Diabetes occurs when the body cannot produce enough insulin, a hormone that helps keep blood sugar (glucose) at healthy levels. High blood sugar can lead to a range of health problems.
While type 2 diabetes has been a growing health concern among the general population, another type of diabetes diagnosed only in pregnant women is also of growing concern. It’s called gestational diabetes, and it develops in 6 to 9% of pregnancies.
Gestational diabetes is caused by pregnancy itself. During pregnancy, an organ called the placenta develops in the uterus to provide nutrients and oxygen to the developing fetus. Gestational diabetes occurs when the placenta releases hormones that prevent the mother from producing enough insulin to lower her blood sugar, which in turn can affect the baby’s health.
Studies show that having high blood sugar during pregnancy accelerates the child’s growth. The mother’s extra blood glucose passes through the placenta, giving the baby high blood glucose levels and causing the baby’s pancreas to make extra insulin. The extra blood glucose is stored as fat, so the baby gains much more weight than normal. This can lead to problems during birth or even premature birth.
Additionally, because of the extra insulin made by the baby’s pancreas, the newborn may have very low blood glucose levels at birth and have a higher risk for breathing problems. Babies born with excess insulin are more likely to be obese as children and develop type 2 diabetes as adults.
“Many factors contribute to the rise of gestational diabetes. Certainly, obesity in the population is a significant factor and eating foods that are high in carbohydrates or high in sugar increase risk,” says Dr. Starikov. “Also, age is a risk factor, and a lot of pregnancies are now in women who are older.”
A woman’s risk of developing gestational diabetes also is higher if she has a strong family history of the condition, or if she is overweight or had a higher risk of diabetes before becoming pregnant.
Unlike type 2 diabetes, gestational diabetes usually has no symptoms, so your OB/GYN will order a gestational diabetes screening test as part of your prenatal care.
If you’re at average risk of gestational diabetes, you will most likely be screened between 24 and 28 weeks of pregnancy. If your risk is higher, your doctor will test for gestational diabetes earlier in your pregnancy.
During the initial screening test, you’ll drink a sugary solution and your doctor will measure your blood glucose levels one hour later. If this test is abnormal, the doctor usually orders a three-hour sugar test, where your blood sugar is tested several times over a period of three hours after you drink the solution.
If you have gestational diabetes, your doctor will recommend several guidelines to help manage your blood sugar.
“For the majority of women, the management of gestational diabetes involves simple dietary modifications, such as decreasing the amount of sugar intake,” says Dr. Starikov. “If that isn’t enough, you may need medication to help control blood sugar, or some women may need insulin injections.”
Scripps has a care management program especially for women who develop gestational diabetes that includes nurses who are certified diabetes educators, nutritionists, endocrinologists and maternal fetal medicine physicians who specialize in high-risk pregnancy care.
“We review each patient and decide what’s the most appropriate course of management for each individual, with the goal of a healthy baby,” says Dr. Starikov. “In addition, we monitor these women more closely to help ensure their babies are doing well. Most women have excellent outcomes.”
For most women, gestational diabetes ends with delivery or shortly thereafter. Some women, especially those with risk factors, may develop type 2 diabetes following pregnancy and require ongoing management.