Helping prevent gestational diabetes

Gestational diabetes or diabetes of pregnancy affects five to18 percent of pregnancies. This condition develops when pregnant women cannot produce enough insulin to keep blood levels of glucose in check. It is important to recognize and treat gestational diabetes in order to minimize the risk of complications to both mom and baby. Complications include having a large baby (9lbs or more), stillbirth, neonatal hypoglycemia (low blood sugar in the newborn) and preeclampsia. Women are usually screened for the disease between 24 and 28 weeks of gestation. Those who have certain risk factors should be screened sooner. Risks factors include a history of gestational diabetes, obesity, and a strong family history of diabetes.  Drinking a sweet drink then having blood drawn one hour later is how the test is performed. 

Once diagnosed, pregnant women must see a dietician to develop a healthier eating plan and are monitored very closely in order to prevent complications. The number of prenatal visits increases.  Women are usually required to check their blood sugars four times a day (before breakfast, and one hour after each meal). The baby is monitored closely as well via frequent ultrasounds. Usually, women are able to control blood sugar levels with simple modifications in their diets. In cases where blood sugars cannot be controlled with diet and exercise, then insulin or other medications may be required. The route and timing of delivery depends on whether or not the woman is on medication for blood sugar control and also how large the baby is. Many women are able to have vaginal deliveries. However, the risk of trauma to both mother and baby during delivery is increased with uncontrolled gestational diabetes if the baby is too large. When the fetus is estimated to be a certain weight (over 4500 grams), then cesarean delivery is recommended. 

Although gestational diabetes usually resolves after delivery, one-third to two-thirds of women are still at risk for developing it in subsequent pregnancies. Obese women have a 50-75 percent risk of Type II Diabetes, while women of normal weight have a less than 25 percent risk. Therefore, women with gestational diabetes should be retested 6 to 12 weeks after delivery. Gestational diabetes is not uncommon. Although many women do well, the diagnosis is not without risks to both mother and baby. For this reason, it is important to decrease your risk of developing it through proper diet, exercise, and maintaining a healthy weight. 

Eboni C. January, MD

Obstetrics and Gynecology-BJK People’s Health Centers