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Gestational Diabetes

What is gestational diabetes?

Gestational Diabetes "GD" is diabetes that is found for the first time when a woman is pregnant.

Gestational (jes-TAY-shun-ul) diabetes is diabetes that is found for the first time when a woman is pregnant. Out of every 100 pregnant women in the United States, three to eight get GD. Diabetes means that your blood glucose (also called blood sugar) is too high. Your body uses glucose for energy. But too much glucose in your blood can be harmful. When you are pregnant, too much glucose is not good for your baby.

What is my risk of gestational diabetes?

To learn your risk for GD, check each item that applies to you. Talk with your doctor about your risk at your first prenatal visit.

I have a parent, brother, or sister with diabetes.

I am African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.

I am 25 years old or older.

I am overweight.

I have had GD before, or I have given birth to at least one baby weighing more than 9 pounds.

I have been told that I have "pre-diabetes," a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. Other names for it are "impaired glucose tolerance" and "impaired fasting glucose."

If you checked any of these risk factors, ask your health care team about testing for gestational diabetes.

You are at high risk if you are very overweight, have had gestational diabetes before, have a strong family history of diabetes, or have glucose in your urine.

You are at average risk if you checked one or more of the risk factors.

You are at low risk if you did not check any of the risk factors.

How is gestational diabetes diagnosed?

Your health care team will check your blood glucose level. Depending on your risk and your test results, you may have one or more of the following tests.

Fasting blood glucose or random blood glucose test.

Your doctor may check your blood glucose level using a test called a fasting blood glucose test. Before this test, your doctor will ask you to fast, which means having nothing to eat or drink except water for at least 8 hours. Or your doctor may check your blood glucose at any time during the day. This is called a random blood glucose test.

These tests can find gestational diabetes in some women, but other tests are needed to be sure diabetes is not missed.

Your health care provider will check your blood glucose level to see if you have gestational diabetes.

Screening glucose challenge test.

For this test, you will drink a sugary beverage and have your blood glucose level checked an hour later. This test can be done at any time of the day. If the results are above normal, you may need further tests.

Oral glucose tolerance test.

If you have this test, your health care provider will give you special instructions to follow. For at least 3 days before the test, you should eat normally. Then you will fast for at least 8 hours before the test.

The health care team will check your blood glucose level before the test. Then you will drink a sugary beverage. The staff will check your blood glucose levels 1 hour, 2 hours, and 3 hours later. If your levels are above normal at least twice during the test, you have GD.

Above-normal results for the oral glucose tolerance test*

Fasting	95 or higher
At 1 hour	180 or higher
At 2 hours	155 or higher
At 3 hours	140 or higher

Note: Some labs use other numbers for this test.

*These numbers are for a test using a drink with 100 grams of glucose.

How will gestational diabetes affect my baby?

Untreated or uncontrolled GD can mean problems for your baby, such as;

being born very large and with extra fat; this can make delivery difficult and more dangerous for your baby

low blood glucose right after birth

breathing problems

If you have GD, your health care team may recommend some extra tests to check on your baby, such as;

an ultrasound exam, to see how your baby is growing

"kick counts" to check your baby's activity (the time between the baby's movements) or special "stress" tests

Working closely with your health care team will help you give birth to a healthy baby.

Both you and your baby are at increased risk for type 2 diabetes for the rest of your lives.

How will gestational diabetes affect me?

Often, women with GD have no symptoms. However, gestational diabetes may;

increase your risk of high blood pressure during pregnancy

increase your risk of a large baby and the need for cesarean section at delivery

The good news is your gestational diabetes will probably go away after your baby is born. However, you will be more likely to get type 2 diabetes later in your life. You may also get gestational diabetes again if you get pregnant again.

Some women wonder whether breastfeeding is OK after they have had GD. Breastfeeding is recommended for most babies, including those whose mothers had gestational diabetes.

Gestational diabetes is serious, even if you have no symptoms. Taking care of yourself helps keep your baby healthy.

How is gestational diabetes treated?

Treating GD means taking steps to keep your blood glucose levels in a target range. You will learn how to control your blood glucose using

Using a meal plan will help keep your blood glucose in your target range.

a meal plan

physical activity

insulin (if needed)

Meal Plan

You will talk with a dietitian or a diabetes educator who will design a meal plan to help you choose foods that are healthy for you and your baby. Using a meal plan will help keep your blood glucose in your target range. The plan will provide guidelines on which foods to eat, how much to eat, and when to eat. Choices, amounts, and timing are all important in keeping your blood glucose levels in your target range.

You may be advised to;

limit sweets

eat three small meals and one to three snacks every day

be careful about when and how much carbohydrate-rich food you eat; your meal plan will tell you when to eat carbohydrates and how much to eat at each meal and snack

include fiber in your meals in the form of fruits, vegetables, and whole-grain crackers, cereals, and bread

For more about meal planning, call the National Diabetes Information Clearinghouse for a copy of "What I need to know about Eating and Diabetes".

Physical activity can help you reach your blood glucose targets.

Physical Activity

Physical activity, such as walking and swimming, can help you reach your blood glucose targets. Talk with your health care team about the type of activity that is best for you. If you are already active, tell your health care team what you do.

Insulin

Some women with GD need insulin, in addition to a meal plan and physical activity, to reach their blood glucose targets. If necessary, your health care team will show you how to give yourself insulin. Insulin is not harmful for your baby. It cannot move from your bloodstream to the baby's.

How will I know whether my blood glucose levels are on target?

Your health care team may ask you to use a small device called a blood glucose meter to check your levels on your own. You will learn;

Each time you check your blood glucose, write down the results.

how to use the meter

how to prick your finger to obtain a drop of blood

what your target range is

when to check your blood glucose

You may be asked to check your blood glucose

when you wake up just before meals

1 or 2 hours after breakfast

1 or 2 hours after lunch

1 or 2 hours after dinner

The following chart shows blood glucose targets for most women with gestational diabetes. Talk with your health care team about whether these targets are right for you.

Blood glucose targets for most women with GD

On Waking	not above 95
1 hour after a meal	not above 140
2 hours after a meal	not above 120

Each time you check your blood glucose, write down the results in a record book. Take the book with you when you visit your health care team. If your results are often out of range, your health care team will suggest ways you can reach your targets.

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