Gestational Diabetes




Introduction

Gestational diabetes is a type of diabetes that occurs only during pregnancy. Like other forms of diabetes, gestational diabetes affects the way your body uses sugar (glucose) — your body's main source of fuel. The result may be dangerously high blood sugar levels.

Any pregnancy complication is concerning, but there's good news. You can manage gestational diabetes by eating healthy foods, exercising regularly and, if necessary, taking medication. Taking good care of yourself can help ensure a healthy pregnancy for you and a healthy start for your baby.

Thankfully, gestational diabetes is short-lived. Blood sugar levels typically return to normal soon after delivery.

Signs and symptoms

Rarely, gestational diabetes may cause excessive thirst or increased urination. For most women, however, gestational diabetes doesn't cause noticeable signs or symptoms.

Causes

During digestion, your body breaks down carbohydrates from foods such as bread, pasta, vegetables, fruits and dairy products into various sugar molecules. One of these sugar molecules is glucose, a main source of energy. Glucose is absorbed directly into your bloodstream after you eat, but it can't enter your cells without the help of insulin.

Your pancreas — a gland located just behind your stomach — produces insulin continuously. When your blood sugar increases after eating, insulin production also increases. The extra insulin "unlocks" your cells to more sugar, which provides your body with energy and helps maintain a normal level of sugar in your blood.

During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones make your cells more resistant to insulin. As your placenta grows larger in the second and third trimesters, it secretes more of these hormones — making it even harder for insulin to do its job.

Normally, your pancreas responds by producing enough extra insulin to overcome this resistance. But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your cells and too much stays in your blood. This is gestational diabetes.

Gestational diabetes usually develops during the second trimester — sometimes as early as the 20th week, but often not until later in the pregnancy.



Treatment

Controlling your blood sugar level is essential to keeping your baby healthy and avoiding complications during delivery. Your treatment plan may include:
  • Blood sugar monitoring. Your health care provider may ask you to check your blood sugar level four to five times a day to make sure you're keeping your blood sugar within a healthy range. This may sound inconvenient and difficult, but it'll get easier with practice. To test your blood sugar, you draw a drop of blood from your finger using a small needle (lancet), then place the blood on a test strip inserted into a blood glucose meter — a device that measures and displays your blood sugar level.
    Your health care provider will also monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin — which can lead to low blood sugar right after birth.
  • Diet. Eating the right kind and amount of food is one of the best ways to control your blood sugar level. This often means more fruits, vegetables and whole grains — foods that are high in nutrition and low in fat and calories — and fewer animal products and sweets. Even so, no single diet is right for every woman. You might want to consult a registered dietitian or a diabetes educator to create a meal plan based on your blood sugar level, height, weight, exercise habits and food preferences.
  • Exercise. Exercise lowers your blood sugar level by transporting sugar to your cells, where it's used for energy. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. And there's more. Regular exercise can help prevent some of the discomforts of pregnancy, such as back pain, muscle cramps, swelling, constipation and difficulty sleeping. It can also help prepare you for labor and delivery.
    With your health care provider's OK, aim for moderate aerobic exercise on most days of the week. If you haven't been active for a while, start slowly and build up gradually. Walking, cycling and swimming are often good choices during pregnancy. Ordinary activities such as housework and gardening also count.
  • Medication. If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar level. For some women, the oral medication glyburide may be an option as well.
Your baby will need close observation, too. Your health care provider may monitor your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date — or sometimes earlier — your health care provider may induce labor. Delivering your baby after your due date may increase the risk of complications.

Prevention

There are no guarantees when it comes to preventing gestational diabetes— but the more healthy habits you can adopt before pregnancy, the better.
  • Eat healthy foods. Choose foods low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.
  • Get more physical activity. Aim for 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your bike. Swim laps. If you can't fit in a long workout, break it up into smaller sessions spread throughout the day.
  • Lose excess pounds. Weight loss during pregnancy isn't usually recommended. But if you're planning ahead, losing weight may help you have a healthier pregnancy. Focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.


Credit: National Institute of Health.
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