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Gestational diabetes is defined as glucose intolerance during pregnancy. During your pregnancy, hormonal changes can cause your body to be less sensitive to the effect of insulin. These changes can lead to high blood sugar and diabetes. High blood sugar levels in pregnancy are dangerous for both mother and baby.
Between weeks 24 and 28 of pregnancy, almost all pregnant women are screened for glucose intolerance. If you have risk factors for diabetes (like being overweight, family history of diabetes, or some sugar in your urine), you will be screened sooner. After drinking or eating 50 grams of glucose, a blood test is done. If your blood sugar level is less than 130 to 140, it is considered normal.
If your level is higher than 130 to 140, a more complete test is done before a diagnosis of gestational diabetes is made. You will be given directions to follow. The diagnosis is made if 2 out of the 4 blood sugar readings on this next test are high.
If you have gestational diabetes, the steps listed here will help you control the disease:
- Meet with a registered dietitian who is expert in diabetes.
- Learn how to check your blood sugar levels with a glucose meter.
- Check your sugar levels fasting and 1 to 2 hours after each meal.
- Check your urine for ketones to be sure you are getting enough calories and carbohydrates.
- Follow a meal plan that has the right balance of protein, carbohydrates, and fat.
- Eat 5 to 6 smaller meals rather than 2 to 3 larger ones.
- Include a bedtime snack in your meal plan.
- Monitor weight gain, which is a key component of pregnancy care whether you are glucose intolerant or not, but especially important if you are.
Many women are frightened and upset when they learn about their diagnosis. After the initial shock wears off, most report improving their diet and increasing their exercise level.
Some women may need to treat gestational diabetes with insulin to control blood glucose levels and avoid complications for the fetus. Regular ultrasounds, especially early in the third trimester of pregnancy, will help your doctor decide if insulin is necessary. Your doctor or diabetes educator will teach you the required techniques for using insulin and should provide good support.
Gestational diabetes usually disappears with the end of the pregnancy. You should be checked by your doctor 6 weeks or longer after delivery. However, if you have had gestational diabetes, you are at greater risk for developing diabetes later in your life.
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Reviewed By: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Boston, MA, Senior Medical Editor, A.D.A.M., and Meryl Lindenberg, MS, RD, CDE, LD, Cardiovascular Health Center and Diabetes Management Program, Newton-Wellesley Hospital, Boston, MA.
