Diabetes and Pregnancy

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.

 

Getting prenatal care early and having regular checkups helps improve your health and the health of your baby. Having prenatal screening at 24 to 28 weeks of pregnancy will help detect gestational diabetes early.

If you are overweight, getting your weight within the normal body mass index (BMI) range will decrease your risk of gestational diabetes.

 

Pregnancy hormones can block insulin from doing its job. When this happens, glucose level may increase in a pregnant woman's blood.

You are at greater risk for gestational diabetes if you:

  • Are older than 25 when you are pregnant
  • Come from a higher risk ethnic group, such as Hispanic American, African American, Native American, Southeast Asian, or Pacific Islander
  • Have a family history of diabetes
  • Gave birth to a baby that weighed more than 9 pounds (4 kg) or had a birth defect
  • Have high blood pressure
  • Have too much amniotic fluid
  • Have had an unexplained miscarriage or stillbirth
  • Were overweight before your pregnancy
  • Gain too much weight during your pregnancy
  • Have polycystic ovarian syndrome

Most of the time there are no symptoms. The diagnosis is made during a routine prenatal screening.

Mild symptoms, such as increased thirst or shakiness, may be present. These symptoms are usually not life threatening to the pregnant woman.

Other symptoms may include:

  • Blurred vision
  • Fatigue
  • Frequent infections, including those of the bladder, vagina, and skin
  • Increased thirst
  • Increased urination

Gestational diabetes most often starts halfway through the pregnancy. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to look for the condition. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy.

Once you are diagnosed with gestational diabetes, you can see how well you are doing by testing your glucose level at home. The most common way involves pricking your finger and putting a drop of your blood on a machine that will give you a glucose reading.

The goals of treatment are to keep blood sugar (glucose) level within normal limits during the pregnancy, and to make sure that the growing baby is healthy.

WATCHING YOUR BABY

Your health care provider should closely check both you and your baby throughout the pregnancy. Fetal monitoring will check the size and health of the fetus.

A nonstress test is a very simple, painless test for you and your baby.

A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen.
Your provider can compare the pattern of your baby's heartbeat to movements and find out whether the baby is doing well.

DIET AND EXERCISE

The best way to improve your diet is by eating a variety of healthy foods. You should learn how to read food labels, and check them when making food decisions. Talk to your provider if you are a vegetarian or on another special diet.

In general, when you have gestational diabetes your diet should:

  • Be moderate in fat and protein
  • Provide your carbohydrates through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice)
  • Be low in foods that contain a lot of sugar, such as soft drinks, fruit juices, and pastries

If managing your diet does not control blood sugar (glucose) level, you may be prescribed diabetes medicine by mouth or insulin therapy.

Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will.