During pregnancy, the health of the mother and baby is of utmost importance. Gestational diabetes mellitus (GDM) is one of several conditions that can occur during pregnancy, even if the mother did not have diabetes before getting pregnant.
According to the CDC, two to 10 percent of pregnancies can result in GDM making it the most common medical pregnancy complication. While it can be managed with lifestyle shifts to result in a healthy pregnancy, it can also lead to some concerns if left untreated.
Discover in-depth what gestational diabetes is, how it affects the health of the mother, baby, how to lower risk, and what to do if you have it.
What Is Gestational Diabetes?
Gestational diabetes occurs during pregnancy when the body does not make enough (or the body is not responding to) insulin. The result is higher than normal blood sugar/blood glucose levels. What makes GDM unique is blood sugar usually goes back to normal after delivering the baby.
The changes in hormones during pregnancy, along with the natural increased weight gain, can play a role in the development of diabetes during pregnancy.
What Causes Gestational Diabetes?
Unfortunately, there is no single known specific cause of GDM. However, the following are factors that can increase risk:
• Mother being overweight or obese
• Having polycystic ovary syndrome (PCOS)
• Later age at childbearing, women >40 years of age have a more than twofold increased risk of GDM
• Previous history of GDM or previously giving birth to a baby over 9 pounds
• Family history of type 2 diabetes mellitus
• Ethnicity of African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander person
Gestational Diabetes Test
Remember, even if there are no risk factors, pregnant women could still develop gestational diabetes. Therefore, it is important for all pregnancies to be tested for GDM.
If at high risk, your doctor will probably test for GDM within the early stages of pregnancy. If there are no risk factors, taking an oral glucose tolerance test (OGTT) can happen between 24 and 28 weeks of pregnancy.
This involves fasting overnight, getting a blood draw, drinking a sugary liquid, and getting blood drawn every hour for three hours after. If two or more draws have high blood sugar levels, GDM is diagnosed.
If the first OGTT is high, another OGTT is done to confirm a diagnosis.
Gestational Diabetes Signs and Symptoms
Symptoms and signs of gestational diabetes can either be non-existent or go largely unnoticed. Therefore, it is important to get tested for GDM even if you “feel fine”.
Some with GDM may have increased thirst, hunger, and urination. However, these can be easy to overlook as anything over what is already increased from pregnancy in general.
How Gestational Diabetes Affects the Baby and Mother
The importance of diagnosing and testing for gestational diabetes is important for the health of the mother and baby both immediately and for the future.
Mothers with gestational diabetes increase their risk of high blood pressure and preeclampsia during pregnancy. There is a higher risk for a larger size baby, over nine pounds, which could increase the risk of a c-section. Pre-term labor is also an increased risk for the baby which could include problems with breathing or low blood sugar after delivery.
Both the baby and mother have an increased risk for type 2 diabetes later in life with GDM. The CDC suggests 50 percent of women with GDM can develop type 2 diabetes later in life.
Lastly, a serious concern for untreated GDM is a stillbirth. Therefore, diagnosing and treating GDM early and throughout pregnancy is beneficial for the mother and baby.
What could happen to mother and baby with GDM may sound alarming, but there is good news!
What to Do If You Have Gestational Diabetes
The mother can do many things before and during pregnancy to best manage GDM and lower the risk for health complications down the road.
Being overweight or obese before pregnancy is the biggest risk factor for GDM. Therefore, losing weight before becoming pregnant can help lower the risk. During pregnancy, work with your doctor and a dietitian to maintain a healthy pregnancy weight.
Regular exercise in addition to eating a healthy, balanced diet can also go a long way for best managing GDM. Ask your doctor what would be best for you before starting an exercise program during pregnancy.
Gestational Diabetes Recap
GDM is one of the most common medical complications of pregnancy. The body either stops making enough or becomes resistant to insulin resulting in elevated blood sugar. While the exact cause is not clearly known, being overweight, having a family history of type 2 diabetes, certain ethnicities, or being of late childbearing age can increase the risk for GDM.
Taking an OGTT can diagnose GDM and should be done even if a pregnancy is normal. From this confirmed diagnosis, it is best to work with a doctor and dietitian to manage GDM with a healthy diet, exercise, and maintaining a healthy weight. The mother and baby can both have complications from GDM including an increased risk for diabetes later in life.
References:
Diabetes risk factors. Centers for Disease Control and Prevention. Published April 5, 2022. https://www.cdc.gov/diabetes/basics/risk-factors.html.
Gestational diabetes. Centers for Disease Control and Prevention. Published August 10, 2021. https://www.cdc.gov/diabetes/basics/gestational.html.
Gestational diabetes. Mayo Clinic. Published April 9, 2022. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339.
McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nature News. Published July 11, 2019. https://www.nature.com/articles/s41572-019-0098-8.
Tests & diagnosis for gestational diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. Published May 2017. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational/tests-diagnosis.
