Every pregnant woman in the United States will get tested for gestational diabetes in the second trimester – sometime between 24 and 28 weeks pregnant. This is a routine test that is part of regular prenatal care, and it allows your physician to provide better obstetric care.
So, what is gestational diabetes? And how can it affect your pregnancy?
What is Gestational Diabetes?
Gestational diabetes is a type of diabetes (high blood sugar) that develops in pregnancy. For a majority of women, this form of diabetes occurs only during pregnancy. Unlike Type 1 or Type 2, gestational diabetes often disappears after your baby is born. In rare cases, gestational diabetes transforms into Type 2 diabetes after delivery.
According to the American Diabetes Association, gestational diabetes impacts 18 percent of all pregnancies. Other health organizations, like the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), report gestational diabetes occurs less often – between 3 to 8 percent. Regardless of what statistic is more accurate, there’s no denying that gestational diabetes is one of the more common health complications in pregnancy.
What Causes Gestational Diabetes?
Researchers don’t know exactly what causes this pregnancy complication, but it is widely accepted that hormonal changes play a role in the development of gestational diabetes. When you’re pregnant, hormones produced by the placenta block the action of insulin – a hormone produced by the pancreas, which opens up your cells so that they can convert glucose (the sugar in your body) into energy. Because the action of insulin is blocked in pregnancy, a pregnant woman’s cells can develop insulin resistance, which means the cells don’t respond to insulin in the same way. The cells in the body don’t open like they should, so glucose levels increase in your blood.
To combat these higher blood sugar levels, a pregnant woman’s pancreas will produce more insulin – roughly three times its normal amount – to lower the blood sugar levels in her body. When a woman has gestational diabetes, her pancreas do not produce enough insulin to overcome this pregnancy-induced insulin resistance. As a result, glucose increases to high levels in her blood. This high blood sugar (or gestational diabetes) can cause problems for the pregnancy.
The Complications of Gestational Diabetes
Fortunately, gestational diabetes doesn’t affect a pregnant woman until the late second trimester. By this time, the baby’s body and organs has already been formed. Unlike with other types of diabetes, gestational diabetes does not cause birth defects. The primary concern with gestational diabetes is macrosomia – a baby who is overly “fat.”
When you have uncontrolled gestational diabetes, the extra blood glucose (high blood sugar) passes to your baby through the placenta, giving him or her high blood glucose levels. This can cause your baby’s placenta to produce extra insulin to lower this extra blood glucose. Because your baby is receiving more energy than he or she requires for healthy fetal development, the extra energy gets stored as fat on your baby’s body.
Although you might think that having an overly fat baby will make him or her cuter, babies who are born too fat (a condition called macrosomia) are at higher risk of becoming hypoglycemic (low blood sugar levels) at birth, and he or she is at higher risk for breathing problems. Your newborn also faces type 2 diabetes and childhood obesity later in life.
Giving birth to a larger than normal sized baby also puts you at higher risk for having a cesarean section (C-section). If you opt for a vaginal birth, you’ll have a longer, more difficult labor. And there’s a higher risk that your baby will face shoulder dystocia – a rare but life-threatening condition in which the baby’s head is delivered, but the shoulders get stuck inside your body.
Risk Factors for Gestational Diabetes
Although any pregnant woman can face gestational diabetes in pregnancy, you are higher risk for developing this pregnancy complication in the following circumstances:
- You were overweight before getting pregnant.
- Over age 25.
- There is a family history of diabetes.
- You’ve given birth to an overly large baby (9 pounds or more) in the past.
- There was sugar in your urine at a previous prenatal visit.
- You have high blood pressure.
- There’s too much amniotic fluid in your womb.
- You had gestational diabetes in a previous pregnancy.
- A previous pregnancy ended with an unexplained stillbirth.
- You have delivered a baby with a birth defect in the past.
Keep in mind that every woman is at risk for developing gestational diabetes. Even if you don’t have a risk factor for it, just being pregnant puts you at higher risk. This is why glucose screening tests in the second trimester are critical to your overall prenatal health.
Symptoms of Gestational Diabetes
In a majority of the time, women with gestational diabetes do not experience any symptoms. When they do have symptoms, they tend to be mild and not life threatening. Symptoms of gestational diabetes can include:
- Blurry Vision – Your vision suddenly gets blurry, or it isn’t as sharp as it used to be.
- Fatigue – You are more tired than normal.
- Increased Thirst – You are constantly drinking water or fluids because you’re more thirsty than normal.
- Increased Urination – You are always running to the bathroom to pee.
- Nausea and vomiting
- Weight loss, even though you’re hungrier than normal
- Frequent infections, especially bladder, vaginal, or skin infections.
Because many of the symptoms of gestational diabetes – like fatigue, increased urination, nausea and vomiting – are similar to pregnancy symptoms, it is really difficult to diagnose gestational diabetes from the symptoms alone.
Pregnant women are typically diagnosed with gestational diabetes in the second trimester. As part of your prenatal care, you will undergo an oral glucose tolerance test between 24 and 28 weeks of pregnancy to screen for this pregnancy complication.
What Happens if I’m Diagnosed with Gestational Diabetes?
If you’re diagnosed with gestational diabetes in pregnancy, don’t freak out. Most women who develop this complication are able to control their blood sugar levels with diet and exercise, more frequent prenatal visits, and insulin therapy (in more severe cases).
With gestational diabetes, you will need to check your blood sugar levels often throughout the day. Your doctor may want you to check your glucose levels before each meal, and two hours after you eat. Ask your doctor for specific guidance.
You will also need to follow specific dietary guidelines that your doctor prescribes. In general, a diabetes diet may include a moderate amount of fat and protein, and a very carefully controlled level of carbohydrates – including fruits and vegetables, as well as bread, cereal, rice, and pasta products. Your doctor will probably ask you to reduce the amount of foods that have a high sugar content, as well.
If your diet alone doesn’t help control your blood sugar levels, your physician may prescribe insulin injections to help.
Women with gestational diabetes also benefit from moderate exercise (30 minutes a day). Exercising helps your body process glucose and often manage your blood sugar levels. Brisk walking and swimming are two great exercises to do when you’re pregnant.