Managing Gestational Diabetes During Pregnancy

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gestational diabetes oral glucose tolerance test

Glucose is essential to your health because it is the main source of energy for the cells in your body. Insulin is a hormone that allows the glucose to enter these cells to produce energy. Diabetes is a disease in which there is an imbalance between these two hormones. Gestational diabetes is a term given to mothers who were not diabetic prior to their pregnancy, but have a high blood sugar during pregnancy. Understanding the disease and all of its symptoms will help you and your baby have a healthy pregnancy and safe delivery.

Causes of Gestational Diabetes

The American Diabetes Association estimates that gestational diabetes effects 4% of expectant mothers, approximately 135,000 cases per year, making it one of the highest health problems associated with pregnancy. The exact cause of gestational diabetes is unclear, though it is believed to be that hormones from the placenta block the action of insulin in the mothers body.

This prevents a pregnant mother from building up and using the amount of insulin she needs during pregnancy. In turn, expectant mothers cannot control the amount of glucose in their body, causing high blood sugar.

 

Who is at Risk for Developing High Blood Sugar in Pregnancy?

There are some expectant mothers that are at higher risk of developing gestational diabetes than others. Women that are overweight prior to getting pregnant, as well as those with a family history of diabetes have a higher rate of gestational diabetes, as well as women who have had an unexplained stillbirth in the past.

Women over the age of 35 and those with a history of high blood pressure are also at risk. A thorough health history should be obtained by your physician at the beginning of your pregnancy to determine your risk of developing the disease.

Signs and Symptoms of Gestational Diabetes

 

Signs and symptoms of gestational diabetes are rare. If a patient does have complaints it is usually increased thirst and increased urination. This is due to the increase amount of glucose in your bloodstream, which causes your body to pull fluid from your tissues, leaving you thirsty. The increased fluid intake increases your amount of urination. Many woman attribute these symptoms to their pregnancy, not realizing that is related to high blood sugar.

Detecting Gestational Diabetes in Expectant Mothers

Gestational diabetes typically does not occur until after 24 weeks gestation in a pregnancy. Laboratory screening is usually done around 28 weeks gestation. This test, called a Oral Glucose Tolerance test, should be a routine screening for every pregnancy.

In the Oral Glucose Tolerance test, women are given sweet liquid to drink, then have blood drawn 30-60 minutes after drinking the liquid to test their glucose levels. A high glucose level may indicate gestational diabetes. The Glucose Tolerance Test should be performed earlier in the pregnancy for women who have had a history of gestational diabetes in previous pregnancies.

Effects of Gestational Diabetes on the Fetus

The dangers with gestational diabetes are the effects that it can have on the unborn baby. The excess amount of glucose present in the mothers’ body crosses to the fetus, leaving the baby with an increased amount of glucose. When the fetus has an extra amount of glucose, it causes the fetus’ pancreas to work overtime to create a higher amount of insulin. This extra insulin causes extra energy to be stored as fat. This results in a high birth weight, or large baby, of mothers who have gestational diabetes.

The term macrosomia is given to “fat” babies as the result of high glucose levels. Babies with macrosomia typically have issues in regulating their glucose levels after delivery, which leaves them at risk of breathing issues after birth. Also, a vaginal delivery may be too dangerous to attempt with a large baby. Macrosomia babies have a higher risk of trauma in the birth canal, such as shoulder and head injuries. To prevent any injuries to the baby, a caesarian section may need to be performed to assure a healthy delivery.

Treatment of Gestational Diabetes

The good news is that gestational diabetes usually goes away after delivery, but it must be treated properly during the pregnancy in order to ensure a safe delivery and a healthy baby. The treatment for gestational diabetes is unique to each individual. The physician caring for the patient will set up an individualized plan to control and maintain healthy blood sugar levels. This plan will include special meal plans, as well as physical activity. It will also include blood glucose screening, usually at least once a day. Insulin injections or oral medications may be necessary when diet and exercise are not effective in managing the disease. Approximately 15% of pregnant women with gestational diabetes need insulin shots.

Expectant mothers who are diagnoses with gestational diabetes should continue to get follow-up care after delivery. Sometimes the diagnosis of gestational diabetes may actually be Type 1 or Type 2 diabetes that was just detected during the pregnancy.

According to the American Diabetes Association, approximately 50% to 75% of expectant mothers with gestational diabetes who remain obese after delivery develop diabetes later in life. Less than 25% develop diabetes that are a healthy weight after delivery. A healthy lifestyle with good eating habits and exercise can decrease your odds of developing diabetes later in life. It is vital to your health, as well as your baby’s health, to take control of gestational diabetes once diagnosed. Left untreated, the disease will not only affect you, but your unborn child. These effects are not just during the pregnancy, but throughout life.

 

Managing Gestational Diabetes During Pregnancy

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