Gestational diabetes (or gestational diabetes mellitus) is a form of diabetes that affects pregnant women. According to March of Dimes—a non-profit organization dedicated to improving the health of mothers and babies—6 of every 100 pregnant people develop gestational diabetes. This condition can usually be managed with a healthy lifestyle and close monitoring from a licensed health care provider. If left untreated, however, it can result in scary complications for both the mother and fetus.
In this blog article, we’ll look into what causes gestational diabetes, the symptoms it causes, how it is diagnosed, and how it is treated. If you’re looking for more information, book an online gestational diabetes appointment on Sesame to speak to a health care provider about any questions or concerns you have.
Gestational diabetes causes
Gestational diabetes is the development of diabetes in pregnancy. It occurs when blood glucose levels (blood sugar levels) get too high, primarily due to hormonal and physiological changes (such as weight gain) in a pregnant woman's body.
During pregnancy, the placenta produces hormones that can interfere with the body's ability to effectively use insulin, a hormone responsible for regulating blood sugar levels. As a result, insulin resistance often increases during pregnancy, and the pancreas may struggle to produce enough insulin to compensate.
This imbalance leads to high blood sugar levels, causing gestational diabetes. While genetics and pre-existing insulin resistance may play a role, the primary biological cause is the hormonal disruption associated with pregnancy, which affects insulin sensitivity and production.
Gestational diabetes often develops in the third trimester or the 24-48th weeks of pregnancy.
Gestational diabetes risk factors
Gestational diabetes can develop in anyone during pregnancy. However, several risk factors can put you at an increased risk of developing this condition.
Factors that put you at higher risk of developing gestational diabetes include:
- Age (women over the age of 25 are more likely to develop gestational diabetes)
- High blood pressure
- Heart disease
- Obesity
- Prediabetes or personal history of GD
- Family history of diabetes
- Polycystic ovary syndrome (PCOS)
- Previous birth of a baby weighing more than 9 lbs
- Race: Women of African, Asian, Hispanic, Native American or Pacific Island descent are more likely to develop gestational diabetes
Gestational diabetes symptoms
Gestational diabetes rarely causes any noticeable symptoms.
Some mild effects of this condition may include:
- Frequent urination
- Thirst
- Nausea
- Fatigue
These symptoms are not unlike common side effects of pregnancy, making it hard to discern if you are dealing with an underlying health problem. Because of this, testing and close monitoring in collaboration with your health care provider is critical to catching gestational diabetes before it causes any serious complications.
Gestational diabetes complications
Even though the symptoms of GD are mild, the condition can lead to serious complications for your baby and you if left untreated. GD can lead to complications such as:
- Excessive birth weight (macrosomia)
- Cesarean birth (C-section)
- Low blood sugar (hypoglycemia) in the baby
- Preterm birth
- Obesity
- Pre-eclampsia: Characterized as high blood pressure (gestational HTN) and internal organ damage in the mother during pregnancy
- Future diagnosis of diabetes in the child and mother
- Stillbirth
In addition to the complications listed above, gestational diabetes in pregnancy can significantly increase the mother’s risk of developing type 2 diabetes later in life. According to the CDC, about 50% of women with gestational diabetes develop type 2 diabetes.
Despite these complications, there are preventive measures you can take to reduce your risk of gestational diabetes and help ensure a healthy pregnancy and healthy baby.
Gestational diabetes prevention
While there are no guaranteed steps for preventing this type of diabetes, you can take several steps to reduce your risk of developing it.
Preventive measures include:
Start with a healthy weight: Maintaining a healthy weight through a balanced diet and regular physical activity is a crucial strategy for preventing gestational diabetes. When a woman is overweight or obese before pregnancy, her body may have difficulty processing insulin, increasing the risk of gestational diabetes during pregnancy.
Adopting a healthy lifestyle before and during pregnancy can manage weight and improve insulin sensitivity. Eating healthy food rich in fiber and low in processed sugars, along with consistent physical activity, helps regulate blood sugar levels, reduce excess weight gain, and lower the likelihood of developing gestational diabetes, ultimately promoting a healthier pregnancy for both mother and baby.
Maintain a healthy weight: Some weight gain during pregnancy is natural. However, gaining too much weight can quickly lead to the development of gestational diabetes. Talk to your health care provider about how much weight is healthy to gain during pregnancy and what steps you can use to take care of yourself.
Gestational diabetes diagnosis
Because gestational diabetes causes few symptoms, it is essential to be tested for undiagnosed type 2 diabetes during your first prenatal visit. People with diabetes usually undergo more intensive prenatal care to monitor fetal growth, blood sugar levels, and weight gain.
During pregnancy, you should be tested in the third trimester for gestational diabetes.
Two primary diagnostic tests are commonly used to screen for gestational diabetes during pregnancy. The first is the glucose challenge test (GCT), typically administered between 24 and 48 weeks of gestation. A pregnant woman drinks a sugary solution during this test, usually containing 50 grams of glucose. After an hour, her blood sugar levels are measured. Elevated glucose levels at this stage may warrant further evaluation.
The second test, if necessary, is the glucose tolerance test (GTT). If the GCT results indicate a potential issue, the GTT is performed. This test involves fasting overnight and then drinking a more concentrated glucose solution. Blood samples are taken at fasting intervals over a few hours to monitor how the body processes glucose.
Abnormal results in this test can confirm the diagnosis of gestational diabetes. Early detection through these screening tests allows for timely management and reduces the risk of complications for both the mother and the baby during pregnancy and childbirth.
Gestational diabetes treatment
Gestational diabetes is commonly treated with lifestyle adjustments and careful monitoring.
Blood sugar monitoring and insulin injection
If you are diagnosed with GD, you must monitor your blood sugar levels. Your health care provider will prescribe you a glucose monitor to do this. You may need to check your blood sugar levels 2-4 times daily.
Commonly used antepartum glycemic targets are:
- Fasting blood glucose concentration: <95 mg/dL
- One-hour postprandial blood glucose concentration: <140 mg/dL
- Two-hour postprandial glucose concentration: <120 mg/dL
10-20% of women require insulin supplementation during pregnancy to maintain blood sugar levels. This is often administered as a subcutaneous injection. Talk to your provider about the different types of insulin administration and what treatment is best for you.
Healthy diet
Eating a clean and healthy diet can help manage GD and prevent complications such as type 2 diabetes in the future. To do this, work with a registered dietitian to ensure that you are getting a balance of vegetables, lean proteins, and healthy fats with fruits on occasion. Eat regular healthy meals to prevent your blood sugar from spiking, and try to eat around the same time daily.
Additionally, cut out highly processed and sugary foods. Not only are these foods bad for your general health, but they can worsen GD and increase your risk of type 2 diabetes in the future.
Exercise
Talk to your obstetrician or work with a licensed physical therapist to create an exercise program that is safe for you. Regular exercise can control blood sugar levels and help general wellness during pregnancy. Aim for at least 30 minutes of moderate physical activity every day. Exercise that increases muscle mass, including aerobic, resistance, and circuit training, appears to improve glucose management, primarily from increased tissue sensitivity to insulin. As a result, exercise can reduce both fasting and after-meal blood glucose concentrations, and in some patients with GDM, the need for insulin may be obviated. Walking, stationary biking, and swimming are healthy, low-impact activities that can help improve your health and manage gestational diabetes during pregnancy.
While gestational diabetes can lead to health problems for mother and baby, it can be managed with the treatment options detailed above. Starting your pregnancy at a healthy weight and with already-established good habits can help with prevention. Testing for diabetes during prenatal care and during pregnancy can also help you address any concerning indicators before they become serious.
