PREGNANCY
Gestational Diabetes: A Non-Sugar-Coated Guide
5 to 10% of pregnant women receive the unwelcome news that they have gestational diabetes. Here’s what you need to know.
Written by
Dr. Harvey Karp
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PREGNANCY
Written by
Dr. Harvey Karp
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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider. Breastmilk is the best source of nutrition for babies. It is important that, in preparation for and during breastfeeding, mothers eat a healthy, balanced diet. Combined breast- and bottle-feeding in the first weeks of life may reduce the supply of a mother's breastmilk and reversing the decision not to breastfeed is difficult. If you do decide to use infant formula, you should follow instructions carefully.
You’re heading into the third trimester. The home stretch is finally in sight, but there is one last hurdle to surmount before labor and delivery: the gestational diabetes test. Typically done between 24 and 28 weeks, the test involves drinking a syrupy sweet liquid an hour before having blood drawn to measure glucose (called the glucose tolerance test). How common is gestational diabetes? Most women will get the all-clear, but one in 10 receive the unwelcome news that they have gestational diabetes.
Some women get high blood sugar during pregnancy…aka gestation. That means that, after eating, the sugar from the carbohydrates in your meal hangs around in the blood, instead of entering your cells to fuel them until your next meal. This happens because the body stops responding to your natural insulin—the hormone that opens the “little doors” on each cell to let the sugar leave the blood and enter the cell. Fortunately, gestational diabetes is very manageable and tends to go away after giving birth.
Common symptoms of gestational diabetes include:
Since many of those signs and symptoms are similar to normal pregnancy side effects (hello, fatigue and nausea!), the best way to detect diabetes is to get tested. Sugar in your urine—noticed during your routine urine test—may be the first warning sign. But usually diabetes is detected when a woman starts having the symptoms listed above or—if she is at high risk— when her provider does the glucose tolerance test in the 6th or 7th month of pregnancy.
During pregnancy, insulin resistance naturally increases, which is actually a good thing! It makes it easier to share nutrients with your growing babe-to-be. However, if insulin resistance gets too strong, the sugar will have a hard time entering the cells and build up in the blood (it also gets peed out, which is why sugar may first be detected in the urine test). There are a few predisposing factors that can subtly push some women towards diabetes.
Towards the end of your second trimester (24-28 weeks), your doctor may schedule a gestational diabetes screening test, also known as the glucose challenge. You’ll be asked to chug a cup of thick, sweet liquid. (Pro tip: It tastes better when refrigerated!) An hour later, blood is drawn to see how high your blood sugar spiked. If the test is normal, you’re good to go. If it’s abnormal, many doctors will schedule you for a second screening called the oral glucose tolerance test. During this longer version of the glucose challenge, blood sugar is measured at 1, 2, and 3 hour intervals after drinking the sugar solution. (Bring a book or a freshly charged phone…you’ll be there a while!) If your results are again abnormal, you’ll be given a diagnosis of gestational diabetes.
If you’re told you have gestational diabetes…don’t panic. Proper treatment typically leads to normal pregnancies and healthy babies. But, you do need to get proper treatment. Left untreated, gestational diabetes can definitely cause problems. One risk is that baby gets too big (fed by all that extra sugar). A too-big baby (called macrosomia) could make it hard to deliver vaginally and require a C-section. Another risk is high blood pressure (also called preeclampsia). Preeclampsia is a serious condition that can necessitate an emergency deliver…even if the baby is premature. As for the babies, they are often be born with unacceptably low levels of blood sugar (risking seizures), jaundice, or breathing issues. They can even be put at risk of later obesity and diabetes. But take heart—treating your gestational diabetes can prevent these issues.
Most pregnant women with diabetes can breathe a sigh of relief once baby makes her big debut. Although there is a somewhat higher risk of type 2 diabetes later in life. Breastfeeding, eating whole foods, and exercising regularly can all help to reduce your weight and speed recovery from diabetes.
It’s not possible to entirely prevent gestational diabetes, but if you’re planning to get pregnant, tip the scales in your favor by starting from a healthy weight, eating well, and moving your body every day.
Some mamas-to-be with diabetes get better with just a few lifestyle changes, while others require medicine. Typically, eating small, frequent, healthy meals can help level out blood sugar.
You’ll want to cut out junk food like sodas and swap simple carbs (white bread, white potatoes) for complex carbs (whole grains, sweet potatoes) while getting plenty of protein, fruits, and veggies. And, of course it also helps to get more sleep and do regular, aerobic exercise.
Overwhelmed? Nutritional counseling is covered by many health insurance plans, so it’s definitely worth looking into! There are also sample meal plans available online. As long as your doctor is on board, moderate exercise—such as a daily walk—will help too.
For more serious cases of gestational diabetes, an oral medication such as Metformin or injections of insulin may be necessary. Both are safe for your baby.
The bottom line: Gestational diabetes can be scary-sounding, but with help from your doctor, it can be managed in order to ensure a safe delivery and healthy baby. Now that’s the kind of sweet we like to see!
