What You Need To Know During Pregnancy About Gestational Diabetes, Including Signs, Symptoms And Treatment Of Gestational Diabetes

Most pregnant women will be tested for gestational diabetes during pregnancy. Find out the top 5 common questions about gestational diabetes, including risk factors, signs, symptoms, treatment and how this will affect childbirth.
Ami Burns

Saul Weinreb, MD, a board-certified OB/GYN and Senior Medical Advisor of AskMyOBGYN.com answers five of our top questions on gestational diabetes.

What is gestational diabetes?
Diabetes is an inability to properly metabolize sugar that causes high levels of glucose in the blood. According to the American College of Obstetricians and Gynecologists, pregestational diabetes – meaning a woman was diabetic before pregnancy -- affects approximately 1 in 10 women. Gestational Diabetes (GD) refers to diabetes that starts during pregnancy, and is thought to affect about 2-10% of all pregnancies.

What are risk factors for gestational diabetes?
It’s important to understand that any pregnant woman can develop gestational diabetes, but the following factors may increase your risk:
• Being overweight or obesity
• Moms who are older than 25 years
• Non-Caucasian ethnicity (Native American, Asian, Hispanic, African American or Pacific Islander)
• Family history of diabetes
• History of GD in a previous pregnancy
• History of stillborn or very large infant
• Moms with polycystic ovary system

“Proper nutrition, weight loss and exercise really do make a difference,” says Dr. Weinreb. “Although there certainly are people who develop GD despite having a normal weight and lifestyle, there is no question that the risk is much higher in women who are physically inactive and overweight, so being healthy really might make the difference for you.”

How do I know if I have gestational diabetes?
The standard test for gestational diabetes is called a glucose challenge test, and is usually done between 24 and 28 weeks of pregnancy. “This consists of taking a drink of a liquid with 50 grams of glucose, and then checking your blood glucose level one hour later,” explains Dr. Weinreb. “If the glucose levels are normal, you don’t have diabetes, and you just continue regular prenatal care. If it’s elevated, that’s considered a positive screen.

A positive screen does not mean that you have diabetes, just that you require further testing to determine if you have gestational diabetes.  The testing then is a little more extensive.  First thing in the morning, while still fasting, you take a 100 gram drink of the sweet fluid (twice as many calories as the one hour test).  Your blood is drawn four times.  Once before you drink the glucose, and then once each hour for three hours.  This test is diagnostic. That means that if two values are over the normal level, you have diabetes, and you will be treated for it.  If the test is negative, then you don't have diabetes.

If I test positive for GD, what are my treatment options?
“Many women do not require medical treatment,”says Dr. Weinreb, “but if it can’t be controlled with diet and exercise, you will require medication. This can be oral medication or insulin shots.” Bottom line, discuss the options with your doctor or midwife.

Will gestational diabetes affect labor or birth?
Your midwife or doctor may do additional testing to check baby’s well-being as you get closer to your due date. Sometimes GD causes a baby to be very large, which may necessitate an assisted vaginal delivery with forceps or vacuum or even a c/section. Your doctor or midwife may talk to you about inducing labor. Learn more about labor induction and birthing large babies.

You can find out more information about gestational diabetes and how it may affect your pregnancy, labor and birth by talking to your doctor or midwife. “The best thing you can do is to follow your doctor’s advice and keep your gestational diabetes under good control.”

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