Gestational Diabetes

Diabetes mellitus is a condition in which too much sugar stays in the blood instead of being used for energy.  Health problems can occur when blood sugar is too high. Some women develop diabetes for the first time during pregnancy. This condition is called gestational diabetes and requires special care during and after pregnancy.

The body produces a hormone called insulin that keeps blood sugar levels in the normal range. During pregnancy, higher levels of pregnancy hormones can interfere with insulin. Usually, the body can make more insulin to keep the sugar levels normal. But in some women, the body can't make enough insulin and their blood sugar levels go up, causing complications for mother and baby.

Typically, gestational diabetes will go away after childbirth, but leave you at risk for diabetes later in life. Although gestational diabetes can occur in women without risk factors, it's more likely to occur in women who are/have a history of:

• Overweight or obese
• Physically inactive
• African American, Asian American, Hispanic, Native American or Pacific Island background
• Gestational diabetes in a previous pregnancy
• Previous high birth weight (greater than 9 pounds) baby
• High blood pressure
• Heart disease
• Polycystic ovarian syndrome (PCOS)

When a woman has gestational diabetes, her body passes more sugar to her baby than it needs. With too much sugar her baby can gain too much weight.  These large babies can lead to complications for the mother and baby, including:

• Labor difficulties
• Cesarean deliveries
• Heavy bleeding after delivery
• Severe tears of the birth canal
• High blood pressure and preeclampsia
• Babies with jaundice, breathing problems, and trauma in the birthing process are at increased risk of stillbirth

ALL pregnant women should be screened for gestational diabetes.

Mothers with gestational diabetes will need to modify their diets and more frequent prenatal visits. Blood sugar will need to be monitored carefully and daily. Fetal growth and well-being will be monitored. Medication or insulin may be needed.  Also, the severity of the condition must be taken into consideration for the timing and method of delivery. Most women with gestational diabetes can complete a full-term pregnancy, though a cesarean section is more likely.

Blood sugar should be checked in the months following delivery.  If the blood sugar is normal, mothers will need to be tested for diabetes at one to three years.