Gestational diabetes

Overview

Gestational diabetes is diabetes that's first diagnosed during pregnancy. Pregnancy sometimes is called gestation. Like other types of diabetes, gestational diabetes affects how the body's cells use sugar, also called glucose. Gestational diabetes causes high blood sugar that can affect a pregnancy and a baby's health.

The good news is that you may be able to control gestational diabetes. Eat healthy foods, exercise and, if needed, take medicine. Controlling blood sugar can help keep you and your baby healthy, and it may help prevent some problems during delivery.

For most people who have gestational diabetes, blood sugar goes back to its usual level soon after a baby is born. But if you've had gestational diabetes, you have a higher risk of getting type 2 diabetes. That means you'll need to be tested for changes in blood sugar more often.

When to see a doctor

If possible, seek healthcare when you start to think about trying to get pregnant. Then your healthcare professional can check your risk of gestational diabetes and your overall wellness. Once you're pregnant, your healthcare professional will check you for gestational diabetes as part of your prenatal care.

If you have gestational diabetes, you'll need checkups more often. These extra checkups are most likely to be during the last three months of pregnancy. Your healthcare professional will check your blood sugar level and your baby's health.

Risk factors

Risk factors for gestational diabetes include:

• Being overweight or obese.
• Not being physically active.
• Having prediabetes.
• Having had gestational diabetes during an earlier pregnancy.
• Having a hormone condition called polycystic ovary syndrome.
• Having a parent or sibling with diabetes.
• Having delivered a baby weighing more than 9 pounds (4.1 kilograms).
• Being of a certain race or ethnicity, such as Black, Hispanic, American Indian and Asian.

Complications that may affect your baby

If you have gestational diabetes, your baby may be at higher risk of:

• High birth weight. If your blood sugar level is high, it may cause your baby to grow too large. Babies who weigh 9 pounds or more are more likely to become stuck in the birth canal, have birth injuries or need a C-section delivery.
• Early birth. High blood sugar may raise the risk of labor and delivery before your pregnancy due date. This is called preterm birth. Or you could need an early delivery because the baby is large.
• Trouble breathing. Babies born early may have a condition that makes breathing hard, called respiratory distress syndrome.
• Low blood sugar. Sometimes babies have low blood sugar, called hypoglycemia, shortly after birth. Severe hypoglycemia may cause seizures. Being fed right away and sometimes getting glucose through a vein can raise the baby's blood sugar level.
• Obesity and type 2 diabetes later in life. Babies have a higher risk of being obese and having type 2 diabetes later in life.
• Stillbirth. Gestational diabetes that is not treated could result in a baby's death either before or shortly after birth.

Prevention

There is no sure way to prevent gestational diabetes. But having healthy habits before pregnancy can help. If you've had gestational diabetes, these healthy choices also might lower your risk of getting diabetes again. That includes developing gestational diabetes during another pregnancy and developing type 2 diabetes in the future.

• Eat healthy foods. Choose a variety of foods high in fiber and low in fat and calories. Focus on fruits, vegetables and whole grains. Eat healthy portion sizes.

• Keep active. Exercising before and during pregnancy can help protect you from getting gestational diabetes. Aim for 30 minutes of moderate activity on most days of the week. Take a brisk daily walk. Ride a bike. Swim laps.

  Short bursts of activity add up. These might include parking further away from the store when you run errands or taking short walks throughout the day.

• Start pregnancy at a healthy weight. If you're planning to get pregnant, losing extra weight before you do may help you have a healthy pregnancy. Make lasting changes to your eating habits, such as eating more vegetables and fruits.
• Don't gain more weight than recommended. Gaining some weight during pregnancy is healthy. But gaining too much weight too quickly can raise your risk of gestational diabetes. Ask your healthcare professional what a good amount of weight gain is for you.

Tests for gestational diabetes

Screening tests for gestational diabetes most often include:

• Initial glucose challenge test. You drink a syrupy glucose solution. One hour later, you 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), means you have gestational diabetes.

  A blood sugar level below 140 mg/dL (7.8 mmol/L) usually is thought to be within the standard range on a glucose challenge test. But this may vary by clinic or lab.

  If your blood sugar level is higher than expected, you'll need another glucose tolerance test to find out if you have gestational diabetes.

• Follow-up glucose tolerance testing. This test is like the first test. But the sweet drink has even more sugar. Your blood sugar is checked every hour for three hours. If two of the blood sugar readings are higher than expected, that means you have gestational diabetes.

Lifestyle changes

Your lifestyle is an important part of keeping your blood sugar in a healthy range. Because your body is working hard to support your growing baby, it's not a good idea to lose weight during pregnancy. But your healthcare professional can help you set weight gain goals based on your weight before pregnancy.

Healthy lifestyle choices include:

• Healthy diet. A healthy diet focuses on foods that are high in nutrition and fiber and low in fat and calories. It includes fruits, vegetables, whole grains and lean protein. A healthy diet limits refined carbohydrates. These include white bread, white rice and sweets.

  A registered dietitian or a certified diabetes care and education specialist can help you with meal planning. Those plans usually are based on a pregnant person's weight, pregnancy weight gain goals and blood sugar level. The amount of exercise you get, foods you like to eat and your budget also should be part of the planning.

• Staying active. Regular physical activity plays a key role in every wellness plan before, during and after pregnancy. Exercise lowers your blood sugar. And regular exercise can help ease some common discomforts of pregnancy. These might include back pain, muscle cramps, swelling, constipation and sleep problems.

  With your healthcare professional's OK, try to do 30 minutes of moderate exercise most days of the week. If you haven't been active before, start slowly and build up little by little. Walking, cycling and swimming are good choices during pregnancy. Everyday activities such as housework and gardening also count.

Medicines

If diet and exercise aren't enough to keep your blood sugar in a healthy range, you may need insulin shots to lower your blood sugar. A small number of people with gestational diabetes need insulin to reach their blood sugar goals.

Some healthcare professionals prescribe medicine taken by mouth to manage blood sugar levels. Others believe that more research is needed to make sure those types of medicines are as safe and work as well as insulin shots for gestational diabetes.

Follow-up after delivery

Your healthcare professional checks your blood sugar after delivery and again in 6 to 12 weeks. This is to make sure that your blood sugar has returned to the standard range. If your blood sugar level is back in that range, you'll need to have your diabetes risk checked at least every three years.

If tests show that you have prediabetes, talk with your healthcare professional about steps you can take to help prevent it from turning into type 2 diabetes. If test results show you have type 2 diabetes, work with your healthcare team to make a plan to control it.

Preparing for your appointment

You'll likely find out you have gestational diabetes from routine screening test during your pregnancy. Your healthcare professional may refer you to other health professionals who specialize in diabetes. These might include an endocrinologist, a certified diabetes care and education specialist, and a registered dietitian.

You may want to ask a family member or friend to go to your appointment with you to help remember all the information you get.

Here's some information to help you get ready for your appointment.

What to expect from your doctor

Your healthcare professional might have questions for you, including:

• Have you been more thirsty than usual or urinated more than usual? If so, when did these symptoms start? How often do you have them?
• Do you have a parent or sibling who has diabetes?
• Have you been pregnant before? Did you have gestational diabetes during your earlier pregnancies?
• Did you have other problems in earlier pregnancies?
• If you have other children, how much did each weigh at birth?