Am I at Risk of Gestational Diabetes?

Prenatal appointments and tests allow your doctor to keep a close eye on you and your baby’s health throughout your pregnancy. One important test you can expect is a glucose challenge test to screen for gestational diabetes. This common pregnancy complication can have potentially serious consequences for you and your baby. Early detection is critical.

If you’re newly pregnant or considering pregnancy, you may wonder what causes gestational diabetes and if you are at risk. Keep reading to learn more about this condition, the risk factors, and what to do if you develop gestational diabetes.

What Is Gestational Diabetes?

Gestational diabetes is a form of diabetes that can happen during pregnancy, usually around the 24th week. It develops when your body doesn’t produce enough insulin, the hormone that regulates blood sugar.

Insulin moves sugar (glucose) from your blood into your cells. Without adequate insulin, too much sugar stays in your blood.

High blood sugar is dangerous for you and your baby. Gestational diabetes increases your baby’s risk of:

  • A large birth weight (over nine pounds), making delivery more difficult.
  • Low blood sugar.
  • Obesity and diabetes later in life.
  • Premature birth, with a greater risk that their lungs or other organs aren’t fully developed.
  • Stillbirth. This is when a baby dies after 20 weeks of pregnancy.

This condition also puts you at risk for:

  • A cesarean section, which has a longer recovery time compared to a vaginal delivery.
  • Preeclampsia, a serious type of high blood pressure that may lead to kidney, liver, or brain damage.
  • Type 2 diabetes later in life.

Doctors screen all pregnant women for gestational diabetes by doing a blood glucose challenge test between 24 and 28 weeks of pregnancy. With this test, you’ll drink a sugary drink and have your blood drawn after one hour.

If your blood sugar is high, your health care provider may order a follow-up blood test to confirm gestational diabetes.

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Symptoms of Gestational Diabetes

Most of the time, gestational diabetes doesn’t cause symptoms unless your blood sugar is very high. In that case, you might notice these symptoms:

  • Hungrier or thirstier than usual.
  • Blurred vision.
  • Nausea or vomiting.
  • Losing weight without trying.
  • Urinating more frequently than usual.

What Causes Gestational Diabetes?

Pregnancy hormones cause most women to develop insulin resistance during the later part of pregnancy. Insulin resistance means your cells can’t use insulin properly; it’s an early warning sign of diabetes. Most pregnant women can produce extra insulin to compensate, and they don’t develop gestational diabetes.

However, in about two to 10% of pregnancies, a woman’s body can’t make enough insulin, and blood sugar remains high. It’s impossible to predict who will develop gestational diabetes, but these factors increase your risk:

  • Being older than 25.
  • Being overweight (a BMI over 25).
  • Having a family history of diabetes.
  • Having polycystic ovarian syndrome (PCOS).
  • Having prediabetes (an A1C greater than 5.7).
  • A history of heart disease or metabolic syndrome (high triglycerides, low HDL cholesterol, and high blood pressure).
  • A prior history of gestational diabetes.
  • A sedentary lifestyle without regular exercise.

Tell your doctor if you have one or more of these risk factors. They may wish to screen you earlier in your pregnancy.

Can I Reduce My Risk of Gestational Diabetes?

You can’t change certain risk factors like your age or family history of diabetes. But you can reduce other gestational diabetes risks, like being overweight or too sedentary.

It’s best to develop healthy habits before you get pregnant and continue them throughout your pregnancy. These tips can help:

  • Aim for a healthy weight. Try to lose excess weight before you become pregnant by reducing sugary foods and beverages, fast foods, and packaged snacks.
  • Get at least 30 minutes of moderate exercise most days by walking, swimming, or doing other physical activities you enjoy.
  • Include more plant foods in your diet. They are high in fiber and can promote healthier blood sugar and weight.
  • Make sleep a priority. Aim for seven to nine hours of quality sleep each night. It helps balance insulin and other hormone levels.
  • Take medications as recommended to maintain good health.

Pregnancy weight gain and gestational diabetes

Although being overweight can increase your risk of gestational diabetes, you shouldn’t try to lose weight during pregnancy. Your baby needs a healthy diet with ample calories to grow and develop normally. To provide enough nutrients for your baby, you should eat:

  • About 300 calories more each day during the second trimester.
  • About 450 extra calories during the third trimester.

If you diet or restrict calories while pregnant, your baby may have a low birth weight. That can increase their risk of illnesses and developmental delays.

Ask your doctor about your weight gain goals from week to week and throughout your pregnancy. Most doctors recommend gaining at least 15 pounds, even if you’re overweight at the start of your pregnancy.

Treatments for Gestational Diabetes

If blood tests show gestational diabetes, your health care provider will refer you to a diabetes educator. They’ll teach you how to check your blood sugar and plan healthy meals and snacks. Your health care team will also closely watch you and your baby to ensure you both stay healthy.

Getting a gestational diabetes diagnosis is scary and can feel overwhelming. But, it’s important to know that many people can manage the condition with diet and lifestyle changes during pregnancy.

Eating a healthy diet and exercising more are key to managing gestational diabetes. You’ll also learn how to count carbohydrate grams at each meal and snack, if necessary.

These things can promote a healthy blood sugar:

  • Choose more high-fiber foods, like whole grains, nuts, seeds, fruits, vegetables, and beans throughout the day.
  • Limit foods with added sugar, like candy, desserts, and sweetened soft drinks.
  • Limit refined carbohydrates like pasta, white bread, and white rice.
  • Time your meals and snacks, so you eat every three to four hours.
  • Walk or do other forms of moderate exercise each day.

If these things alone aren’t effective at keeping your blood sugar within your target range, your doctor may recommend insulin injections.

Your Future Health

Gestational diabetes goes away after your baby arrives. But it increases your risk of developing type 2 diabetes later in life.

Follow up with your doctor after you deliver your baby and have annual wellness checkups. That allows your health care provider to monitor your blood sugar and prescribe medication, if needed, to prevent diabetes.

Eating well, exercising, and maintaining a healthy weight can also significantly reduce your risk of diabetes. Talk to your doctor if you need education or support.

National Institute of Diabetes and Digestive and Kidney Diseases. Gestational Diabetes. LINK.

StatPearls Publishing. Gestational Diabetes. LINK

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.