following the recommended gestational weight gain guidelines could help prevent the development of gestational diabetes.

“The phrase, ‘eating for two,’ shouldn’t be a free pass for nine months,” Mills said. “In actuality, the recommended guidelines for caloric intake in pregnancy are more like eating for 1.2 people instead of two.”

Learning to control gestational diabetes

Obstetricians at Novant Health refer patients who are diagnosed with gestational diabetes to the diabetes center. There, patients receive education about dietary modifications they can make to help control their sugar levels.

“This connection with the diabetes center is something insurance will most likely cover if a woman has gestational diabetes, otherwise few people get to have it covered by their insurance,” Morris said. “Not everyone has an opportunity to have nutrition and diet counseling, which can help create healthy habits for the rest of a patient’s life.”

If a woman is unable to control her sugar with diet alone, she is then referred to a maternal-fetal medicine specialist.

“If a woman is experiencing trouble regulating her sugar levels, the diabetes center will send her lab work for us to review,” Mills said. “She will then come in for a consultation visit and we’ll typically prescribe medication.”

Complications from gestational diabetes

If gestational diabetes is not well-controlled, both the mother and her baby can be at risk for complications, such as:

  • Excessive birth weight. If gestational diabetes is not controlled, the baby’s blood sugar can be too high. The baby is “overfed” and grows extra-large, causing discomfort and problems during delivery. Very large babies are more likely to become wedged in the birth canal, sustain injuries at birth or require a cesarean section birth.
  • Early birth and respiratory distress syndrome. Because of a mother’s high blood sugar, she is at greater risk of going into labor early. Babies born early may experience respiratory distress syndrome, a condition that makes breathing difficult. They may need help breathing until their lungs mature and grow stronger. Even if the baby isn’t born early, he or she could still be at risk for respiratory distress syndrome.
  • Low blood sugar. Gestational diabetes in the mother can lead to low blood sugar in the baby shortly after birth because their own insulin production is high. Severe episodes may cause seizures in the baby.
  • Preeclampsia. Gestational diabetes can increase a woman’s risk of developing high blood pressure during pregnancy. It can also raise her risk of preeclampsia and eclampsia – two serious complications of pregnancy that can cause high blood pressure and other symptoms that can threaten the lives of both mother and baby.
  • Future diabetes. If the mother has gestational diabetes, both she and the baby can be at risk to develop Type 2 diabetes later in life.

Recovering from gestational diabetes

Mills said most women experience a rapid return to normal blood sugar levels after delivery. However, women who have gestational diabetes are at a sevenfold risk of developing Type 2 diabetes later in life. Because of this risk, a follow-up glucose test is recommended six to 12 weeks after delivery. 

Novant Health offers online resources, maternity tours and educational classes for expecting mothers. Click here to find out more.





Published: 4/12/2016