Gestational diabetes is one of the diseases pregnant women are tested for during their pregnancy. Treating it is important for the health of the mother and her baby. Maternal-fetal medicine specialist Donald R. Coustan, MD, answers some questions about gestational diabetes.
What is gestational diabetes and how common is it?
Gestational diabetes is a condition in which the changes of pregnancy bring about an increase in the mother's insulin resistance, but the mother is unable to produce an adequate increase in insulin production to overcome that resistance. Consequently, the mother develops high blood sugar levels, commonly called gestational diabetes.
If am not a diabetic normally, how can I become diabetic when pregnant?
The changes of pregnancy sometimes increase a woman’s insulin resistance. In most cases, the condition disappears after the baby is born, but sometimes it persists. In such cases, the mother probably had diabetes prior to pregnancy but it had not been diagnosed.
Are there any symptoms to gestational diabetes? How can I be sure I have it?
There are usually no symptoms. The diagnosis is made by a glucose tolerance test, in which the mom drinks a container of sugar water after she fasts overnight. Her blood sugar is measured prior to the drink, and each hour after the drink for a total of three hours. If two or more of the four values are elevated, we diagnose gestational diabetes.
Will this cause birth defects in my baby?
While mothers with pre-existing diabetes are at increased risks for congenital malformations in their offspring, gestational diabetes is probably not associated with an increased risk for birth defects since it typically does not appear until after the baby has fully formed. However, moms who had pre-existing diabetes, undiagnosed prior to pregnancy, would be at increased risk for birth defects in their babies.
Does gestational diabetes need to be treated? What happens if it is not treated?
We do need to treat gestational diabetes. If the mother is hyperglycemic and the high blood sugar levels are not treated over time, there is an increased risk of stillbirth, macrosomia (a large baby), respiratory problems in the newborn and other problems.
How is it treated?
We usually start by dietary counseling, called "medical nutrition therapy." The mother checks her own blood sugars throughout the day. If the diet is not sufficient to normalize her blood sugar levels, we then recommend insulin or, in some cases, oral antidiabetic agents.
What changes should I make in my diet? Does exercise help?
You should consult with a dietitian who can help you make the necessary changes in your diet. Exercise may also be helpful. Consult with your obstetrician before starting an exercise program.
Will the gestational diabetes go away once I deliver?
Will I get gestational diabetes the next time I get pregnant?
There is a roughly 50-percent chance of recurrence risk in future pregnancies.
Will I develop type 2 diabetes later in life as a result?
There is a 50-percent chance that women who are gestational diabetic will develop type 2 diabetes within 20 years of their pregnancy.
If you are concerned about gestational diabetes, please call the Diabetes in Pregnancy Program at 401-274-1122, extension 2930.
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