Gestational Diabetes

Diabetes occurs when the cells in your body can no longer properly process glucose. As a result, your blood sugar levels can become unregulated, quickly becoming too high or too low. As a result, uncontrolled diabetes can have significant health impacts. For most people, diabetes will develop either early in childhood or due later in adult life; most often, the development of adult-onset diabetes is anything but sudden.

That can change when you’re pregnant.

Gestational diabetes is diagnosed when you develop diabetes during your pregnancy. Your OBGYN or Midwife will want to monitor your gestational diabetes closely, as there can be possible complications for both you and your baby. However, with the right treatment, gestational diabetes can be successfully managed and will usually go away after the delivery of your baby.

What Causes Gestational Diabetes?

Most physicians believe that gestational diabetes is caused, at least in part, because the placenta produces certain hormones during pregnancy that encourage a buildup of glucose in your blood. Usually, the pancreas handles glucose spikes by producing extra insulin. But there are times when your pancreas just can’t keep up, and gestational diabetes is the result.

No one knows why certain people develop gestational diabetes and others don’t. But there are some risk factors which could make you more likely to develop diabetes should you become pregnant. Those risk factors include:

• Medical history: Your personal and family medical history will have a significant bearing on your diabetes risk. For example, if an immediate family member has diabetes, your risk for developing this gestational variant of the disease is increased.
• Previous delivery: If you previously gave birth to a child that was considered large for gestational age (LGA) or had macrosomia, you may be at an increased risk for developing diabetes during your next pregnancy.
• Medical conditions: Some medical conditions, such as polycystic ovary syndrome can also increase your odds of developing diabetes.
• Race: Cases of gestational diabetes have been reported in higher proportions among individuals who identify as Asian American, American Indian, Black and Latino. These communities seem to experience a higher risk profile for developing this condition.
• Body weight: Those who are overweight or obese may be at a higher risk for developing diabetes.
• Age: Women over the age of 35 may have a higher risk of developing diabetes.

The cause and effect relationships between all of these risk factors and the presentation of gestational diabetes is not totally understood. That’s why these are risk factors–and not causes. Just because you exhibit one or more of these risk factors does not mean you will develop diabetes. But when your OBGYN or Midwife know these risk factors are present, they can more closely monitor you during your pregnancy.

What Are the Symptoms of Gestational Diabetes?

In general, gestational diabetes does not have any significant and discernible symptoms. You may be thirsty more often (and, therefore, urinate more often). But when you’re pregnant, these symptoms can be challenging to isolate: are you peeing more often because you’re developing diabetes or because, well, you’re pregnant and your body is changing?

That’s why your OBGYN or Midwife will recommend screening your insulin and blood glucose levels during your pregnancy. Unless there are specific indications or risk factors that suggest gestational diabetes may be present earlier, these screenings usually begin during the second trimester.

Possible Complications From Gestational Diabetes

Uncontrolled gestational diabetes can present complications for both the mother and the baby (before and after birth). The complications that affect the mother include the possibility of requiring a C-section delivery, the possible development of preeclampsia and high blood pressure, as well as a heightened risk of developing diabetes in the future.

In terms of possible complications for the baby, those may include:

• Stillbirth
• Preterm delivery
• Breathing conditions, such as respiratory distress syndrome
• Excessive weight at birth (this can cause injury to the child during delivery)
• Higher chances of obesity later in life
• Higher risk of developing type-2 diabetes later in life
• Low blood sugar

The good news is that these complications are largely preventable so long as your diabetes is being successfully managed. If you’re diagnosed with gestational diabetes you may be asked to visit a specialist (endocrinologist) to help manage it.

Depending on your situation, you may also be asked to monitor your blood sugar at home. This is usually achieved via daily finger prick.

Treatments for Gestational Diabetes

There are several reliable methods that your OBGYN or Midwife will recommend to manage and treat gestational diabetes. You’ll work with your healthcare providers to find the method that works best for you and your condition. Your Midwife or OBGYN may suggest one of the following treatments:

A Healthy Lifestyle
The first step in controlling your gestational diabetes will likely be to adopt a healthy lifestyle. This generally means:

• Minimizing the amount of refined sugar you eat. Most OBGYNs and Midwives will recommend that you avoid sweets and candy bars and opt instead for fruits.
• Eating plenty of whole wheat and whole grains.
• Exercising daily. You’ll want to talk to your OBGYN or Midwife about exercise levels–typically, anything you were doing before you were pregnant is just fine. If your Midwife or OBGYN gives you the go-ahead, you’ll want to aim for at least 30 minutes of moderate exercise a day. This will lower the amount of glucose in your blood.

Your OBGYN or Midwife will be able to recommend practical and realistic ways for you to safely improve your health choices while you are pregnant.

Monitor Your Blood Sugar
Treating your gestational diabetes may also require monitoring your blood sugar on a daily basis. A healthy diet and exercise can keep your blood sugar from getting too high, but something like vomiting (a common presentation of morning sickness) can cause your blood sugar to drop into an unhealthy range.

Daily monitoring of your glucose levels via a finger prick and a blood glucose meter can help ensure that your blood sugar stays in a safe and healthy zone.

Medication
If your gestational diabetes cannot be managed by a combination of lifestyle changes and blood sugar monitoring, you may be prescribed medication in the form of insulin injections. Roughly 10-20% of women with gestational diabetes will need to take insulin to manage their symptoms at some point during their pregnancy. Your Midwife or OBGYN will be able to address any concerns you might have about insulin injections and discuss the best way to control your blood sugar levels for the duration of your pregnancy.

Monitoring After Delivery

In the vast majority of cases, effective management and treatment can minimize the possible complications from gestational diabetes. And for most women, the condition will effectively disappear once you deliver your baby.

However, your OBGYN or Midwife will want to continue monitoring your diabetes symptoms after you deliver your baby to make sure this is the case. In most cases, this means checking your bloodwork six to twelve weeks after delivery to ensure your blood sugar levels and insulin production have returned to normal.

Controlling Gestational Diabetes
No one knows why some women will develop gestational diabetes and others don’t. What’s important, however, is not necessarily why you develop this condition–but, rather, that you are able to successfully manage this condition.

When your condition is fully managed and under control, you’ll have less reason to worry about possible complications. You’ll be able to look forward to a normal and healthy delivery!

If you have questions about gestational diabetes or how to stay healthy during your pregnancy, contact our Wilmette or Glenview offices to schedule an appointment today!