Gestational Diabetes Mellitus (GDM): Here are the facts

Pregnant woman at a doctor's checkup

November is National Diabetes Month and, this year, the nation is focusing on gestational diabetes mellitus (GDM), a type of diabetes only diagnosed during pregnancy. Women who are diagnosed with gestational diabetes do not have a previous diabetes diagnosis. 

The condition, previously considered to be relatively rare, only occurring in three to four percent of pregnancies, has doubled in recent years, affecting six to eight percent of pregnancies.

Though gestational diabetes typically disappears after birth, women experiencing GDM during pregnancy have a fifty percent chance of developing Type 2 diabetes later in life. Additionally, babies born to women diagnosed with GDM also face increased life-long risks of developing both Type 2 diabetes and obesity.

What is Gestational Diabetes Mellitus (GDM)?

GDM occurs when a pregnant woman’s body doesn’t produce enough insulin during pregnancy. Insulin; a hormone made by the pancreas, transports blood sugar into the body’s cells to use as energy.  Hormonal changes during pregnancy compromise a woman’s ability to use insulin effectively, also known as insulin resistance; for a woman with GDM, this resistance is so strong, the blood sugar levels remain dangerously high.

The good news is, GDM is easy to diagnose and control. Most women with GDM deliver healthy babies; however, if the condition is not carefully monitored and treated, GDM leads to uncontrolled blood sugar levels that may cause complications for both mother and baby.

GDM Risk Factors

It’s important to note that anyone can develop gestational diabetes. However, there are certain factors that place you in a higher-risk category including,

  • Being over the age of 25
  • Being overweight
  • Having a family history of Type 2 diabetes
  • Having GDM during a previous pregnancy
  • Giving birth to a baby weighing nine plus pounds in a previous pregnancy
  • Having a hormone disorder called polycystic ovary syndrome (PCOS)
  • Descending from  African American, Hispanic/Latino American, Native American, Alaska Native, Native Hawaiian, or Pacific Islander lineage

While you can’t change your age, family history, or ethnicity, there are steps you can take to reduce your risk. For example, you can lower gestational diabetes risk by achieving your ideal weight prior to becoming pregnant. Having an active lifestyle before and throughout pregnancy, in addition to a healthy nutrition plan, can also help guard against this condition.  

If you do find yourself diagnosed with this condition, lifestyle choices, such as eating healthy foods and exercising, can help reduce future Type 2 diabetes risk after birth. In fact, women diagnosed with gestational diabetes who achieve a healthy body weight after delivery significantly decrease their chances of developing Type 2 diabetes later in life. 

GDM Complications for Baby

As mentioned above, untreated gestational diabetes doesn’t solely affect the mom-to-be. There are a variety of risks for babies of mothers with uncontrolled gestational diabetes, including;

  • Excessive birth weight – extra glucose in mother’s bloodstream crosses the placenta and triggers baby’s pancreas to create extra insulin, which may lead to macrosomia, a condition where babies grows too large. Babies weighing nine plus pounds at birth are likely to become wedged in the birth canal, sustain injuries during birth, or require Caesarian–section birth.
  • Early (preterm) birth – a mother’s unmonitored high blood sugar may increase early labor risk or may require early delivery intervention because of baby’s large size.
  • Respiratory distress syndrome – babies born pre- or to-term to mothers with GDM may have difficulty breathing and may require medical intervention until their lungs mature and strengthen.
  • Low blood sugar (hypoglycemia) – Occasionally, babies of mothers with GDM develop low blood sugar shortly after birth because their own insulin production levels are high, sometimes causing seizures. Timely feedings and an intravenous glucose solution can normalize baby’s blood sugar level.
  • Future increased risk of Type 2 diabetes and obesity later in life 
  • Stillbirth - If left untreated, GDM may result in a baby’s death either before or shortly after birth.

Tests

During pregnancy, your doctor will test for gestational diabetes between 24 and 28 weeks. While these tests may seem cumbersome, they are incredibly important as there are no clear, specific symptoms associated with gestational diabetes.

The glucose challenge test examines a pregnant woman’s blood sample in a non-fasted state. If the test results in high blood glucose, an oral glucose tolerance test (OGTT) is performed over the course of three hours to confirm or deny diagnosis.

Managing GDM during Pregnancy

Successful management of GDM usually involves maintaining a sound nutrition plan that sustains healthy blood glucose levels with a meal and snack schedule.  Women diagnoses with GDM are encouraged to engage in an active lifestyle, including moderate exercise.

A doctor or dietician can create a personalized nutrition plan which outlines the types and quantities of healthy food a GDM patient should eat in order to control blood sugar levels during pregnancy. A patient will, most likely, need to check and track blood sugar levels throughout the pregnancy in order to confirm levels are staying within a normal range.

If GDM persists after changes to diet and exercise, your doctor may prescribe insulin, metformin, or other medication.  Prescribed GDM medications do not adversely affect baby’s health.

Your doctor will continue to monitor your blood sugar through 6 to 12 weeks post-partum.

Optimizing Your Health after GDM

While mothers diagnosed with GDM during pregnancy face increased risk of developing the condition with subsequent pregnancies, as well as obesity and Type 2 diabetes later in life, there are a variety of lifestyle changes that can be implemented in order to prevent such conditions.

Achieving and maintaining a healthy body weight post-pregnancy, committing to healthy nutrition, and engaging in an active lifestyle are all important components of optimal health after GDM.

Talk to your Capital Women’s Care team  about your family history and your pregnancy to institute a sound, personalized care plan to monitor you and your baby’s health.

Our Mission

The providers of Capital Women's Care seek the highest quality medical and ethical standard in an environment that nurtures the spirit of caring for every woman.

 

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