Conditions InDepth: Gestational Diabetes

Gestational diabetes is a form of diabetes that begins during pregnancy and usually resolves after the baby is born.

During pregnancy, placental hormones (growth hormone, prolactin, cortisol, placental lactogen, progesterone) are produced that can block the effectiveness of insulin, leading to a relative insulin resistance. Insulin is a hormone that helps the body convert food into energy. Without insulin, glucose from the food you eat cannot enter cells, and glucose builds up in the blood.

In most women, the pancreas increases insulin production enough to offset this resistance. When the pancreas fails to keep pace, gestational diabetes occurs. In addition to causing problems for the mother, the excess glucose in the blood can cross the placenta and cause problems for the baby.

Complications for women with gestational diabetes mellitus include an increased chance of:

• Cesarean delivery
• High blood pressure
• Metabolic syndrome
• Type 2 diabetes

Complications affecting the fetus or infant include:

• Macrosomia (abnormally large baby) and problems during delivery (eg, shoulder dystocia)
• Respiratory distress syndrome (breathing problems)
• Other conditions (eg, low blood glucose levels, low calcium levels, high bilirubin levels)
• Increased rate of stillbirth

Children whose mothers had gestational diabetes are at higher risk for developing type 2 diabetes.

If you have gestational diabetes, maintaining good control over your glucose levels during pregnancy significantly reduces the risk of complications to you and to your baby.