How to Prevent Gestational Diabetes During Pregnancy

Your body undergoes many unique changes during pregnancy, most notably hormonal changes. Some women develop gestational diabetes, which occurs when your body cannot produce enough insulin during pregnancy. Treating gestational diabetes will help ensure you have a healthy pregnancy and baby.

What is gestational diabetes?

Gestational diabetes is a form of diabetes that occurs during pregnancy. Like other types of diabetes, gestational diabetes affects how the body processes glucose, or sugar, causing glucose levels to be higher than they should be. Pregnancy hormones can make it harder for insulin to move glucose from your blood to other cells in your body.

According to the Centers for Disease Control, between 2 and 10 percent of pregnancies are affected by gestational diabetes. And it affects pregnant women who have never been diagnosed with diabetes.

What causes gestational diabetes?

There is some new research into the various causes of gestational diabetes - a recent study looked at the cause in the pancreas, where insulin is made, versus the level of the body's cells and how they use that insulin. Currently, people with diabetes are treated similarly, but in the future we may have more information on how best to treat pregnant women based on where the cause of the disease originated.

How can diet and exercise help you prevent or treat gestational diabetes?

We know that gestational diabetes is caused by the body's inability to process glucose normally. Maintaining a healthy weight, eating a balanced, low-sugar diet, and regular exercise help the body keep blood sugar under control. Exercise is especially important because it helps the body become more sensitive to insulin (the hormone that allows cells to use blood sugar for energy).

Is gestational diabetes routinely tested during pregnancy?

Yes, most women are tested for gestational diabetes. Typically we test for this between 24 and 28 weeks gestation (at the end of the second trimester or the beginning of the third trimester). This usually involves drinking a sugary drink with a set amount of glucose in it, and then measuring your blood sugar level an hour later to see how your body is processing that sugar. In women with risk factors, they can be tested in early pregnancy during the 1st trimester.

Do you have to fast or not eat certain things before the test?

You do not have to be sober for the first test. Some people recommend that you avoid eating sugary foods before the test, as this could falsely increase the result. I generally recommend people eat a breakfast of eggs and whole grain toast with no honey or jam.

What happens if the screening test is positive? Does this mean I have gestational diabetes?

 A positive test doesn't mean you have gestational diabetes, but it does mean we need to do a longer, more comprehensive test to determine if you have the condition.

What are the warning signs of gestational diabetes?

Gestational diabetes usually has no symptoms, which is why it's so important to get tested during routine prenatal care. Your medical history and whether you have any risk factors may suggest to your doctor that you may have gestational diabetes, but you need to get tested to know for sure. Risk factors include:

• Overweight or obese
• Family history of type 2 diabetes
• They previously gave birth to a baby who weighed more than nine pounds
• Have had gestational diabetes in a previous pregnancy
• Women who are African American, Hispanic/Latino, Native American, Alaskan Native, Hawaiian Native, or Pacific Islander

How is gestational diabetes treated?

There is a lot you can do to get your gestational diabetes under control. Be sure to go to all your prenatal appointments and follow your treatment plan, which includes:

1. Check your blood sugar to make sure your levels are staying within a healthy range.
2. Eating healthy food in the right amounts at the right time. Follow a healthy eating plan established by your midwife, doctor or nutritionist.
3. Consistent, moderate exercise helps your body make better use of insulin, as long as you do it safely. Before you begin, talk to your medical team about what type of exercise will work best for you.
4. Monitoring your baby. Your midwife or doctor will monitor your baby's growth and development.

If a healthy diet and exercise aren't enough to control your blood sugar, your midwife or doctor may prescribe insulin or other medications to control your blood sugar.

What can happen to her health if a pregnant woman does not get her gestational diabetes under control?

• Increased risk of preeclampsia, a condition that causes high blood pressure. In the worst case, it can be life-threatening for both mother and child.
• Increased likelihood of needing a cesarean section
• Higher risk of developing regular diabetes

If you have gestational diabetes, are you more likely to develop normal diabetes later?

Women with gestational diabetes have about a 50 percent chance of developing type 2 diabetes later in life. That's one of the reasons it's important to check for diabetes with your midwife or doctor after your baby is born, and to get regular check-ups in the years after birth

The good news is that a healthy diet, regular exercise, and weight loss can help reduce your chances of developing diabetes later in life. Sometimes people can make lifestyle changes upon learning they have gestational diabetes during pregnancy, which can help them stay healthy later in life.

How does gestational diabetes affect the baby?

Babies born to women with gestational diabetes are at risk of being larger than normal, weighing more than 9 pounds, which can make delivery difficult or increase the likelihood that a cesarean section will be needed. They are also at increased risk of preterm birth and may experience low blood sugar after birth. These babies have a higher chance of developing type 2 diabetes themselves later in life.

Uncontrolled diabetes can even increase the chances of stillbirth, so it's really important to know about it so we can manage it and prevent these things from happening.

Are you thinking about getting pregnant? Healthy habits are important to you and your baby?

If you're considering getting pregnant, you can help start the pregnancy as healthily as possible by eating a healthy diet and exercising to reduce the risk of gestational diabetes. Women with a body mass index in the obese or overweight category can reduce their risk of diabetes by losing weight before pregnancy.

If you have diabetes or gestational diabetes, it's important to attend your prenatal visits so your doctor can help you learn how best to manage this condition and improve your outcome and that of your baby.