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Gestational diabetes

Glucose intolerance during pregnancy

 

Gestational diabetes is high blood sugar ( diabetes ) that starts or is first diagnosed during pregnancy.

Causes

 

Pregnancy hormones can block insulin from doing its job. When this happens, glucose level may increase in a pregnant woman's blood.

You are at greater risk for gestational diabetes if you:

  • Are older than 25 when you are pregnant
  • Come from a higher risk ethnic group, such as Hispanic American, African American, Native American, Southeast Asian, or Pacific Islander
  • Have a family history of diabetes
  • Gave birth to a baby that weighed more than 9 pounds (4 kg) or had a birth defect
  • Have high blood pressure
  • Have too much amniotic fluid
  • Have had an unexplained miscarriage or stillbirth
  • Were overweight before your pregnancy
  • Gain too much weight during your pregnancy
  • Have polycystic ovarian syndrome

 

Symptoms

 

Most of the time there are no symptoms. The diagnosis is made during a routine prenatal screening.

Mild symptoms, such as increased thirst or shakiness, may be present. These symptoms are usually not life threatening to the pregnant woman.

Other symptoms may include:

  • Blurred vision
  • Fatigue
  • Frequent infections, including those of the bladder, vagina, and skin
  • Increased thirst
  • Increased urination

 

Exams and Tests

 

Gestational diabetes most often starts halfway through the pregnancy. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to look for the condition. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy.

Once you are diagnosed with gestational diabetes, you can see how well you are doing by testing your glucose level at home. The most common way involves pricking your finger and putting a drop of your blood on a machine that will give you a glucose reading.

 

Treatment

 

The goals of treatment are to keep blood sugar (glucose) level within normal limits during the pregnancy, and to make sure that the growing baby is healthy.

WATCHING YOUR BABY

Your health care provider should closely check both you and your baby throughout the pregnancy. Fetal monitoring will check the size and health of the fetus.

A nonstress test is a very simple, painless test for you and your baby.

  • A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen.
  • Your provider can compare the pattern of your baby's heartbeat to movements and find out whether the baby is doing well.

DIET AND EXERCISE

The best way to improve your diet is by eating a variety of healthy foods. You should learn how to read food labels, and check them when making food decisions. Talk to your provider if you are a vegetarian or on another special diet.

In general, when you have gestational diabetes  your diet should:

  • Be moderate in fat and protein
  • Provide your carbohydrates through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice)
  • Be low in foods that contain a lot of sugar, such as soft drinks, fruit juices, and pastries

If managing your diet does not control blood sugar (glucose) level, you may be prescribed diabetes medicine by mouth or insulin therapy.

Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will.

 

Outlook (Prognosis)

 

There are many risks of having diabetes in pregnancy when blood sugar is not well controlled. With good control, most pregnancies have good outcomes.

Pregnant women with gestational diabetes tend to have larger babies at birth. This can increase the chance of problems at the time of delivery, including:

  • Birth injury (trauma) because of the baby's large size
  • Delivery by C-section

Your baby is more likely to have periods of low blood sugar ( hypoglycemia ) during the first few days of life.

Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy .

After delivery:

  • Your high blood sugar (glucose) level often goes back to normal.
  • You should be closely followed for signs of diabetes over the next 5 to 10 years after delivery.

 

When to Contact a Medical Professional

 

Call your provider if you are pregnant and you have symptoms of diabetes .

 

Prevention

 

Getting prenatal care early and having regular checkups helps improve your health and the health of your baby. Having prenatal screening at 24 to 28 weeks of pregnancy will help detect gestational diabetes early.

If you are overweight, getting your weight within the normal body mass index (BMI) range will decrease your risk of gestational diabetes.

 

 

Open References

References

American Diabetes Association. Standards of medical care in diabetes—2016. Diabetes Care . 2016;39(suppl 1):S1-S106.

Landon MB, Catalano PM, Gabbe SG. Diabetes mellitus complicating pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 40.

Metzger BE. Diabetes mellitus and pregnancy. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 45.

Moyer VA. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med . 2014;160:414-420. PMID: 24424622 www.ncbi.nlm.nih.gov/pubmed/24424622 .

 
  • Pancreas

    Pancreas - illustration

    The pancreas is located behind the liver and is where the hormone insulin is produced. Insulin is used by the body to store and utilize glucose.

    Pancreas

    illustration

  • Gestational Diabetes

    Gestational Diabetes - illustration

    Gestational diabetes is defined as glucose intolerance during pregnancy. During your pregnancy, hormonal changes can cause the body to be less sensitive to the effect of insulin. These changes can lead to high blood sugar and diabetes. High blood sugar levels in pregnancy are dangerous for both mother and baby.

    Gestational Diabetes

    illustration

    • Pancreas

      Pancreas - illustration

      The pancreas is located behind the liver and is where the hormone insulin is produced. Insulin is used by the body to store and utilize glucose.

      Pancreas

      illustration

    • Gestational Diabetes

      Gestational Diabetes - illustration

      Gestational diabetes is defined as glucose intolerance during pregnancy. During your pregnancy, hormonal changes can cause the body to be less sensitive to the effect of insulin. These changes can lead to high blood sugar and diabetes. High blood sugar levels in pregnancy are dangerous for both mother and baby.

      Gestational Diabetes

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

        Tests for Gestational diabetes

         
         

        Review Date: 5/16/2016

        Reviewed By: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

         
         
         

         

         

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