Gestational diabetes is diabetes diagnosed for the first time during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health.
While any pregnancy complication is concerning, there's good news. Expectant mothers can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery.
In women with gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you have a higher risk of getting type 2 diabetes. You'll need to be tested for changes in blood sugar more often.
For most women, gestational diabetes doesn't cause noticeable signs or symptoms. Increased thirst and more-frequent urination are possible symptoms.
If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can check your risk of gestational diabetes along with your overall wellness. Once you're pregnant, your doctor will check you for gestational diabetes as part of your prenatal care.
If you develop gestational diabetes, you may need checkups more often. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health.
Researchers don't yet know why some women get gestational diabetes and others don't. Excess weight before pregnancy often plays a role.
Normally, various hormones work to keep your blood sugar levels in check. But during pregnancy, hormone levels change, making it harder for your body to process blood sugar efficiently. This makes your blood sugar rise.
Some women have a greater risk of gestational diabetes. Risk factors for gestational diabetes include the following:
Gestational diabetes that's not carefully managed can lead to high blood sugar levels. High blood sugar can cause problems for you and your baby, including an increased likelihood of needing a C-section to deliver.
If you have gestational diabetes, your baby may be at increased risk of:
Gestational diabetes may also increase your risk of:
There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. If you've had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes in the future.
If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy.
If you're at high risk of diabetes — for example, if you're overweight or obese before pregnancy or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes early in pregnancy, likely at your first prenatal visit.
Screening tests may vary slightly depending on your health care provider, but generally include:
Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level of 190 milligrams per deciliter (mg/dL), or 10.6 millimoles per liter (mmol/L) indicates gestational diabetes.
A blood sugar below 140 mg/dL (7.8 mmol/L) is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, you'll need another glucose tolerance test to determine if you have the condition.
Treatment for gestational diabetes includes:
Managing your blood sugar levels helps keep you and your baby healthy. Close management can also help you avoid complications during pregnancy and delivery.
Your lifestyle — how you eat and move — is an important part of keeping your blood sugar levels in a healthy range. Doctors don't advise losing weight during pregnancy — your body is working hard to support your growing baby. But your doctor can help you set weight gain goals based on your weight before pregnancy.
A healthy diet focuses on fruits, vegetables, whole grains and lean protein — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. A registered dietitian or a diabetes educator can help you create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.
Regular physical activity plays a key role in every woman's wellness plan before, during and after pregnancy. Exercise lowers your blood sugar, and as an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping.
With your doctor's OK, aim for 30 minutes of moderate exercise on most days of the week. If you haven't been active for a while, start slowly and build up gradually. Walking, cycling and swimming are good choices during pregnancy. Everyday activities such as housework and gardening also count.
While you're pregnant, your health care team may ask you to check your blood sugar four or more times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range.
If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar. Between 10% and 20% of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors prescribe an oral medication to control blood sugar, while others believe more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.
An important part of your treatment plan is close observation of your baby. Your doctor may check your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date — or sometimes earlier — your doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.
Your doctor will check your blood sugar after delivery and again in six to 12 weeks to make sure that your level has returned to normal. If your tests are normal — and most are — you'll need to have your diabetes risk assessed at least every three years.
If future tests indicate type 2 diabetes or prediabetes, talk with your doctor about increasing your prevention efforts or starting a diabetes management plan.
It's stressful to know you have a condition that can affect your unborn baby's health. But the steps that will help control your blood sugar level — such as eating healthy foods and exercising regularly — can help relieve stress, nourish your baby and help prevent type 2 diabetes in the future.
You may feel better if you learn as much as you can about gestational diabetes. Talk to your health care team, or read books and articles about gestational diabetes. Some women find a support group for women with gestational diabetes helpful.
You'll likely find out you have gestational diabetes from routine screening during your pregnancy. Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy.
Here's some information to help you get ready for your appointment and know what to expect from your doctor or other health professional.
Make a list of questions to help make the most of your time with your doctor. For gestational diabetes, some basic questions to ask your doctor include:
Your doctor is also likely to have questions for you, especially if you're seeing him or her for the first time. Your doctor may ask:
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