Gestational diabetes is a type of diabetes that develops during pregnancy. If a pregnant woman has never had diabetes before pregnancy, but experiences high blood glucose levels during pregnancy, she will be diagnosed with gestational diabetes.
How does someone get gestational diabetes?
Researchers are still uncertain as to what causes gestational diabetes, but it is very likely that the condition has to do with pregnancy hormones. During pregnancy, the placenta produces very high levels of pregnancy hormones. These hormones can inhibit the response of the mother’s insulin, the substance which takes glucose out of the blood stream and uses it for energy. This creates insulin resistance in the mother, which results in high levels of glucose in the blood (hyperglycemia). Hyperglycemia during pregnancy can affect the health and growth of the fetus. It can cause the baby to grow too large for a safe vaginal delivery and can increase the risk of shoulder dystocia. After birth, the baby can experience neonatal hypoglycemia as a result of high levels of insulin in his or her body.
Who is at risk for gestational diabetes?
All women should be tested for gestational diabetes during pregnancy, but there are specific risk factors that make certain women more likely to develop the condition.
Risk factors for gestational diabetes include:
- Age: Women over the age of 35 (this is considered “advanced maternal age“) have a higher risk of developing gestational diabetes.
- Weight: Women who are overweight (have a BMI of 30 or more) going into their pregnancy have a higher risk of developing gestational diabetes.
- Personal history: Women who have had gestational diabetes during previous pregnancies have a higher risk of developing it again in later pregnancies. Women who delivered babies that were over 9 pounds or had unexplained stillbirths previously may also be at a higher risk of gestational diabetes.
- Genetics: Women who have a family history of diabetes have a higher risk of developing gestational diabetes.
- Race: Native American, Hispanic, Asian, and African-American women are more likely to be diagnosed with gestational diabetes.
- Abdominal fat content: Women with more abdominal fat during the first trimester of pregnancy are more likely to develop gestational diabetes later on in that pregnancy.
- Pre-diabetes diagnosis: Women who are informed that their glucose levels are high before pregnancy are at a higher risk of developing gestational diabetes during that pregnancy.
- Bed rest: Women who have been put on bed rest by their doctors are more likely to put on excessive pregnancy weight. Thus, these women are at a higher risk of developing gestational diabetes.
When is gestational diabetes diagnosed?
If a woman is at high risk for gestational diabetes, her doctor may choose to test for the disease at one of her first prenatal visits. If a woman is at average risk of developing gestational diabetes, she will likely be given a glucose test between 24 and 28 weeks of pregnancy. The U.S. government recommends that all pregnant women be screened for gestational diabetes around week 28 of pregnancy.
The diagnosis of gestational diabetes involves one glucose challenge test to measure blood sugar levels. If the blood sugar level is higher than normal, this means the woman is at higher risk of having gestational diabetes. In order to know for sure if the woman has gestational diabetes, the doctor will then administer a glucose tolerance test. Only this specific test can confirm gestational diabetes.
How common is gestational diabetes?
According to the Center for Disease Control and Prevention, gestational diabetes is found in nearly 9.2% of pregnant women across America.
Does a gestational diabetes diagnosis mean that my pregnancy is high-risk?
If a patient is diagnosed with gestational diabetes, the doctor will likely recommend frequent check-ups to monitor the patient’s blood sugar during the last three months of pregnancy. According to What to Expect: Having a High Risk Pregnancy, a diagnosis of gestational diabetes means that the patient has a high-risk pregnancy. High-risk pregnancy does not necessarily mean that the patient will absolutely have complications with the pregnancy and delivery, but it does mean that the patient may have a higher chance of having complications. Therefore, her doctor will need to monitor her more carefully and deliver the baby in a well-equipped hospital to prevent adverse outcomes.
How can gestational diabetes affect the birth and the new baby?
With regular monitoring and proper treatment from a doctor, women with gestational diabetes can have healthy pregnancies. If left untreated (and sometimes even with proper treatment), however, gestational diabetes can cause serious complications for mother and baby:
- Preeclampsia: Mothers with gestational diabetes are at a higher risk of developing preeclampsia, or pregnancy-induced hypertension (high blood pressure). Preeclampsia can cause many serious complications for mother and child, including placental abruption, preterm delivery, intrauterine growth restriction (IUGR), and more. It can also lead to eclampsia in the mother, which is preeclampsia with accompanying seizures. This condition is life-threatening and requires immediate delivery, no matter how far along the pregnancy is. Preeclampsia can also lead to problems for a baby after birth, including low blood sugar levels, jaundice, and breathing difficulties.
- Macrosomia: Babies experiencing uncontrolled gestational diabetes can develop a condition called fetal macrosomia, in which they grow too large. Macrosomia makes vaginal deliveries challenging because it can cause the baby to sustain birth injuries, cause the baby to become stuck in the birth canal, or require the use of forceps or a vacuum extractor. It leads to an increased risk of oxygen deprivation (hypoxic-ischemic encephalopathy/HIE) and fetal trauma. To avoid these complications, a c-section delivery may be implemented. Macrosomia can also lead to low blood sugar levels and a higher risk of breathing problems for baby at birth. This also increases a baby’s risk of developing type 2 diabetes and obesity down the road.
How is gestational diabetes treated?
If controlled, gestational diabetes can often lead to a healthy pregnancy. Your doctor is responsible for monitoring your gestational diabetes and instructing you as to how to control it. He or she will likely implement the following tools to monitor your gestational diabetes:
- Monitoring blood sugar: Your doctor will likely take your blood sugar during your office visits and a health care team will measure and monitor your blood sugar during labor and delivery. Your doctor may ask that you monitor your own blood sugar at home during the months before delivery, which can be done using home testing tools provided by medical staff.
- Diet and exercise instructions: Your doctor might offer advice on how to improve your diet and exercise routines to assist with maintaining a normal blood sugar. You may be referred to consult with a dietician during your pregnancy.
- Monitoring your baby’s growth: Your doctor will likely monitor your baby’s growth and development with ultrasounds or other tests at your prenatal visits. If you don’t go into labor by your due date, your doctor may induce labor to keep the baby from getting too large.
- Medication: If diet and exercise aren’t enough, your doctor may suggest insulin injections or oral blood sugar control medication to lower blood sugar.
Trusted Legal Help for Gestational Diabetes
Children with birth injuries often go on to require extensive care resources for the remainder of their lives. If you or a loved one experienced injuries, you may be eligible for compensation from a birth trauma suit. We encourage you to reach out to our team of attorneys for a free legal consultation to determine if medical malpractice caused your loved one’s injuries. At Reiter & Walsh ABC Law Centers, we handle 100% birth trauma cases, and many of our cases have involved gestational diabetes injuries. Contact us today for your free case review:
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Learn More about Gestational Diabetes:
- American Diabetes Association: What is Gestational Diabetes?
- What to Expect: Gestational Diabetes During Pregnancy
- Center for Disease Control and Prevention: Diabetes and Pregnancy PDF
- Center for Disease Control and Prevention: Prevalence Estimates of Gestational Diabetes Mellitus in the United States
- Center for Disease Control and Prevention: Gestational Diabetes and Pregnancy
- Mayo Clinic: Gestational Diabetes
- What to Expect: Having a High Risk Pregnancy
- American Pregnancy Association: Diabetes During Pregnancy
- Mayo Clinic: Fetal Macrosomia