Gestational Diabetes And Health After Pregnancy

Gestational diabetes is a type of diabetes that develops during pregnancy in a woman who has not previously been diagnosed with diabetes. The condition is fairly common: the CDC estimates that every year, between 2% and 10% of U.S. pregnancies are affected by gestational diabetes, which often develops late in the second or in the third trimesters..

What Causes Gestational Diabetes?

When a woman develops high blood sugar during pregnancy, it is known as gestational diabetes.

"Gestational diabetes happens when the expectant mother's body is not using its own insulin effectively, efficiently or properly," explained Alexis Harper, APN, an advanced practice nurse in endocrinology with Franciscan Health Olympia Fields.

This change results from normal hormonal changes related to pregnancy.

“During the last trimester of pregnancy, your body needs two to three times more insulin than normal, and for women with gestational diabetes, their pancreas cannot keep up with this need,” said Amanda Crosby, RD, LD, CDCES, a dietitian and certified diabetes educator at Franciscan Healthy Living Center Lafayette.

What Are Symptoms Of Gestational Diabetes?

Gestational diabetes typically doesn’t cause any obvious symptoms, though some women may notice increased thirst or urination.

If your blood sugar is high, however, you may experience these signs of gestational diabetes:

• Frequent urination
• More hungry or thirsty than normal
• Blurred vision
• Nausea or vomiting
• Losing weight even though eating more

Am I At Risk Of Gestational Diabetes?

Certain risk factors put women at risk for gestational diabetes during pregnancy:

• Being overweight or obese
• A family history of diabetes
• Having given birth previously to an infant weighing greater than 9 pounds
• Age over 25
• Race (women who are American Indian, Asian American, African-American, Hispanic or Latino, or Pacific Islander have a higher risk)
• Having prediabetes, also known as impaired glucose tolerance

How Is Gestational Diabetes Diagnosed?

OBGYNs routinely screen all expectant mothers for gestational diabetes between weeks 24 and 28 of their pregnancy. This is part of standard prenatal care. However, gestational diabetes can be diagnosed as late as the 40th week of pregnancy.

Health care providers conduct two types of glucose tests during pregnancy to check for gestational diabetes.

The initial glucose challenge test is scheduled during the second trimester. During this test, mothers-to-be drink a glucose solution and have their blood sugar level measured one hour later using a blood test.

A second screening is ordered if the first test's blood sugar level measures higher than normal. A glucose tolerance test or three-hour glucose test, is ordered for confirmation. This test is more comprehensive, involving multiple blood draws at specific intervals. Additionally, it requires women to fast for several hours beforehand to ensure accurate results. If blood sugar results remain higher than normal during this longer test, doctors will diagnose the mom-to-be as having gestational diabetes.

Is Gestational Diabetes Bad For The Baby?

Gestational diabetes, if unmonitored or untreated, can lead to excessive birth weight or preterm labor for the newborn and, in severe cases, even stillbirth.

“If a baby gets too much glucose from the mother’s elevated glucose, they run the risk of being born large for gestational age (more than 8 lbs 13 oz.), developing hypoglycemia – a condition marked by low blood sugar – or they could require a NICU stay,” Crosby said. “An elevated birth weight for the baby could also lead to problems during labor, leading to a C-section,” she adds.

How Does Gestational Diabetes Hurt The Mother's Health?

Gestational diabetes can cause an elevated risk for high blood pressure or preeclampsia in the mother – a potentially life-threatening pregnancy complication.

"The mother, if she has gestational diabetes, has a 50% higher risk of developing regular type 2 diabetes later in life," said Milli Jain Gupta MD, a board-certified endocrinologist who and practices at Franciscan Physician Network in Munster, Ind. "So, all of that needs to be caught in time and treated, and there's value in that."

How Do You Manage Gestational Diabetes?

Expectant mothers with gestational diabetes often can manage their condition by adding doctor-approved, moderate exercises and a well-balanced diet rich in fresh fruits and vegetables and low in fat and sugar, with the goal of maintaining blood sugar levels during pregnancy.

"So long as you have clearance from your OBGYN, even moderate exercise  - such as simply walking - can help naturally lower insulin resistance," Harper said.

Expectant moms diagnosed with gestational diabetes should prioritize good nutritional choices for the benefit of their health and the health of their baby.

“A healthy eating plan includes fruits, vegetables, whole grains (oatmeal, quinoa, brown rice, barley, whole grain bread, etc.), low-fat dairy, nuts, and lean meats,” Crosby said.

Women with gestational diabetes should limit their intake of processed foods, sugary beverages and foods, and fried foods.

To help maintain a healthy glucose level, women diagnosed with gestational diabetes should eat something every 2-5 hours, aiming for at least three meals per day and a snack between meals if they feel hungry.

It’s a good idea to prep small snacks of proteins or veggies to avoid the temptation of grabbing bags of chips or sweets when days get too busy.

Examples of healthy snacks include:

• An apple with peanut butter
• Clementine oranges and nuts
• A small, 6-inch quesadilla
• Crackers and cheese
• Yogurt and berries
• Pita chips and hummus
• Popcorn

While planning a daily diet, be especially mindful of carbohydrate intake – since eating too many at once could cause a spike in blood sugar.

“Ideally, pregnant women should try to limit their carbohydrate intake to 170 grams/daily, spread out evenly throughout the day,” Crosby said.

To avoid a spike in glucose levels in the morning, women should plan to eat a bedtime snack of around 30 grams of carbohydrates. “The liver can release stored glucose levels while you sleep and cause elevations in the morning. Most moms find that eating a bedtime snack helps prevent this,” Crosby explained.

Insulin injections may be necessary if diet and exercise alone can't control your blood sugar levels. While most women with gestational diabetes can manage with other methods, a small percentage may require insulin to achieve their blood sugar goals. Consistency in taking insulin as directed by your primary care physician or ob-gyn ensures appropriate blood sugar regulation, reducing the risk of complications and promoting a healthier pregnancy.

How Do I Monitor Gestational Diabetes?

Mothers-to-be with gestational diabetes are shown how to screen their blood sugar levels at home multiple times a day using fingerstick tests or a continuous blood glucose monitoring system. By monitoring frequently, expectant moms can feel confident their blood sugar levels are staying within safe levels - both for their well-being and their baby's.

Does Gestational Diabetes Go Away?

Most cases of gestational diabetes resolve on their own following labor and delivery.

"In a high percentage of cases - perhaps 80 to 90 percent of cases - gestational diabetes will go away after childbirth," Harper said.

New mothers diagnosed with gestational diabetes during pregnancy will likely require follow-up blood glucose screening roughly eight to 12 weeks after labor and delivery to verify that their blood sugar levels have returned to normal ranges.

If a new mother's gestational diabetes does not resolve following childbirth, this will lead to a diagnosis of Type 2 diabetes - followed by long-term interventions and treatments as needed. For new nursing mothers, doctors can prescribe diabetes management medications that are safe to use even while breastfeeding.

Can I Get Gestational Diabetes In Future Pregnancies?

Women who have had gestational diabetes have an increased risk of developing gestational diabetes again with future pregnancies, Harper said. In some instances, doctors may recommend that women with previous cases of gestational diabetes plan to screen for the condition earlier than 24 weeks in subsequent pregnancies.

How Can I Reduce The Risk Of Type 2 Diabetes?

About 50% of women diagnosed with gestational diabetes are at risk of developing type 2 diabetes later on. You can reduce this risk by achieving a healthy body weight after delivery. Proactive monitoring and maintaining a healthy lifestyle can play a vital role in preventing future complications.

While this statistic may sound discouraging, women can reduce the risk of diabetes onset by prioritizing long-term, healthy weight management, eating well and getting adequate exercise in the months and years following their baby's birth.

Get Help From A Diabetes Educator

If you’re diagnosed with gestational diabetes, make plans to talk with a diabetes educator who can help you create a care strategy that includes learning how to check your glucose, developing a tailored meal plan, and creating a physical activity schedule to keep your blood sugar levels in check to protect your health – and the health of your growing baby.

“Meeting with a diabetes educator will help you learn the tips and tools to confidently manage this new condition,” Crosby said.