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Gestational diabetes is a form of diabetes that occurs for the first time when a woman is pregnant. This type of diabetes is caused by a change in the way a woman's body responds to the hormone insulin during her pregnancy. This change results in elevated levels of blood sugar, also known as blood glucose.
Gestational diabetes develops in about 2% to 10% of pregnancies in the United States every year. It is important to diagnose and treat gestational diabetes to avoid health complications for you and your baby.
Being healthy prior to becoming pregnant decreases a woman’s chance of developing gestational diabetes. This includes achieving and maintaining a healthy pre-pregnancy weight.
Signs and symptoms can include:
- Glucose (sugar) in urine (revealed in a test done in your doctor’s office)
- Unusual thirst
- Frequent urination
- Frequent infections of bladder, vagina, and skin
- Blurred vision
What are the risk factors?
The risk factors commonly associated with an increased chance of developing gestational diabetes include:
- Having a history of gestational diabetes in previous pregnancies
- Being overweight or obese
- Being older than 25 years
- Having a family history of diabetes (especially if a parent or sibling has diabetes)
- If you previously delivered a baby weighing more than 9 pounds
- Having glucose in your urine
- Being African-American, Hispanic, Native American or Asian
- Having "prediabetes," also known as impaired glucose tolerance
How do I know if I have gestational diabetes?
If you are at high risk for developing gestational diabetes, your blood glucose levels will likely be checked at your first prenatal visit. The American Diabetes Association recommends screening for gestational diabetes at the first prenatal visit for women with known risk factors.
If your blood glucose results are normal, your levels will be checked again between the 24th and 28th weeks of your pregnancy. It is recommended that all pregnant women be screened for gestational diabetes at that time.
What happens at a screening?
To screen for gestational diabetes, your doctor will order a glucose challenge test or glucose screening test. This test requires you to drink a sweet liquid and then have your blood drawn an hour after drinking the liquid. No fasting is required for this test. If the results are normal, no other tests are done.
If the results are positive, some doctors may order another test called an oral glucose tolerance test. This test is conducted by measuring your fasting blood glucose level, then after drinking a glucose drink your blood will be measured every hour for two to three hours. High blood glucose levels at any two or more blood test times means you have gestational diabetes.
If the results are positive, your doctor will recommend a treatment plan. Treating and managing gestational diabetes is critical to your health and your baby's health.
What effect can gestational diabetes have?
- Increased chances of delivering a baby weighing more than 9 pounds (putting infants at risk of birth injury due to large size)
- Increased need for a cesarean section
- Increased risk to the mother of hypertension and preeclampsia
- Increased risk to the mother of developing type 2 diabetes later in life
Treating Gestational Diabetes
Effectively managing and treating gestational diabetes can significantly reduce the likelihood of complications. Typically, gestational diabetes is treated and managed through daily blood glucose monitoring and by making dietary changes to help keep your blood glucose levels within the normal range. Some doctors may also recommend an exercise regimen.
Sometimes, when dietary changes do not control the blood glucose levels, you may need to start insulin therapy or take other medications. Your physician will determine the best treatment plan for your gestational diabetes, including how often per day you should check your blood glucose levels.
Your physician and pharmacist can teach you how to monitor your blood glucose levels at home, how to use the recommended blood glucose meter and how to give yourself insulin injections if needed.
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