Medically verified by Dr. Connie Newman.
Angie Buchanan, 37, loved how smoothly she sailed through her first pregnancy. “I didn’t have morning sickness, my energy levels were good, and I had just realized that pretzel bites would be the answer to my carbohydrate cravings,” Buchanan said in an email.
Then, after a routine test, she received a call from her gynecologist who blew the wind out of her sails: Buchanan had gestational diabetes, which is diabetes for the first time during pregnancy (pregnancy). It happens because the body can’t make enough insulin to control blood sugar levels. This leads to high blood sugar, which can negatively affect the health of both mother and child.
The cause of gestational diabetes is unknown, but it probably has to do with the interaction between gestational hormones and insulin levels. Gestational diabetes affects up to 10% of pregnancies in the United States each year.
Health conditions such as obesity, polycystic ovarian syndrome (PCOS), and high blood pressure can increase the risk of gestational diabetes, as can lack of physical activity, an immediate family member with diabetes, and a history of heart disease.
Women who are Asian-American, Black, Hispanic, and Native American are also at higher risk. While it is unclear why race and ethnicity play a role in the development of gestational diabetes, the evidence suggests that this could be due to factors such as body composition, lifestyle, and genetics.
Because gestational diabetes is so common, all pregnant women are routinely screened for it during their second trimester, typically between the 24th and 28th week of pregnancy. If a woman is at risk, she may be tested earlier in the pregnancy.
Screening for gestational diabetes, known as a glucose tolerance test, can be done using two different methods. The one-step strategy involves drinking a sweet sugar solution after an overnight fast and then drawing blood at three intervals. Gestational diabetes is diagnosed when at least one glucose level exceeds set values in each interval.
The second method involves drawing blood an hour after drinking a sweet sugar solution. If the plasma glucose level is at a certain level, you will have another test.
In this follow-up test, blood will be drawn from you while you are fasting. Then drink an even sweeter glucose solution and have blood drawn again after one, two and three hours. A diagnosis of gestational diabetes is made when two of the four glucose levels meet certain criteria.
Effects on mother and child
If left untreated, gestational diabetes can pose a health risk to the mother and her fetus. A pregnant woman with gestational diabetes whose blood sugar is not controlled is more likely to need a caesarean section (caesarean section). She is also more likely to develop preeclampsia and dangerously high blood pressure during pregnancy.
In addition, the fetus can experience a number of serious complications, including high blood sugar levels, which can cause the baby to grow very large and potentially make delivery difficult or result in premature delivery. Conversely, a woman who takes medication for gestational diabetes may develop hypoglycemia or low blood sugar. Hypoglycemia during pregnancy can cause the baby to have low blood sugar at birth.
After you’ve been diagnosed with gestational diabetes, learn how to check and monitor your blood sugar. In some women, gestational diabetes can be controlled with a low-carb, natural, added sugar and starch diet, along with a high-protein diet and exercise. Others may need medication.
“I cut sugar, gave up my cravings for pretzels, kept moving, and kept a log of my food every day,” said Buchanan. “Even so, it was still very difficult to handle.”
Buchanan were prescribed drugs that increase the release of insulin into the bloodstream. Other oral medications and / or insulin injections can also be used to control blood sugar.
Socioeconomic factors can be a barrier to treatment for some women with gestational diabetes, both during and after pregnancy. Women in lower income brackets may have to wait longer for appointments and may face barriers to postpartum follow-up care that include costs, inadequate childcare, or the inability to take time to work.
Long-term health risks
Unfortunately, the effects of gestational diabetes on a woman’s health don’t stop after her baby is born.
“Children born to mothers with gestational diabetes are at greater risk of obesity and diabetes when they grow up,” said Dr. Connie Newman, Associate Professor of Medicine at NYU’s Grossman School of Medicine and a member of the HealthyWomen’s Women’s Health Advisory Council.
Up to 60% of women with gestational diabetes develop type 2 diabetes, which occurs when the body becomes resistant to the insulin the body makes. However, it is not inevitable.
A 2019 meta-analysis of people with blood sugar levels classified as prediabetic found that lifestyle changes, including improved diet and physical activity, reduced the risk of type 2 diabetes by 47%.
Buchanan understands the importance of these lifestyle modifications. Despite eating well and exercising when her son was four, Buchanan began to see the effects of gestational diabetes on her blood sugar.
“Currently my levels are prediabetic,” she said. So she makes decisions to keep her blood sugar under control, just like she did during pregnancy.
“I once again tweak my diet, maintain an exercise routine, and watch my weight,” said Buchanan, “which is probably best in the long run anyway.”
American Diabetes Association
American College of Obstetricians and Gynecologists