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Gestational Diabetes

Gestational diabetes mellitus (GDM) is a condition that occurs in pregnant women and is characterized by having high blood sugar during pregnancy. GDM affects about 7% of all pregnant women.1 This condition usually occurs after the sixth month of pregnancy and typically goes away after the baby is born.

Are you at risk for GDM?

Although any pregnant woman can develop GDM, the following risk factors are linked to GDM:

  • Over the age of 25
  • Overweight
  • Family history of diabetes
  • Hispanic American, African American, American Indian, or Asian American
  • Diagnosed with GDM during a previous pregnancy

How is GDM diagnosed?

Only a blood test can determine if you have GDM. If you have never had GDM before, you will likely be tested between the 24th and 28th weeks of pregnancy. If you have had GDM during an earlier pregnancy, you should be tested for it when you see your healthcare provider for the first time about your new pregnancy.

How GDM can affect you — and your baby

If you have GDM, you have too much sugar in your blood. High blood sugar levels are unhealthy for both you and your baby.

Risks to your baby include:

  • a larger birth size, which could result in the increased need for a cesarean delivery
  • low blood sugar (hypoglycemia) at birth due to increased insulin levels
  • jaundice, a yellowing of the skin due to an increased level of bilirubin
  • breathing problems due to early birth and underdeveloped lungs

Your risks include:

  • Difficult labor, due to delivering a larger baby, and may require a cesarean delivery
  • Increased risk of vaginal, bladder, and kidney infections
  • Toxemia, a serious complication causing high blood pressure and swelling
  • Continuing to have diabetes after the baby is born
  • Developing type 2 diabetes later in life (occurs in about half of women with GDM)

How is gestational diabetes treated?

Once GDM is diagnosed, it needs to be treated immediately. The goal of GDM treatment is to keep your blood sugar levels normal so you can have a healthy pregnancy and deliver a healthy baby. You will need to carefully follow the specific treatment plan your healthcare team designs for you.

There are several ways that you can help keep your blood sugar levels in a healthy range:

  • Eat a healthy, well-balanced diet, as directed by your healthcare team
  • Maintain a healthy pregnancy weight gain, between 25 to 35 pounds
  • Test your blood sugar 4 to 6 times each day
  • Test your urine for unhealthy, acidic waste products called ketones
  • Get a moderate amount of safe exercise, such as walking, swimming, and prenatal stretching exercises as directed by your healthcare team
  • Keep records of your blood sugar levels, ketone levels, and changes in your diet or exercise plans

In you are unable to control your high blood sugar with diet and exercise as recommended by your healthcare team, you may need to take insulin injections. This is the case in 20% to 50% of women with GDM.

Your future health

In over 90% of women with GDM, diabetes goes away after delivery. However, about half of all women who have had GDM eventually develop type 2 diabetes. That is why it is very important that you stay physically active, maintain a healthy weight, be tested for diabetes regularly, and know the symptoms of type 2 diabetes.

Reference
1. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2008;31(suppl 1):S12-S54.