What is gestational diabetes?
- Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. Your body uses glucose for energy. Too much glucose in your blood is not good for you or your baby.
- Gestational diabetes is usually diagnosed during late pregnancy. If you are diagnosed with diabetes earlier in your pregnancy, you may have had diabetes before you became pregnant.
- Treating gestational diabetes can help both you and your baby stay healthy. You can protect your baby and yourself by taking action right away to control your blood glucose levels.
- If you have gestational diabetes, a health care team will likely be part of your care. In addition to your obstetrician-gynecologist, or OB/GYN—the doctor who will deliver your baby—your team might include a doctor who treats diabetes, a diabetes educator, and a dietitian to help you plan meals.
What causes gestational diabetes?
- Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels.
- During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body's cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body's need for insulin. If your pancreas can't make enough insulin, you will have gestational diabetes.
- All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.
Your chances of getting gestational diabetes are higher if you:
- are overweight
- have had gestational diabetes before
- have given birth to a baby weighing more than 9 pounds
- have a parent, brother, or sister with type 2 diabetes
- have pre-diabetes, meaning your blood glucose levels are higher than normal yet not high enough for a diagnosis of diabetee
- are African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander American
- have a hormonal disorder called polycystic ovary syndrome, also known as PCOS
You can lower your chances of getting gestational diabetes by:
- losing extra weight
- increasing your physical activity level before you get pregnant
- Taking these steps can improve how your body uses insulin and help your blood glucose levels stay normal.
- REMEMBER: Once you are pregnant, you should not try to lose weight. You need to gain some weight for your baby to be healthy. However, gaining too much weight too quickly may increase your chances of getting gestational diabetes. Your doctor will tell you how much weight gain and physical activity during pregnancy are right for you.
When will I be tested for gestational diabetes?
- You will probably be tested for gestational diabetes between weeks 24 and 28 of your pregnancy.
- If you have a higher chance of getting gestational diabetes, your doctor may test for diabetes during the first visit after you become pregnant. If your blood glucose level is above normal at that time, you may be diagnosed with diabetes rather than gestational diabetes.
How will gestational diabetes affect my baby?
- If you have high blood glucose levels because your gestational diabetes is not under control, your baby will also have high blood glucose. Your baby's pancreas will have to make extra insulin to control the high blood glucose. The extra glucose in your baby's blood is stored as fat.
- Untreated or uncontrolled gestational diabetes can cause problems for your baby, such as
- being born with a larger than normal body—a condition called macrosomia—which can make delivery difficult and more dangerous for your baby
- having low blood glucose, also called hypoglycemia, right after birth
- having breathing problems, a condition called respiratory distress syndrome
- having a higher chance of dying before or soon after birth
- Your baby also might be born with jaundice. Jaundice is more common in newborns of mothers who had diabetes during their pregnancy. With jaundice, the skin and whites of the eyes turn yellow. Jaundice usually goes away, but your baby may need to be placed under special lights to help. Making sure your baby gets plenty of milk from breastfeeding will also help the jaundice go away.
How will gestational diabetes affect me?
- Gestational diabetes may increase your chances of
- having high blood pressure and too much protein in the urine, a condition called preeclampsia
- having surgery—called a cesarean section or c-section—to deliver your baby because your baby may be large
- becoming depressed
- developing type 2 diabetes and the problems that can come with this disease
During Pregnancy: Remember, in order to take care of your baby, you must first take care of yourself. Keep regular checkups. “Feeling fine” does not mean you should skip any appointments. Women with gestational diabetes often have no symptoms. Your health care team will be on the lookout for any problems from gestational diabetes.
After Giving Birth: Your diabetes will probably go away after your baby is born. However, even if your diabetes goes away after the birth, you may have gestational diabetes if you get pregnant again or will be more likely to have type 2 diabetes later in your life.
How is gestational diabetes treated?
Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range. Targets are numbers you aim for. Your doctor will help you set your targets. You will learn how to control your blood glucose using
- healthy eating
- physical activity
- insulin shots, if needed
After I have my baby, how can I find out whether I still have diabetes?
- You will need to visit your doctor to have a blood glucose test 6 to 12 weeks after your baby is born to see whether you still have diabetes. For most women, blood glucose levels return to normal after pregnancy. However, in 5 to 10 percent of women with gestational diabetes, blood glucose levels do not return to normal. Testing shows that these women have diabetes, usually type 2 diabetes. They will need to manage their diabetes through diet, physical activity, and medicines if needed.
- Even if your blood glucose levels return to normal after your pregnancy, your chances of having diabetes—usually type 2 diabetes—later in life are high. Therefore, you should be tested at least every 3 years for diabetes or pre-diabetes.
REMEMBER: You can do a lot to prevent or delay type 2 diabetes by making these lifestyle changes. Here are a few more tips! Good luck with your healthy ways!:
- Reach and stay at a healthy weight. Try to reach your pre-pregnancy weight 6 to 12 months after your baby is born. Then, if you still weigh too much, work to lose at least 5 to 7 percent of your body weight and keep it off. For example, if you weigh 200 pounds, losing 10 to 14 pounds can greatly reduce your chance of getting diabetes.
- Be physically active for at least 30 minutes most days of the week.
- Follow a healthy eating plan. Eat more grains, fruits, and vegetables. Cut down on fat and calories. Your health care team can help you design a meal plan.
- Ask your doctor if you should take the diabetes medicine, metformin. Metformin can lower your chances of having type 2 diabetes, especially if you are younger and heavier and have pre-diabetes or if you have had gestational diabetes.