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About Diabetes in Pregnancy

Gestational Diabetes

Gestational diabetes is a type of diabetes that can occur in pregnancy. During pregnancy an organ called the placenta develops in the mother’s womb.

This organ connects mother and baby and is responsible for baby’s adequate food supply.

The placenta frees a substance that blocks insulin function, resulting in insulin resistance. To overcome this resistance, pregnant woman need up to 3 times more insulin than normal. Gestational diabetes starts when an organ called the pancreas cannot produce enough insulin needed during pregnancy. Without enough insulin, sugar that is in the blood cannot be converted into energy. The sugar level accumulates in the blood and produces hyperglycemia (high sugar levels ). Gestational diabetes affects 5-10 % of all pregnancies, but is more frequent in women with the following risk factors:

  • Age: 25 y/o or older
  • Overweight
  • Ethnicity: African-American, Hispanic, Asian
  • Family History of Diabetes
  • History of Gestational Diabetes in prior pregnancy
  • History of large baby

Diagnosis

Gestational diabetes in general does not cause any symptoms or discomfort to mothers. For this reason during prenatal care, mothers have a glucose tolerance test at 24-28 weeks. If this test is positive, the provider will order a longer glucose tolerance test (over a three hour period). If you have a history of Gestational Diabetes, this test will be ordered at your first prenatal visit.

Complications

How can gestational diabetes affect my pregnancy?

Usually, gestational diabetes is a very mild disorder for mother, but can cause some other complications throughout pregnancy:

Mother

  • premature contractions
  • impact on your blood pressure
  • abnormal amniotic fluid
  • urinary and vaginal infections
  • bleeding at delivery

Baby

  • large baby ( 9 lb. or greater)
  • obesity
  • fetal distress at delivery
  • trauma at birth
  • brain development delay

 

Treatment

There are 3 ways to control high sugar levels:

  • Diet
  • Exercise
  • Medications

Diet is the best way to treat Gestational Diabetes. The meal plan consists of 2000 calories divided into 3 meals ( breakfast, lunch and dinner) with 3 snacks in between. We recommend limiting simple carbohydrates ( sugar, honey, sodas, cookies, cake ).

Exercise: The American Diabetes Association recommends 30 minutes of walking at least 5 times a week

Medication: Insulin is prescribed when diet and exercise don’t adequately control high sugar levels. Insulin administration is in injection form, as oral pills are contraindicated in pregnancy. Insulin administered to mother does not harm the fetus. Usually, after delivery, sugar levels return to normal and insulin is stopped.

Postpartum

  • For the majority of women gestational diabetes disappears after delivery (about 95 %). In a small percentage of cases, diabetes continues.
  • This is why there is the recommendation for evaluation with another glucose tolerance test 2 months after delivery or after you finish breast feeding, to make sure diabetes has resolved
  • Even if diabetes has resolved, we recommend evaluation every 2-3 yrs.
  • Women who have had Gestational Diabetes have a higher chance of developing Type 2 Diabetes.
  • Risk of developing diabetes correlates with family history, obesity, sedentary life style
  • We encourage women to lose all the weight gained in pregnancy, maintain a healthy diet and to be active • Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster