Gestational Diabetes

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When you are pregnant, high blood sugar levels are not good for your baby.

About seven out of every 100 pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the first time when a woman is pregnant. Most of the time, it goes away after you have your baby. But it does increase your risk for developing type 2 diabetes later on. Your child is also at risk for obesity and type 2 diabetes.

Most women get a test to check for diabetes during their second trimester of pregnancy. Women at higher risk may get a test earlier.

If you already have diabetes, the best time to control your blood sugar is before you get pregnant. High blood sugar levels can be harmful to your baby during the first weeks of pregnancy – even before you know you are pregnant. To keep you and your baby healthy, it is important to keep your blood sugar as close to normal as possible before and during pregnancy.

Prevention

Either type of diabetes during pregnancy increases the chances of problems for you and your baby. To help lower the chances talk to your health care team about:

• A meal plan for your pregnancy
• A safe exercise plan
• How often to test your blood sugar
• Taking your medicine as prescribed. Your medicine plan may need to change during pregnancy.

Diagnosis

• Get tested for diabetes 6 to 12 weeks after your baby is born. If the test is normal, get tested every 3 years. If the test results show that your blood sugar (glucose) is higher than normal but not high enough to be diabetes, also called prediabetes, get tested for diabetes every year.
• Talk to your doctor about your test results and what you can do to stay healthy.
• If your test results show that you could get diabetes and you are overweight, ask your doctor about what changes you can make to lose weight and for help in making them. You may need to take medicine such as metformin to help prevent type 2 diabetes.

Treatment

Because gestational diabetes can hurt you and your baby, you need to start treatment quickly.

Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don’t have gestational diabetes. Treatment for gestational diabetes always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections.

If you’re testing your blood glucose, the American Diabetes Association suggests the following targets for women who develop gestational diabetes during pregnancy. More or less stringent glycemic goals may be appropriate for each individual.

• Before a meal (preprandial): 95 mg/dl or less
• 1-hour after a meal (postprandial): 140 mg/dl or less
• 2-hours after a meal (postprandial): 120 mg/dl or less

You will need help from your doctor, nurse educator, and other members of your health care team so that your treatment for gestational diabetes can be changed as needed. For you as the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarean section birth that very large babies may require.

Sticking with your treatment for gestational diabetes will give you a healthy pregnancy and birth, and may help your baby avoid future poor health.