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What is gestational diabetes?

Women's Care
Oct 10, 2019

St. Joseph’s/Candler OB/GYN Dr. Wil Negron explains this common pregnancy condition

A diabetes diagnosis during pregnancy can be a scary thing for most women. However, pregnant women with gestational diabetes (diabetes during pregnancy) can still have healthy babies with help from their physician and by taking steps to manage blood sugar levels.

Gestational diabetes is a type of diabetes diagnosed in a pregnant woman who did not have diabetes before she was pregnant. It is typically diagnosed in the middle of the pregnancy, 20 weeks after gestation, and resolves within 12 weeks postpartum, explains St. Joseph’s/Candler Physician Network – OB/GYN Dr. Wil Negron.

Dr. Wil Negron

Gestational diabetes can be difficult to diagnose if a woman was not recently tested for diabetes before she becomes pregnant. That’s why Dr. Negron strongly recommends yearly exams with a primary care physician.

Related Article: Are you seeing a healthcare provider annually?

Still, gestational diabetes is common, occurring in more than 200,000 pregnancies each year in the United States, and comes with risk factors for both mom and baby that should be taken seriously.

What causes gestational diabetes?

During pregnancy, the placenta produces a hormone that can affect how a woman’s body uses insulin. Gestational diabetes is not caused by having too little insulin. Instead, this hormone – called human placental lactogen – keeps the body from using the insulin as it should. This is called insulin resistance.

As the placenta grows, it makes more of the hormone and the risk for insulin resistance becomes greater, especially if a female already has an increased risk for diabetes, Dr. Negron says. Normally, the pancreas is able to make more insulin to overcome insulin resistance, but if it cannot make enough to overcome the effects of the placenta’s hormones, a pregnant female can develop gestational diabetes.

Who’s most at risk of developing gestational diabetes?

Certain women may be more likely to get gestational diabetes including those who:

  • Become pregnant at 35-years-old and older
  • Were overweight before pregnancy
  • Previously had gastric bypass surgery
  • Had in vitro fertilization or infertility issues
  • Have polycystic ovarian syndrome
  • Have a family history of diabetes, especially a first-degree relative
  • Experienced gestational diabetes in previous pregnancies

Additionally, multiple risk factors put women at an increased risk of gestational diabetes including poor diet, sedentary lifestyle and obesity, Dr. Negron adds.

“Eating too much fast food, getting no physical activity are reasons why gestational diabetes is so common,” Dr. Negron says. “You’re not eating for two. My grandmother would say that, but it’s just not true.”

Related Article: Understanding a pregnancy diet and proper weight gain

What are symptoms of gestational diabetes?

When blood sugar levels become very high, women may experience excessive thirst and excessive urinating, Dr. Negron says. Excessive urinating is common in almost all pregnancies because of the pressure of the uterus on the bladder, says Dr. Negron. Many women may not know they have signs of gestational diabetes; that’s why routine doctor’s visits and screening are so important.

How do you test for gestational diabetes?

All pregnant women should be tested for gestational diabetes, Dr. Negron says. Testing is typically done between the 24th to 28th week of pregnancy. A hemoglobin A1C test can be used as a point of reference, but the standard method of screening includes two possible tests:

  • One-hour glucose tolerance test: The patient drinks a special beverage high in sugar, and one hour later, the doctor measures her glucose levels. If the levels are elevated (typically around 140 milligrams per deciliter or higher), it is considered an abnormal result and additional testing is required.
  • Three-hour glucose tolerance test: The patient drinks another beverage with even more sugar than the first. The doctor measures her glucose levels one hour, two hours and three hours later. If two of those test results are higher than normal, then the patient is positive for gestational diabetes.

How do you treat gestational diabetes?

Treatment for gestational diabetes focuses on keeping blood sugar levels in the normal range. Your physician will determine the best course of treatment, but the standard of care typically starts with lifestyle changes – following a proper diet and exercising. Dr. Negron also recommends nutritional counseling and close surveillance for both mom and baby.

Related Article: VIDEO: Modified exercises you can do at any point in your pregnancy

If blood sugar levels do not improve within a few weeks, insulin injections or medications may be needed to help control glucose levels.

“The reason we move on to insulin so soon is because we have a short window where we can get this patient’s blood sugar under control, and we must do it fast in order to prevent any complications of the pregnancy,” Dr. Negron says.

What are complications of gestational diabetes?

If undiagnosed or not treated, gestational diabetes can lead to many complications for both mom and baby. Complications for mom can include:

  • Early delivery
  • Stillbirth
  • Increased risk for C-section delivery
  • High blood pressure
  • Renal failure
  • Stroke
  • Blindness

Complications for baby can include:

  • Insufficient growth of the baby – either born underweight or overweight
  • Hypoglycemic, or low blood sugar
  • Respiratory distress  syndrome
  • Early birth

Gestational diabetes also puts both mom and baby at risk of type 2 diabetes later in life. In fact, if a woman has gestational diabetes, she has a greater than 50 percent chance of developing type 2 diabetes, Dr. Negron says, and that’s not even considering other risk factors such as family history.

How to prevent gestational diabetes?

“What I recommend to all my patients is they visit their primary care physician before getting pregnant, every year,” Dr. Negron says. “That way they can look for any medical conditions, especially if they have a family history or have had gestational diabetes with other pregnancies.”

Dr. Negron also suggests preconception counseling, especially for patients who are at higher risk of developing gestational diabetes.

“You want to be in the best shape that you can entering a pregnancy,” Dr. Negron says. “That’s a main goal. It’s not so much how you plan to deliver your baby or if you are going to have a midwife; it’s more about making sure you are in top condition to carry to full term.”


Dr. Negron sees patients in midtown Savannah and Richmond Hill and is currently accepting new patients. Request an appointment online today.

 

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