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Gestational Diabetes
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Gestational diabetes is diabetes that occurs only when you're pregnant. It causes high blood sugar during pregnancy that can be dangerous to the unborn fetus. Anytime you have a complication of pregnancy, it can be scary. Fortunately, there are treatments for this pregnancy complication and the disease goes away once you're not pregnant again.
There are usually no symptoms of gestational diabetes except for the possibility of increased urination or excessive thirst. This is why it is important to be screened for gestational diabetes during the pregnancy. Gestational diabetes usually comes on in the last three months of the pregnancy or the last trimester so the screening test is often done just before this. The blood test is also done after the delivery to make sure the blood glucose is normal.
The cause of gestational diabetes is not known. It is related to insulin in the blood and the response of the body's tissue cells to insulin. Insulin removes glucose from the bloodstream to be used for energy. In gestational diabetes, placental hormones impair the function of insulin in the body so the blood sugar goes up.
Risk factors for gestational diabetes include being older than the age of 25, having a family or personal history of gestational diabetes or having a personal history of pre-diabetes before pregnancy. If you had a baby greater than 9 pounds in the past, you are at a greater likelihood of having gestational diabetes. If you are overweight, you have a greater risk of developing gestational diabetes. Black, Hispanic, Asian or American Indian women have a greater risk of developing gestational diabetes.
There can be complications to having gestational diabetes in pregnancy. The most common complication is excessive fetal growth leading to fetal macrosomia. Large babies have problems with being delivered and have problems with an increased risk of being delivered by Cesarean section. The infant can also develop hypoglycemia after birth because it has become used to such high blood sugar levels. Babies may be delivered early because of size and may result in respiratory distress syndrome.
Babies born to mothers who have gestational diabetes can become jaundiced more easily. The mothers themselves can have type II diabetes later on in life. This is also true of the babies, who also have a higher risk of obesity. There is an increased risk of developmental problems in babies who are born to mothers with uncontrolled gestational diabetes.
In mothers with gestational diabetes, there is a greater risk of preeclampsia or toxemia of pregnancy. There is an increased risk of urinary tract infections during pregnancy. Future diabetes type II is more common in women who have had gestational diabetes. If a woman reaches her prepregnancy weight, she still has a 25 percent chance of developing type II diabetes.
Testing for gestational diabetes is done in all pregnant women, usually. The screening test is done between 24 and 28 weeks gestation. It is done using a 50 gram load of glucose and is checked an hour after the load is given. If the glucose level is above expected guidelines-above 140 mg/dL-the one hour test is considered suspicious for diabetes. The follow up test for gestational diabetes is a 3 hour test with a 100 gram glucose load. It is a fasting test that can say for sure whether or not you have gestational diabetes.
If you have gestational diabetes, you may be treated with insulin or may just watch your diet and monitor your blood sugar levels closely. There are extra tests that are done to make sure you and the baby are doing well. These include more frequent visits to the doctor's office, a nonstress test and a biophysical profile. A biophysical profile can tell if the baby is healthy within the womb. Moms with gestational diabetes will count fetal movements to make sure the baby is moving in a healthy way.
A blood sugar test is done after the birth of the baby to make sure the gestational diabetes is going away. If it is elevated, you may have type II diabetes that may or may not have been present before the pregnancy.