What to Know About Gestational Diabetes
Gestational diabetes mellitus (GDM)--that can develop during pregnancy in women who don’t already havethe condition--affects approximately ten percent of pregnant women.
occursduring pregnancywhenthebody can’t make enoughinsulin,a hormone made bythepancreas that acts like a key to let blood sugar into the cells in your body for use as energy.
The hormonal fluctuations that the body undergoes during pregnancy, which causes changes such as weight gain, cancausethebody’s cells to use insulin less effectively. All pregnant women experience someduring late pregnancy, butsome haveiteven before theybecomepregnant. Theirpregnanciesstartwith agreaterneed for insulin and are more likely toexperiencegestational diabetes.
But there’s good news, says Melissa Katz,MD,Assistant Professor of Clinical Medicine - Weill Cornell Medical College and Cornell University andAssistant Attending Physician -NewYork-Presbyterian Hospital.
“The chances of being diagnosed with GDM can be markedly decreased by starting pregnancy at a normal weight and with a healthy diet,”Dr. Katzsays. “Women should not eat an excess of carbohydrates.Having a reasonable pre-pregnancy exercise regimen is also helpful.”
Around 70% of cases can be treated with diet modifications and exercise.
“The mother must adjust her dietso the baby receives an appropriate amount of sugar, rather than excessive quantities,”Dr. Katz explains. “This is essential to decrease the risk of complications.”
Those complications can includethe babybeing bornlarge for their gestational age;(low blood sugar)at birth;congenital malformations; and pre-term delivery.
About 30% ofpregnant womenmay need to take insulin or other medication to lower her glucose level.
’s important for mothers with GDM to recognize that a normal glucose level is important, regardless of whether it is achieved with dietormedication” Dr. Katz adds.
The consequences of poor glucose control during pregnancy can include(when a woman who previously had normal blood pressure suddenly develops high blood pressure and protein in her urine or other problems after 20 weeks of pregnancy); gestational hypertension;orexcess amniotic fluid.
Though testing for GDM is usually conducted around the 24thto 28thweek of pregnancy,itmay be done earlier if the mother is in a high-risk category, forexample, if the woman has polycystic ovarian syndrome, prediabetes, and/or obesity.Alsoat higher risk for GDM are women with a family history of Type 2 diabetes, those are older, and those who use steroids during pregnancy.
“Preconception counseling is essential for all women with any risk factors,” Dr. Katz says. “Pre-pregnancy weight loss and nutritional education should be encouraged for overweight or obese women.”
For the mother,GDM usually resolves when the baby is delivered. But the condition can serve as amessageabout herfuture health and pregnancies.
“Aminority of women will remain diabetic or prediabetic,”shesays. “Women with GDM have a ten-fold increased risk of developing Type 2 diabetes later in life,and are likely to have a recurrence in subsequent pregnancies.It’s essential that they implement the lifestyle modifications they learned during pregnancy.”