Gestational Diabetes: What You Need to Know During Pregnancy

Gestational diabetes is a type of diabetes that happens during pregnancy. It affects how your body uses carbohydrates and can cause problems for you and your baby. Fortunately, with the right care, most women have healthy pregnancies.

What Causes Gestational Diabetes?

During pregnancy, hormones change and can make it harder for your body to use insulin. When this happens, blood sugar levels get too high. This doesn’t mean you had diabetes before pregnancy or that you will have it after, but it does increase the risk of developing diabetes later.

Who Is at Risk?

You might have a higher chance of getting gestational diabetes while you’re pregnant if you:

• Are over 25 years old
• Have an immediate family member with diabetes
• Spend most of your day doing sedentary activities
• Are of African American, Latino, Native American, Asian American or Pacific Islander descent
• Had gestational diabetes during a previous pregnancy or previously gave birth to a baby 9 pounds or larger
• Had an overweight or obese Body Mass Index (BMI) before pregnancy
• Have polycystic ovary syndrome (PCOS)

Screening for Gestational Diabetes

Most women don’t notice symptoms of gestational diabetes, making testing an important part of prenatal care.

As a routine part of prenatal visits, doctors test for gestational diabetes between 24 and 28 weeks of pregnancy with a glucose challenge test or an oral glucose tolerance test (OGTT). A glucose challenge test may or may not be done first, but a reading of 140 mg/dl usually requires a follow-up with an OGTT. During an OGTT, you will drink a sugary solution and have a blood sample collected and analyzed for up to three hours.

The Importance of Managing Gestational Diabetes

Having uncontrolled high blood sugar can cause problems at any time of life, including increasing the risk of heart disease, kidney disease and stroke. If blood sugar is not controlled during pregnancy, it can:

• Make your baby grow too big, leading to a difficult birth and increase the risk for cesarean birth
• Increase the risk of preterm labor and still birth
• Cause low blood sugar (hypoglycemia) in your baby after birth
• Increase your risk of high blood pressure during pregnancy (preeclampsia)
• Raise the chance of both you and your baby getting Type 2 diabetes later in life

Managing Gestational Diabetes: Nutrition is Key

The best way to manage blood sugar is through a healthful eating pattern and staying active. Eating a balanced diet that includes protein, healthy fats and carbohydrates, as well as dietary fiber, makes a difference. Physical activity, such as walking or prenatal yoga, also may help keep blood sugar in check.

Consider meeting with a registered dietitian nutritionist (RDN) to help you:

• Learn which foods help keep your blood sugar stable
• Plan meals that give you and your baby the nutrition you need
• Avoid foods that cause big blood sugar spikes
• Manage cravings in a healthful way
• Prevent too much weight gain during pregnancy

Sometimes diet and physical activity aren’t enough to manage blood sugar. Some women may need insulin or medicine, but food and physical activity are the first steps. Women with gestational diabetes should monitor their blood sugar with a blood glucose monitor or continuous glucose monitor. It’s important to work closely with your health care provider during this time.

After Baby Arrives: What’s Next?

For most women, gestational diabetes goes away after delivery. However, having gestational diabetes means you have a higher risk of developing Type 2 diabetes later in life. Healthful eating, staying active and getting regular check-ups can help reduce your risk. Women who had gestational diabetes should be screened for Type 2 diabetes after delivery and then every one to three years after that.

Gestational diabetes can be managed with the right steps. Working with your doctor and an RDN can help you have a healthy pregnancy. Remember: Small changes now can protect your health and your baby’s future.