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Gestational diabetes

Gestational diabetes is diabetes diagnosed for the first time during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health.

While any pregnancy complication is concerning, there's good news. During pregnancy you can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery.

If you have gestational diabetes during pregnancy, generally your blood sugar returns to its usual level soon after delivery. But if you've had gestational diabetes, you have a higher risk of getting type 2 diabetes. You'll need to be tested for changes in blood sugar more often.

Symptoms

Most of the time, gestational diabetes doesn't cause noticeable signs or symptoms. Increased thirst and more-frequent urination are possible symptoms.

Diagnosis

If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy.

If you're at high risk of diabetes — for example, if you're overweight or obese before pregnancy; you have a mother, father, sibling or child with diabetes; or you had gestational diabetes during a previous pregnancy — your health care provider may test for diabetes early in pregnancy, likely at your first prenatal visit.

Routine screening for gestational diabetes

Screening tests may vary slightly depending on your health care provider, but generally include:

  • Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll 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 litre (mmol/L), indicates gestational diabetes.

    A blood sugar level below 140 mg/dL (7.8 mmol/L) is usually considered within the standard range on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than expected, you'll need another glucose tolerance test to determine if you have gestational diabetes.

  • Follow-up glucose tolerance testing. This test is similar to the initial test — except the sweet solution will have even more sugar and your blood sugar will be checked every hour for three hours. If at least two of the blood sugar readings are higher than expected, you'll be diagnosed with gestational diabetes.

Treatment

Treatment for gestational diabetes includes:

  • Lifestyle changes

  • Blood sugar monitoring

  • Medication, if necessary

Managing your blood sugar levels helps keep you and your baby healthy. Close management can also help you avoid complications during pregnancy and delivery.

Lifestyle changes

Your lifestyle — how you eat and move — is an important part of keeping your blood sugar levels in a healthy range. Health care providers usually don't advise losing weight during pregnancy — your body is working hard to support your growing baby. Lifestyle changes include:

  • Healthy diet. A healthy diet focuses on fruits, vegetables, whole grains and lean protein — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. A registered dietitian or a certified diabetes care and education specialist can help you create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.

  • Staying active. Regular physical activity plays a key role in every wellness plan before, during and after pregnancy. Exercise lowers your blood sugar. As an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping.

Blood sugar monitoring

While you're pregnant, your health care team may ask you to check your blood sugar four or more times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range.

Medication

If diet and exercise aren't enough to manage your blood sugar levels, you may need insulin injections to lower your blood sugar. A small number of women with gestational diabetes need insulin to reach their blood sugar goals.

Some health care providers prescribe oral medication to manage blood sugar levels. 

Close monitoring of your baby

An important part of your treatment plan is close observation of your baby. Your health care provider may check your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date — or sometimes earlier — your health care provider may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.

Follow-up after delivery

Your health care provider will check your blood sugar level after delivery and again in 6 to 12 weeks to make sure that your level has returned to within the standard range. If your tests are back in this range — and most are — you'll need to have your diabetes risk assessed at least every three years.

If future tests indicate type 2 diabetes or prediabetes, talk with your health care provider about increasing your prevention efforts or starting a diabetes management plan.

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Be more physically active. There are many benefits to regular physical activity.
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