Diabetes occurs when there is a higher level of glucose in the blood than is normal. Glucose comes from the breakdown of the food you eat. It travels through your body in the blood. A hormone called insulin then helps glucose move from your blood to your cells. Once glucose is in your cells, it can be used for energy. A problem making or using insulin means glucose cannot move into your cells. Instead, the glucose builds up in your blood. The build-up is called hyperglycemia.
Gestational diabetes is a type of diabetes that occurs or is first recognized during pregnancy. The extra glucose can affect the mother and the baby.
Copyright © Nucleus Medical Media, Inc.
Gestational diabetes is caused by reduced sensitivity to insulin during pregnancy.
Gestational diabetes is more common in women who are 25 years and older. It is also more common in women of Hispanic, African-American, Native-American, Asian-American, Indigenous Australian, or a Pacific Islander descent.
Factors that may increase the risk of gestational diabetes include:
Also, hormones that help the baby's growth may interfere with insulin.
This condition usually does not cause any symptoms. If symptoms do occur, they may include:
As part of prenatal screening, you will be tested for gestational diabetes. If you don't have a history of diabetes, the test will be done at 24-28 weeks of gestation. If you have any risk factors, the test may be done earlier in pregnancy. You will be given a drink that has a special glucose solution in it. The level of glucose in your blood will be measured. Other tests may be used that require fasting (not eating or drinking anything). If you are high risk for gestational diabetes or have symptoms, you will be tested earlier in the pregnancy.
The goal of treatment is to return blood glucose levels to normal. Treatment may include:
A dietitian can help you develop a healthy meal plan. Guidelines include:
Do not gain more weight during pregnancy than your doctor advises. Excess weight can increase complications in your pregnancy. It will also make it more difficult to control your diabetes.
Physical activity can make it easier for your body to use glucose. There are some precautions you may need to take or certain exercises you may need to avoid. Ask your doctor about an exercise plan.
A blood glucose monitor will help you check your glucose levels throughout the day. Knowing your glucose level will help you plan your meals, activities, and medication. Keep a record of your results. Discuss them with your doctor at your visits.
You may need to give yourself insulin injections to control diabetes. For some pregnant women, oral medication is recommended.
After delivery, glucose levels usually return to normal. Your glucose levels will be checked to make sure that you no longer have diabetes.
The following may help prevent gestational diabetes:
The American College of Obstetricians and Gynecologists
American Diabetes Association
Canadian Diabetes Association
Women's Health Matters
Gestational diabetes. ACOG practice bulletin No. 30. Obstet Gynecol. 2001;98:525-538.
Gestational diabetes mellitus (GDM). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 27, 2015. Accessed October 7, 2015.
Hillier TA, Pedula KL, Vesco KK, et al. Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose. Obstet Gynecol. 2008;112:1007-1014.
How to treat gestational diabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/gestational/how-to-treat-gestational.html. Updated April 29, 2014. Accessed October 7, 2015.
2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey AB. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes. Obstet Gynecol. 2008;112:1015-1022.
4/1/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Dhulkotia JS, Ola B, Fraser R, Farrell T. Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2010;203(5):457.e1-9.
3/17/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Luoto R, Laitinen K, et al. Impact of material probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: a double-blind, placebo-controlled study. Br J Nutr. 2010. Jun;103(12):1792-1799.
6/9/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Qin JZ, Pang LH, et al. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2013;11:56
10/13/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Zhang C, Tobias DK, et al. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study. BMJ. 2014 Sep 30;349.
Last reviewed September 2015 by Andrea Chisholm, MD Last Updated: 10/13/2014