Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose) — your body’s main fuel. Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health.
Any pregnancy complication is concerning, but there’s good news. Expectant moms can help control gestational diabetes by eating healthy foods, exercising and, if necessary, using medication. Taking good care of yourself can ensure a healthy pregnancy for you and a healthy start for your baby.
In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you’ve had gestational diabetes, you’re at risk for future type 2 diabetes. You’ll continue working with your health care team to monitor and manage your blood sugar.
For most women, gestational diabetes doesn’t cause noticeable signs or symptoms. Rarely, gestational diabetes may cause excessive thirst or increased urination.
When to see a doctor
If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you become pregnant, your doctor will address gestational diabetes as part of your regular prenatal care. If you develop gestational diabetes, you may need more frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will carefully monitor your blood sugar level and your baby’s health.
Your doctor may refer you to additional health professionals who specialize in diabetes management, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy.
To make sure that your blood sugar level has returned to normal after your baby is born, your health care team will check your blood sugar right after delivery and again in six weeks. Once you’ve had gestational diabetes, it’s a good idea to have your blood sugar level tested regularly. The frequency of blood sugar tests will in part depend on your test results soon after you deliver your baby.
Researchers don’t yet know exactly why some women develop gestational diabetes. To understand how gestational diabetes occurs, it can help to understand how pregnancy affects your body’s normal processing of glucose.
Your body digests the food you eat to produce sugar (glucose) that enters your bloodstream. In response, your pancreas — a large gland behind your stomach — produces insulin. Insulin is a hormone that helps glucose move from your bloodstream into your body’s cells, where it’s used as energy.
During pregnancy, the placenta that connects your growing baby to your blood supply produces high levels of various other hormones. Almost all of them impair the action of insulin in your cells, raising your blood sugar. Modest elevation of blood sugar after meals is normal during pregnancy.
As your baby grows, the placenta produces more and more insulin-blocking hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and welfare of your baby. Gestational diabetes usually develops during the last half of pregnancy — sometimes as early as the 20th week, but usually not until later.
Treatments and drugs
It’s essential to monitor and control your blood sugar to keep your baby healthy and avoid complications during your pregnancy and delivery. You’ll also want to keep a close eye on your future blood sugar levels.
Your treatment strategies may include:
• Monitoring your blood sugar. While you’re pregnant, your health care team may ask you to check your blood sugar four to five times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range. This may sound inconvenient and difficult, but it’ll get easier with practice. To test your blood sugar, you draw a drop of blood from your finger using a small needle (lancet), then place the blood on a test strip inserted into a blood glucose meter — a device that measures and displays your blood sugar level.
Your health care team will also monitor and manage your blood sugar during labor and delivery. If your blood sugar rises, your baby’s body may release high levels of insulin — which can cause low blood sugar in your baby right after birth.
Follow-up blood sugar checks are also important. After having gestational diabetes, you’re at increased risk of later developing type 2 diabetes. Work with your health care team to keep an eye on your levels. Maintaining health-promoting lifestyle habits, such as a healthy diet and regular exercise, can help reduce your risk.
• Healthy diet. Eating the right kinds and quantity of food is one of the best ways to control your blood sugar. Doctors don’t advise losing weight during pregnancy — your body is working hard to support your growing baby. But your doctor can help you set weight gain goals based on your weight before pregnancy. Making healthy food choices can help prevent excessive weight gain, which can put you at higher risk of complications.
A healthy diet often focuses on fruits, vegetables and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets. No single diet is right for every woman. You may want to consult a registered dietitian or a diabetes educator to create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.
• Exercise. Regular physical activity plays a key role in every woman’s wellness plan before, during and after pregnancy. Exercise lowers your blood sugar by stimulating your body to move glucose into your cells, where it’s used for energy. Exercise also increases your cells’ sensitivity to insulin, which means your body produces less insulin to transport 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. Exercise can also help get you in shape for the hard work of labor and delivery.
With your doctor’s OK, aim for moderately vigorous exercise on most days of the week. If you haven’t been active for a while, start slowly and build up gradually. Walking, cycling and swimming are often good choices during pregnancy. Everyday activities such as housework and gardening also count.
• Medication. If diet and exercise aren’t enough, you may need insulin injections to lower your blood sugar. Between 10 and 20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors may prescribe an oral blood sugar control medication, such as glyburide. Other doctors feel more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.
• Close monitoring of your baby. An important part of your treatment plan is close observation of your baby. Your doctor may monitor 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 doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.
• Breast-feeding your baby. If you’re interested in breast-feeding and it fits with your work schedule and other obligations, it may help you achieve your post-pregnancy weight goals and avoid later type 2 diabetes. Breast-feeding may also help your baby avoid later obesity and type 2 diabetes.
There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. If you’ve had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes down the road.
• Eat healthy foods. Choose foods high in fiber and low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.
• Keep active. Exercising before and during pregnancy can help protect you against developing gestational diabetes. Aim for 30 minutes of moderate activity on most days of your week. Take a brisk daily walk.
Ride your bike. Swim laps. If you can’t fit a single 30-minute workout into your busy day, several shorter sessions can do just as much good. Park in the distant lot when you run errands. Get off the bus one stop before you reach your destination. Every step you take increases your chances of staying healthy.
• Lose excess pounds before pregnancy. Doctors don’t recommend weight loss during pregnancy — your body is already working overtime to support your baby’s development. But if you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy. Focus on permanent changes to your eating habits. Motivate yourself by remembering the long-term benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.