Pregnancy and gestational diabetes

Some women will experience diabetes for the first time during their pregnancy. This is known as gestational diabetes. Like Type 1 and Type 2 diabetes, the condition can lead to high blood sugar, which can affect your baby and pregnancy.

Almost one in 10 women are diagnosed with gestational diabetes. If you are one of them, your provider will work with you to monitor your condition. You will also check your blood sugar levels at home with a finger prick. Your OB office, and in many cases dietitians, will also meet with you to recommend a healthy eating plan to reduce high blood sugar.

Gestational diabetes usually develops in the second or third trimester and is detected through lab blood tests. For many women, diabetes will disappear after pregnancy, but they will be at a higher risk for it in future pregnancies. Women diagnosed with gestational diabetes are also more at risk to develop Type 2 diabetes later in life.

Key facts about gestational diabetes:

1. What causes gestational diabetes?

Researchers think gestational diabetes is caused by hormonal changes during pregnancy, along with genetic and lifestyle factors.

Pregnant women develop gestational diabetes when their body can’t make enough insulin or use it effectively during pregnancy. Insulin is a hormone that tells your blood sugar to move into cells so they can use it for energy. If insulin is imbalanced, too much blood sugar can circulate in the blood and not be absorbed by cells. This causes blood sugar levels to rise.

2. Why is it concerning for blood sugar levels to rise during pregnancy?

Untreated gestational diabetes can lead to complications such as macrosomia (a baby weighing more than 8 pounds, 13 ounces), which makes delivery more complicated for mom and baby. Gestational diabetes also increases the risk for preterm delivery and preeclampsia (high blood pressure during pregnancy). Women with gestational diabetes are more susceptible to developing Type 2 diabetes later in life. Additionally, babies diagnosed with fetal macrosomia are more likely to be born with lower blood sugar levels, and are at increased risk for metabolic syndrome and childhood obesity.

3. What is insulin resistance and how does it relate to gestational diabetes?

During pregnancy, your body may not use insulin the way it did before you were pregnant. For some people, cells stop responding well to insulin, a condition known as insulin resistance. That breakdown eventually triggers more and more insulin to be released but not enough to keep up with the influx of blood sugar.

All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant. They start pregnancy with an increased need for insulin and are more likely to develop gestational diabetes.

4. What are the symptoms of gestational diabetes?

Most women with gestational diabetes do not experience any symptoms. However, some women may experience increased thirst, frequent urination and fatigue.

5. How is gestational diabetes diagnosed?

Gestational diabetes is usually diagnosed between 24 and 28 weeks of pregnancy. Your provider will order a glucose challenge test to check your blood sugar levels. During this test, you will drink a liquid that contains glucose. After one hour, you’ll have a blood draw to check your blood glucose level.

If the test results are abnormal, a glucose tolerance test will be performed to confirm the diagnosis. You will fast before this three-hour test, drink the glucose solution and have your blood checked three times, an hour apart.

6. How is gestational diabetes treated?

Your provider will help you manage gestational diabetes through healthy eating, physical activity and regular blood sugar monitoring. In some cases, medication may be prescribed to help control blood sugar levels.

7. Can gestational diabetes be prevented?

While there is no guaranteed way to prevent gestational diabetes, you can take some steps to reduce your risk. These include maintaining a healthy weight, eating a balanced diet and staying physically active.

If you have been diagnosed with gestational diabetes, it is important to work closely with your healthcare provider to manage your blood sugar levels and ensure a healthy pregnancy.

8. Are some people more likely than others to get gestational diabetes?

Anyone who is pregnant could develop gestational diabetes. But these factors increase your risk:

• Weight - Being overweight or obese
• Genetics - Having a family history of diabetes. Some ethnicities are also more likely than others to have gestational diabetes.
• Pregnancy history - Experiencing gestational diabetes in a previous pregnancy or already having a baby weighing 9 pounds of more.

Gestational Diabetes in Pregnancy Class

This is a class for expectant mothers who have been diagnosed with gestational diabetes. Your provider will need to refer you to the class. For questions, or to request a referral if you have not already received one, please reach out to your provider. Currently, the class is available at:

• Sentara Williamsburg Regional Medical Center
• Sentara RMH Medical Center
• Sentara Northern Virginia Medical Center

A diabetes care and education specialist will complete an individual assessment with each participant. A group or individual class is also conducted to teach the women and their families:

• Effective meal planning
• Blood glucose monitoring
• How to control blood glucose during their pregnancies

For those who had a diabetes diagnosis prior to becoming pregnant, reach out to your provider to discuss the best course of action for you.