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Pregnancy and
gestational diabetes
Gestational diabetes develops during pregnancy (gestation). Like other
types of diabetes, gestational diabetes affects how your cells use sugar
(glucose). Gestational diabetes causes high blood sugar that can affect
your pregnancy and your baby's health.
Any pregnancy complication is concerning, but there's
good news. Expectant moms can help control gestational
diabetes by eating healthy foods, exercising and, if
necessary, taking medication. Controlling blood sugar
can prevent a difficult birth and keep you and your
baby healthy. In gestational diabetes, blood
sugar usually returns to normal soon after
delivery. But if you've had gestational
diabetes, you're at risk for type 2
diabetes. You'll continue
working with your health care
team to monitor and
manage your blood
sugar.
Symtoms
For most women, gestational diabetes doesn't cause
noticeable signs or symptoms.
Risk factors
Any woman can develop gestational diabetes, but
previous pregnancy, if you delivered a baby who
some women are at greater risk. Risk factors for
weighed more than 4.1 kilograms, or if you had an
gestational diabetes include:
•
•
Age greater than 25. Women older than age 25
unexplained stillbirth.
•
Excess weight. You're more likely to develop
are more likely to develop gestational diabetes.
gestational
Family or personal health history. Your risk of
overweight with a body mass index (BMI) of 30 or
developing gestational diabetes increases if you
higher.
have prediabetes — slightly elevated blood sugar
that may be a precursor to type 2 diabetes — or if
a close family member, such as a parent or sibling,
has type 2 diabetes. You're also more likely to
develop gestational diabetes if you had it during a
diabetes
if
you're
significantly
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Causes
Researchers don't know why some women develop
gestational diabetes. To understand how
gestational diabetes occurs, it can help to
understand how pregnancy affects your body's
glucose processing. Your body digests the food
you eat to produce sugar (glucose) that enters your
bloodstream. In response, your pancreas — a large
gland behind your stomach — produces insulin.
Insulin is a hormone that helps glucose move from
your bloodstream into your body's cells, where it's
used as energy.
During pregnancy, the placenta, which connects
your baby to your blood supply, produces high
levels of various other hormones. Almost all of
them impair the action of insulin in your cells,
raising your blood sugar. Modest elevation of
blood sugar after meals is normal during
pregnancy.
As your baby grows, the placenta produces more
and more insulin-blocking hormones. In gestational
diabetes, the placental hormones provoke a rise in
blood sugar to a level that can affect the growth and
welfare of your baby. Gestational diabetes usually
develops during the last half of pregnancy —
sometimes as early as the 20th week, but generally
not until later.
Complications
Most women who have gestational diabetes deliver
healthy babies. However, gestational diabetes that's
not carefully managed can lead to uncontrolled
blood sugar levels and cause problems for you and
your baby, including an increased likelihood of
needing a C-section to deliver.
Complications that may affect your
baby
If you have gestational diabetes, your baby may be at
increased risk of:
• Excessive birth weight. Extra glucose in your
bloodstream crosses the placenta, which triggers
your baby's pancreas to make extra insulin.
This can cause your baby to grow too large
(macrosomia). Very large babies — those that
weigh 4.5kg or more — are more likely to
become wedged in the birth canal, sustain birth
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•
•
•
injuries or require a C-section birth.
Early (preterm) birth and respiratory distress
syndrome. A mother's high blood sugar may
increase her risk of early labour and delivering
her baby before its due date. Or her healthcare
provider may recommend early delivery because
the baby is large. Babies born early may
experience respiratory distress syndrome — a
condition that makes breathing difficult. Babies
with this syndrome may need help breathing
until their lungs mature and become stronger.
Babies of mothers with gestational diabetes may
experience respiratory distress syndrome even if
they're not born early.
Low blood sugar (hypoglycemia). Sometimes
babies of mothers with gestational diabetes
develop low blood sugar (hypoglycemia)
shortly after birth because their own insulin
production is high. Severe episodes of
hypoglycemia may provoke seizures in the
baby. Prompt feedings and sometimes an
intravenous glucose solution can return the
baby's blood sugar level to normal.
Type 2 diabetes later in life. Babies of mothers
who have gestational diabetes have a higher risk
of developing obesity and type 2 diabetes later
in life.
Untreated gestational diabetes can result in a baby's
death either before or shortly after birth.
Complications that may affect you
Gestational diabetes may also increase the
mother's risk of:
• High blood pressure and preeclampsia.
Gestational diabetes raises your risk of high
blood pressure, as well as, preeclampsia — a
serious complication of pregnancy that causes
high blood pressure and other symptoms that
can threaten the lives of both mother and baby.
•
Future diabetes. If you have gestational
diabetes, you're more likely to get it again
during a future pregnancy. You're also more
likely to develop type 2 diabetes as you get
older. However, making healthy lifestyle
choices such as eating healthy foods and
exercising can help reduce the risk of future
type 2 diabetes.
Of those women with a history of gestational
diabetes who reach their ideal body weight after
delivery, fewer than 1 in 4 eventually develops type
2 diabetes.
Preparing for your appointment
In most circumstances, you'll learn you have
gestational diabetes as the result of routine
screening during your pregnancy. If your blood
sugar tests high, you'll likely be asked to come in
for an appointment promptly. You'll also have
more-frequent regular pre-natal appointments to
monitor the course of your pregnancy. Here's some
information to help you get ready for your
appointment and know what to expect from your
healthcare provider.
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What you can do
•
•
•
•
•
Be aware of pre-appointment restrictions.
When you make your appointment, ask if
you need to fast for blood work or do
anything else to prepare for diagnostic tests.
Write down symptoms you're having,
including those that may seem unrelated to
gestational diabetes. You may not have
noticeable symptoms, but it's good to keep
a log of anything unusual you notice.
Write down key personal information,
including major stresses or recent life
changes.
Make a list of all medications, including
over-the-counter drugs and vitamins or
supplements you're taking.
Take a family member or friend along, if
possible. Someone who accompanies you
may remember something that you missed
or forgot.
Questions to ask your healthcare
provider
Make a list of questions to help make
the most of your time with your
healthcare provider. For gestational
diabetes, some basic questions to ask
your healthcare provider include:
• What can I do to help control my condition?
• Can you recommend a dietitian who can
help me plan meals, an exercise programme,
and coping strategies?
• What will determine whether I need medication
to control my blood sugar?
• What symptoms should prompt me to seek
medical attention?
Don't hesitate to ask other questions.
What to expect from your healthcare
provider
You can take steps to control gestational diabetes as
soon as you're diagnosed. If your healthcare provider
recommends further evaluation, make your follow-up
appointments as soon as possible. Every week
counts for you and your baby.
Follow your healthcare providers advice, and take
good care of yourself. Eat healthy foods, exercise and
learn as much as you can about gestational diabetes.
As a Platinum Health member you
have the benefit of consulting with a
healthcare provider who will assist
you with making the right choices
during your pregnancy. For more
information, kindly contact the
Platinum Health Client Liaison
department on 014 591 6600.