What is gestational diabetes? A Gestational diabetes It is a type of diabetes that develops or is first diagnosed during pregnancy. The condition, like other forms of diabetes, involves high blood sugar levels.
Gestational diabetes is often a temporary disorder that occurs around the second trimester of pregnancy and disappears after a woman gives birth.
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Women who have had gestational diabetes should be closely monitored after birth because they are more likely to develop diabetes later in life, according to the National Institutes of Health (NIH).
A 2014 study by the US Centers for Disease Control and Prevention found that between 4 and 9 percent of pregnant women develop gestational diabetes. Gestational diabetes occurs more frequently among certain ethnic groups, including African Americans, Hispanics, American Indians and Asians, according to the March of Dimes.
Women with gestational diabetes usually have no symptoms or mild, non-life-threatening symptoms, according to the NIH.
These symptoms are mostly related to abnormal blood sugar levels and can include fatigue, excessive thirst and increased urination.
During pregnancy, changes happen in the mother's body to make sugar more available to the fetus, said Dr. Christopher Glantz, professor of obstetrics and gynecology at the University of Rochester Medical Center.
One such change is that the placenta produces hormones that interfere with the action of insulin, a hormone that helps sugar (or glucose) move out of the bloodstream into cells.
This means that the sugar in the mother's bloodstream is less able to get into her own cells, leading to a rise in blood sugar. Normally, the fetus absorbs this extra sugar, so the net result is typically a decline in women's blood sugar, Glantz said.
However, in some women, the placenta can excrete too much of the insulin-blocking hormones, leading to an increase in the mother's blood sugar. If blood sugar levels rise to an abnormally high level, this is considered gestational diabetes.
Some women may have pre-diabetes before becoming pregnant (for example, because they are overweight or obese, which which is a risk factor for the disease), and pregnancy exacerbates the condition, leading to gestational diabetes, he said. Glantz. Other women may have undiagnosed diabetes before becoming pregnant and are diagnosed during pregnancy.
Changes in the levels of the hormones estrogen and progesterone during pregnancy can further disrupt the balance of glucose and insulin in the body.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), risk factors for gestational diabetes include:
Tests for gestational diabetes are usually done around 24 to 28 weeks of pregnancy, according to the NIH. Some women may be tested early in pregnancy if they are at increased risk of gestational diabetes.
Women may undergo a glucose test, in which they drink a sugar solution, and their blood sugar level is tested an hour later. If the woman's blood sugar level is higher than normal, they may need to undergo a second test.
Abnormally high blood glucose levels — or hyperglycemia — can result in more glucose being delivered to the fetus, leading to overgrowth, according to the CDC. If gestational diabetes is left untreated, the baby is more likely to be born too large, according to the March of Dimes.
Even if gestational diabetes goes away after the baby is born, women with the condition have up to a 60% higher risk of developing type 2 diabetes later in life, according to the Cleveland Clinic.
The first step in managing gestational diabetes is to have the patient visit a nutritionist to see if your diet can be modified to lower blood sugar levels, Glantz said. Regular physical activity can also help control blood sugar levels.
If a patient is not able to control their blood sugar levels with diet and exercise alone, women may need to taking medications to lower blood sugar levels, and in some cases, daily insulin injections are needed, he said Glantz.
Women planning to become pregnant can reduce their risk of developing gestational diabetes by losing excess weight and increasing physical activity levels before becoming pregnant, says the NIH.
Once a woman becomes pregnant, she should not try to lose weight, as gaining some weight is necessary for a healthy pregnancy. However, gaining too much weight during pregnancy also increases a woman's risk of gestational diabetes. That's why women should speak with their doctor about how much weight to gain during pregnancy.
A study published in September 2018 in the American Journal of Preventive Medicine suggested that women who are overweight or obese women can safely restrict their pregnancy weight gain with the help of counseling nutritional.
Women who already had gestational diabetes during pregnancy may reduce their risk of developing type 2 diabetes eating a healthy diet (high-fiber foods that are low in fat and calories) and staying physically fit active.