Gestational Diabetes

Gestational diabetes occurs only during pregnancy. It usually develops during the second trimester and almost always disappears after birth.

Who is at risk?
Any woman can develop gestational diabetes, but some are more likely to than others. You are at increased risk if you:

• Have a family history of diabetes
• Are overweight
• Had gestational diabetes with an earlier pregnancy
• Have had a stillborn baby, a large baby, or a baby with birth defects
• Belong to one of these ethnic groups: Native American, Asian, Hispanic, or African American

Risks of diabetes to babies
Gestational diabetes in the mother can cause complications for her baby, such as:

• Larger than normal size and weight, which can cause complications in labor and delivery
• Low blood sugar following birth
• Increased risk for breathing difficulties and other problems

Diagnosis and management
If gestational diabetes is found early, problems for mothers and babies usually can be avoided.

• Glucose screening is recommended between the 24th and 28th weeks of pregnancy.
• Women at higher risk may be screened earlier.
• Glucose tolerance testing follows if screening results are high.

If you have gestational diabetes, your doctor can help you manage with a strategy that may include:

• A meal plan that tells you what to eat, when and how much
• Eating healthy foods, especially those low in fat and high in complex carbohydrates
• Watching your weight gain
• Limiting high-sugar food and drink
• Regular exercise
• Self-monitoring of blood glucose levels

Your doctor also may recommend tests to monitor the baby's health and development:

• Ultrasound, to check the baby's growth
• Amniocentesis, to look for chromosome defects and evaluate lung development
• A nonstress test, to measure the baby's heart rate during movement
• A contraction stress test, to measure the baby's heart rate during contractions of the uterus
• A kick count, where you keep track of baby's movements at certain times each day

After you give birth, blood glucose levels should return to normal. You probably will have a blood glucose test to make sure.

Future screening is advised
If you've had gestational diabetes, regular screening for diabetes is recommended after you give birth. Your doctor will tell you how often you need it. Also:

• Understand that you are risk for gestational diabetes in future pregnancies, even if your tests after delivery are normal.
• Know that you are at risk for type 2 diabetes later in life. About half of women who have gestational diabetes develop adult diabetes. You can minimize this risk by continuing with your healthy eating and exercise plan.