As many as 1 in 10 pregnancies will be affected by gestational diabetes. Factors like the age of the mother and rising obesity rates play a role in this increasingly common pregnancy complication.
HealthyWomen spoke to Maureen E. Farrell, M.D., FACOG, an OB-GYN and Navy veteran, about what a gestational diabetes diagnosis means for you and your pregnancy.
What is gestational diabetes?
Gestational diabetes is glucose intolerance that is diagnosed for the first time during pregnancy. It often resolves shortly after delivery.
What causes gestational diabetes?
Diabetes is caused when a person’s body can’t produce enough of the hormone insulin to manage blood sugar levels, and they get too high. Some women and people assigned female at birth (AFAB) develop diabetes during pregnancy because of hormonal changes. The placenta — the organ in the uterus that nourishes the growing fetus — creates hormones that are needed for a healthy pregnancy. Those same hormones can make it harder to produce enough insulin.
Usually, the body will still manage to control glucose and keep blood sugar at healthy levels throughout pregnancy. But for some people, insulin production can’t keep up.
That’s when gestational diabetes mellitus (GDM) develops.
What are the risk factors for developing gestational diabetes?
Many factors contribute to the development of gestational diabetes, including:
- Having pre-diabetes prior to your pregnancy — pre-diabetes is when your blood sugar levels are higher than normal but not high enough to be considered diabetes
- Previous pregnancies with gestational diabetes
- Having close relatives who have any form of diabetes
- Pregnancies of multiples
- Age — people above the age of 25 are at greater risk
- Previous delivery of a baby weighing more than 9 pounds
- Race — Hispanic, Black, Native American and Asian-American/Pacific Islanders are diagnosed at higher rates than non-Hispanic white people
- Pre-pregnancy weight — those living with overweight and obesity are more likely to develop GDM
- Trauma and PTSD
Can people who have normal blood sugar levels before pregnancy develop gestational diabetes?
Yes. Women who have normal blood sugar levels before pregnancy can develop gestational diabetes.
How is gestational diabetes diagnosed?
Gestational diabetes is diagnosed using a fasting glucose tolerance test. This is most commonly given during the second trimester, between 25 and 28 weeks gestation. People with a previous history of GDM or other risk factors may be screened earlier.
What are the risks of gestational diabetes to the mother?
Babies born to mothers with gestational diabetes tend to be larger than average, which increases the likelihood of delivery complications, including the need for a C-section, excessive bleeding after delivery and damage to the birth canal.
Gestational diabetes also increases the risk of pre-eclampsia. Mild forms of pre-eclampsia can be managed with careful blood pressure monitoring and regular checks on the baby. Serious cases can cause liver and kidney damage to the mother.
What are the risks of gestational diabetes to the baby?
Babies born to mothers with poorly controlled gestational diabetes are often large, which is called macrosomia. This can make delivery dangerous for the baby because they can get stuck in the birth canal. The extra sugar they receive also causes the baby to produce too much insulin in the womb. This can lead to dangerously low blood sugar after delivery. And it increases the child’s risk for developing Type 2 diabetes later in life, as well as obesity and metabolic disorder in childhood.
Pre-eclampsia in the mother, which often goes along with gestational diabetes, can only be treated by delivering the baby, so the risk of preterm birth increases with gestational diabetes, as well.
Severe untreated gestational diabetes can lead to miscarriage or stillbirth.
How do you manage gestational diabetes?
Many pregnant people can keep their blood sugar in check with healthy eating habits and regular exercise. If those methods don’t work, you may need to take insulin. Checking your blood sugar throughout the day, including before and after eating, will let you know if your lifestyle and diet changes are working. Your OB-GYN and possibly a nutritionist will work with you to keep your blood sugar at levels that are safe for you and your baby.
How does gestational diabetes affect long-term health outcomes?
For most women, once the pregnancy hormones are out of the picture, your body will go back to regulating its own blood sugar normally — but not always. Anyone who has had gestational diabetes should be screened six weeks after delivering the baby to ensure their blood sugar levels have returned to normal. Mothers who are diagnosed with gestational diabetes are also at increased risk for other cardiovascular complications after pregnancy, including high blood pressure and heart disease.
One out of every 2 women who develop gestational diabetes will go on to develop Type 2 diabetes. But healthy eating and regular exercise can help lower your chances.
This educational resource was created with support from AstraZeneca.
