Gestational Diabetes

GENERAL INFORMATION:

What is gestational diabetes? Gestational (jes-TAY-shun-al) diabetes (deye-ah-BEE-teez) is also called gestational diabetes mellitus or GDM. It is a form of diabetes that may develop during pregnancy, usually in the second or third trimester. GDM happens when the pregnant woman's body cannot make enough insulin. Insulin helps your body use glucose (sugar). Decreased amount of insulin results in high blood sugar levels in the body.

What causes gestational diabetes? No one knows for sure what causes GDM. It is believed that the hormones made by the placenta block the effects of insulin. The placenta is the tissue in your uterus (womb) that connects the pregnant woman to her baby. The blocking effect on insulin increases as the placenta grows and more of these hormones are produced. Normally, the body makes more insulin to take care of this problem. GDM results when not enough insulin is made.

Who is at risk of having gestational diabetes? One or more of the following factors may increase your risk of having GDM:

• Having a close family member who has diabetes.
  
  
• Having a history of high blood sugar.
  
  
• Having a weight more than your caregiver advised before and during pregnancy.
  
  
• Having given birth to a previous baby weighing more than 9 pounds, 14 ounces.
  
  
• Having glycosuria (sugar in your urine).
  
  
• Women who are black, Hispanic or American Indians have an increased risk of GDM

What are the signs and symptoms of gestational diabetes? You may have one or more of the following:

• Feeling more thirsty than usual.
  
  
• More frequent urination
  
  
• Blurred vision (eyesight).
  
  
• Feeling more tired than usual.
  
  
• Frequent infections of the urinary bladder, vagina, or skin.
  
  
• Gaining more weight than what your caregiver suggests during your pregnancy.
  
  
• Nausea (upset stomach) or vomiting (throwing up).

How is gestational diabetes diagnosed? GDM is found and diagnosed using the following blood sugar tests:

• 50 gram oral glucose challenge test: You will be asked to drink a special liquid containing glucose (sugar). Your blood sugar levels will be measured after one hour. Caregivers usually check pregnant women for GDM at 24 to 28 weeks gestation. If you are at a high risk of having GDM, this test is done on your first visit to your caregiver.
  
  
• 100 gram oral glucose tolerance test: This test is only done if you have an increased glucose challenge test. After drinking a glucose liquid, your blood sugar levels will be measured three times, with one hour between each test. Ask your caregiver for more information about this test.

How is gestational diabetes treated? GDM can be treated and controlled most of the time. The goal is to keep your blood sugar levels as close to normal as safely as possible. A special diet and exercise plan will be set up for you. You will need to learn how to check your blood sugar at home. You may have to check your blood sugar level four times daily. Insulin may be given if your diabetes cannot be controlled by diet alone, or if your diabetes gets worse.

How can gestational diabetes affect you and your baby? You may have one or more of the following effects:

• Development of type 2 diabetes later in life, or GDM in future pregnancies.
  
  
• Frequent infections of the urinary bladder and vaginal area.
  
  
• Greater chance of having a caesarean delivery.
  
  
• Premature (early) labor.

• Hypoglycemia (low blood sugar).
  
  
• Macrosomia (large baby). A large baby is a baby who weighs eight and one-half pounds or more.
  
  
• Prolonged (longer term) newborn jaundice. Babies usually have some jaundice (yellowing of the skin) during their first week of life, but it goes away over time.
  
  
• Twitching of the hands and feet, or cramping muscles. This is caused by low calcium and low magnesium blood levels.

How can gestational diabetes be controlled?

• Diet:
  
  
  • Your caregiver may tell you to avoid concentrated sweets such as cake, cookies, candy, and regular soda. Ask your caregiver if artificial sweetener is safe for you to use while pregnant. Artificial sweetener can be used in place of real sugar in recipes and on foods such as breakfast cereal.
    
    
  • Eat three small meals and three snacks every day. Wait at least 2 to 3 hours between all meals and snacks.
    
    
  • Your caregiver may suggest that you limit carbohydrates. Eating too much carbohydrate at one time can cause your blood sugar to rise to a very high level. Carbohydrates are found in starches (bread, cereal, starchy vegetables, and beans) fruit, milk, and yogurt.
  
  
• Exercise:
  
  
  • Do aerobic exercise such as walking, stationary cycling, swimming, or low impact aerobics. Do 30 minutes of physical activity on most days. It is best to start slowly and do more as you get stronger.
    
    
  • Do non-weight bearing exercise, such as swimming, as the pregnancy progresses. Non-weight bearing exercise may be more comfortable for you. This type of exercise may also be safer for the unborn baby and for the expectant mother than weight-bearing exercise. When walking, wear flat shoes with cushioned soles.

How do I find support and more information? Gestational diabetes is a life-changing disease for you and your family. Accepting that you have gestational diabetes may be hard. You may want to join a support group which is a group of people who also have gestational diabetes. Contact the following for more information:

• American Association of Diabetes Educators
  American Association of Diabetes Educators
  100 West Monroe Street, Suite 400
  Chicago, IL 60603-1901
  Phone: 1-800-338-3633
  Web Address: http://www.aadenet.org
  

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria, VA 22311
  Phone: 1-800-342-2383
  Web Address: http://www.diabetes.org
  

• National Diabetes Information Clearinghouse
  1 Information Way
  Bethesda, MD 20892-3560
  Phone: 1-800-860-8747
  Web Address: www.diabetes.niddk.nih.gov/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Link to Page

Print Page

Email Page