Gestational Diabetes

Gestational diabetes at a glance

• Gestational diabetes is a type of diabetes that can develop during pregnancy in women who didn’t previously have diabetes. It often arises around the 24th week of pregnancy.
• While many women with gestational diabetes have healthy pregnancies, there are some risks and complications associated with this condition that need to be monitored.
• Women who undergo fertility treatments, such as IVF or IUI, may be at a higher risk of developing gestational diabetes.
• Typically, there are no or few noticeable symptoms such as increase thirst. Because of this, it’s important to test for it between weeks 24 and 28.
• Proper management of gestational diabetes through diet and sometimes medications helps ensure a healthier pregnancy and a healthier baby.

What is gestational diabetes?

Gestational diabetes affects between 5% and 9% of pregnancies in the United States each year, according to the Centers for Disease Control and Prevention. It occurs when the body has difficulty managing blood sugar levels due to changes in hormone levels and increased insulin resistance.

During pregnancy, the body undergoes hormonal changes and weight gain, which increase insulin resistance. This resistance makes it harder for cells to use insulin effectively, raising the body’s demand for insulin. Most women experience some insulin resistance in late pregnancy, but those with higher baseline insulin resistance may be more prone to gestational diabetes. Recent studies also show an associated risk of developing the condition with the use of fertility enhancing drugs, which are used if undergoing in vitro fertilization (IVF) and intrauterine insemination (IUI).

Related Reading: Understanding the Link Between Diabetes and Infertility

Long-term health considerations

Women with gestational diabetes are at an increased risk of developing type 2 diabetes later in life – about half do. Moreover, women who have this condition in one pregnancy are at increased risk of developing it again in future pregnancies. Such women should work with a healthcare provider to monitor blood sugar levels after pregnancy and learn strategies to reduce risks (see tips below).

If left untreated, there are implications on both maternal and fetal health such as:

• Increased risk of cesarean delivery.
• Higher likelihood of preeclampsia.
• Macrosomia, or excessive birth weight of baby.
• Long-term risk of type 2 diabetes for both mother and child.

Related Reading: Pregnant or trying? Learn more about possible pregnancy complications.

Risk factors for during pregnancy

Women may be at a higher risk of developing gestational diabetes if they:

• Had gestational diabetes in a previous pregnancy.
• Gave birth to a baby weighing more than 9 pounds.
• Are overweight.
• Have a family history of type 2 diabetes.
• Have polycystic ovary syndrome (PCOS).
• Are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian or Pacific Islander.

While the condition isn’t always preventable, certain lifestyle changes before pregnancy can reduce a woman’s risk. These include maintaining a healthy weight, eating a balanced diet, and engaging in regular physical activity.

Gestational diabetes symptoms & diagnosis

Many women with gestational diabetes experience no or very subtle symptoms. When symptoms do occur, they can include increased thirst or frequent urination, which are also common during pregnancy. Other symptoms include:

• Excessive fatigue.
• Nausea or vomiting.
• Blurred vision.
• Recurring infections.

Test for the condition

Gestational diabetes often doesn’t cause any noticeable symptoms, making screening with a gestational diabetes test that much more important. A glucose challenge test (GCT) is performed around 24-28 weeks of pregnancy. After consuming a sugary drink, blood sugar levels are measured after one hour. If the GCT indicates elevated levels, a 3-hour oral glucose tolerance test is conducted, involving fasting and multiple blood samples after consuming a concentrated glucose solution.

Women who are at higher risk may get tested earlier. Elevated blood sugar early in pregnancy could indicate preexisting diabetes (type 1 or type 2) rather than gestational diabetes, so early diagnosis is crucial.

Gestational diabetes treatments

Gestational diabetes treatments start with proper management of the condition, which helps ensure a healthier pregnancy and a healthier baby.

Managing this form of diabetes involves a combination of lifestyle changes, ongoing tests and, if needed, medication. Here’s how those affected can help control blood sugar levels:

• Monitor blood sugar: Checking levels regularly ensures they stay within a healthy range.
• Stay active: Physical activity lowers blood sugar and enhances insulin sensitivity.
• Eat a balanced diet: Eating the right foods in appropriate portions at consistent times helps regulate blood sugar.
• Stay hydrated: Drink plenty of water throughout the day, as hydration can impact overall health and blood sugar levels.

If these lifestyle measures in conjunction with regular monitoring don’t sufficiently control blood sugar, a doctor may prescribe insulin, metformin or other medications to help keep it within target range.