6 Things We Now Know About Gestational Diabetes
It affects nearly one in 10 pregnancies—even if the mother-to-be didn’t have diabetes before she conceived. Two experts on the condition share what you should know to help keep you and your baby healthy.
Chances are you probably know someone who has diabetes, but did you know that there’s a form of the disease that develops only during pregnancy—in women who’ve never had it before?
It’s called gestational diabetes, and it occurs in up to 9% of all pregnancies, according to a 2014 report from the Centers for Disease Control and Prevention.
Gestational diabetes can result from the fact that the body may use insulin less efficiently while growing a baby, causing your blood glucose levels to rise—a condition known as hyperglycemia, which can cause health problems for both the mother-to-be and her developing baby.
“Any pregnant woman can develop gestational diabetes,” says Amparo Gonzalez, CDE, RN, MPH, Global Senior Director for the Johnson & Johnson Diabetes Institute (JJDI) and a Fellow of the American Association of Diabetes Educators. “Properly treating it is essential for maintaining both the mother’s and the baby’s health.”
Being diagnosed with gestational diabetes may seem overwhelming at first, especially if you’ve had an otherwise healthy pregnancy. But the more you can educate yourself about what you can do to maintain healthy blood glucose levels during your pregnancy, the more manageable and treatable the condition can be.
That’s why we’ve interviewed leading experts on gestational diabetes to share the latest information on the condition that can help keep you and your baby healthy.
Gestational diabetes is ... becoming far more common.
“The proportion of women diagnosed with gestational diabetes doubled between 1996 and 2010,” says Florence M. Brown, M.D., Senior Staff Physician at the Joslin Diabetes Center and Co-Director of the Joslin-Beth Israel Deaconess Medical Center Diabetes in Pregnancy Program.
This could be partly due to the growing number of women who are becoming pregnant later in life: Women who are aged 30 or older are more likely to be diagnosed with the condition, Dr. Brown says.
Other risk factors that may come into play: women who’ve had polycystic ovary syndrome, moms-to-be with a history of delivering a baby weighing more than 9 pounds and those who have a family history of any type of diabetes, Dr. Brown says.
The risk of developing gestational diabetes also increases if you are overweight or obese. But it can occur in healthy-weight women, too, which is why anyone who is pregnant should be tested for the condition.
Gestational diabetes is ... seen more often in certain populations.
“Some groups tend to have gestational diabetes more than others, such as Latinos and Asians,” Gonzalez says, suggesting that there’s a genetic component to the condition.
Indian women seem especially vulnerable. According to a 2016 study published in the Indian Journal of Endocrinology and Metabolism, about 2% of the Indian population had been diagnosed with gestational diabetes in the 1980s; by 2000, the rate had soared to nearly 17%.
To help diagnose these women earlier, before high blood glucose levels can cause problems, JJDI and Johnson & Johnson Medical India funded a joint certificate program between the Public Health Foundation of India and Dr. Mohan’s Diabetes Education Academy in Chennai in 2015.
The goal: help train primary care physicians and obstetricians in the country about the condition in the hopes of identifying as many patients as possible with undiagnosed gestational diabetes.
To date, the program has trained 3,000 doctors in 55 locations across 39 cities—and has received recognition from the International Diabetes Federation.
Gestational diabetes can be ... diagnosed in a couple different ways.
To test for the condition, your doctor will ask you to drink a sweet substance as part of an oral glucose tolerance test, which will cause your blood sugar levels to change. If your pancreas is producing enough insulin, your blood glucose levels will remain in a healthy range. If not, your body won’t produce enough insulin and glucose levels will rise.
If a mother’s high glucose levels reach the baby, the fetus will produce more of its own insulin to counteract the high numbers, even though the baby itself doesn’t have diabetes.
Some doctors may choose to administer a 50-gram glucose drink, along with a blood test, and then follow this up with a 100-gram drink, and a blood test three hours later, if the first result was too high. Others feel the test should be a 75-gram glucose drink, followed by a blood test two hours later, for everyone.
Don’t worry about which gestational diabetes test regimen your MD chooses: Either way, the results will be accurate.
Gestational diabetes can ... lead to serious health consequences for both mom and baby.
High blood sugar levels can cause mothers to deliver larger babies with a higher percentage of body fat, Dr. Brown says. Larger babies may require deliveries by cesarean section, and can be more susceptible to shoulder dystocia (stuck shoulders during vaginal delivery) and other birth injuries, as well as preterm delivery and low blood glucose levels at birth.
Moms with gestational diabetes (which goes away after childbirth) can have an increased risk of developing preeclampsia, a serious condition marked by high blood pressure.
Gestational diabetes can be ... treated with diet and exercise (and medication, when necessary).
For some women, a gestational diabetes diagnosis means needing to take a closer look at what they eat and when they exercise. For others, gestational diabetes may mean taking insulin injections. Your doctor will determine the best course of treatment for your particular case.
“The simple thing is to follow a meal plan that is six small meals a day: three meals and three snacks, and eating meals lower in carbohydrates in the morning,” Gonzalez says. “That means no cereal or fruit for breakfast, and instead choosing proteins, such as eggs.” Moderate exercise, like walking, is also recommended.
Mothers have a 50% risk of developing type 2 diabetes within seven to 10 years following a gestational diabetes diagnosis.
If your gestational diabetes treatment involves medication, your doctor will work with you to determine if you should take certain oral drugs or insulin injections, which lower a mother’s blood glucose levels so that it does not cross the placenta and potentially trigger the baby to gain excess weight before delivery.
If a mother’s high glucose levels reach the baby, the fetus will produce more of its own insulin to counteract the high numbers, even though the baby itself doesn’t have diabetes. This, in turn, will put extra weight on the baby.
“It’s also recommended that a person with gestational diabetes work with a team that could include a dietitian and nurse who are Certified Diabetes Educators,” Gonzalez adds. The team approach helps ensure a mom-to-be is doing all she can to be as healthy as possible.
Gestational diabetes can often ... lead to type 2 diabetes down the road.
The most common question Gonzalez gets from mothers with gestational diabetes is whether their babies will develop it, too. The answer, she says, is not necessarily—although the baby may have a higher risk of developing obesity later in life.
The more crucial question they should be asking: whether they could potentially develop type 2 diabetes in the future.
In fact, Dr. Brown says, moms have a 50% risk of developing the condition within seven to 10 years following a gestational diabetes diagnosis.The good news: According to Dr. Brown, lifestyle changes—including a proper diet and exercise—can help reduce a mother’s risk of developing type 2 diabetes in the future by up to 50%.