Women go through many changes during pregnancy, including changes in how their bodies process insulin. Diabetes is when too much glucose (sugar) stays in the blood instead of being used for energy. Some women develop diabetes for the first time during pregnancy, which is called gestational diabetes.
Pregnancy causes your body to become more insulin resistant. During pregnancy, higher levels of pregnancy hormones can interfere with insulin.
Not all pregnancies lead to gestational diabetes. Exercise and a healthy diet reduce your risk of developing gestational diabetes.
“The main risk of gestational diabetes is having a larger than normal baby or shoulder dystocia, where the baby cannot progress through the birth canal,” said Melissa Stoffel, D.O., OB-GYN with Marshfield Clinic Health System. “That can lead to a more complicated delivery and increase the likelihood you’ll need a C-section.”
It’s important to manage gestational diabetes for the safety of the baby and you.
The blood sugar test takes place during the second trimester of pregnancy
Pregnant women are tested for gestational diabetes at 26-28 weeks. Your doctor may test you early if you have risk factors like previous history of the condition, family history of Type 2 diabetes or elevated body mass index.
The test, called the glucose challenge, involves drinking a sugary solution and having your blood sugar checked an hour later. You’ll need more testing if your results are above normal. Blood sugar levels for pregnant women are considered high if it is above 130 to 140 milligrams per deciliter (mg/dL). A normal blood sugar level for a pregnant woman is between 60–120 (mg/dL).
If you are diagnosed with gestational diabetes, you will have more frequent visits to monitor your health and your baby’s health. You also will need to track your blood sugar and do things to keep it under control.
A glucose meter will test your blood sugar levels. Keep a record of your blood sugar levels and bring it with you to each prenatal visit.
Lifestyle changes are the first choice treatment
“If you’re diagnosed with gestational diabetes, lifestyle changes are first,” Dr. Stoffel said.
You also will have options to connect with a nutritionist to help lower your blood sugar levels. Diet and exercise can keep most women in a safe range without medication.
According to the American College of Obstetricians and Gynecologist (ACOG), insulin is the recommended medication during pregnancy to help women control their blood sugar. Insulin does not cross the placenta, so it doesn’t affect your baby. Your women’s health doctor will teach you how to give yourself insulin shots with a small needle. In some cases, your doctor may prescribe a different medication, as needed.
Risk increases for Type 2 diabetes after pregnancy
Most women’s glucose levels return to normal two to six weeks after the baby is born.
“All women with gestational diabetes will have a two-hour glucose tolerance test at their six-week postpartum visit to make sure levels are returning to normal,” Dr. Stoffel said.
This test involves drinking a glucose liquid and having blood drawn before and after the drink to measure how well your body processes the sugar.
For some, your body may not return to processing insulin normally after pregnancy. ACOG states that “one third of women who had gestational diabetes will have diabetes or a milder form of elevated blood sugar soon after giving birth. Between 15% and 70% of women with gestational diabetes will develop diabetes later in life.”
You also are at increased risk for gestational diabetes in future pregnancies. Talk to your women’s health provider about your previous health history so you and your baby can be monitored.
You can continue to reduce your risk for Type 2 diabetes by eating balanced meals, exercising and maintaining a healthy weight. Talk to your primary care provider to find the best plan for you.
For questions about gestational diabetes, talk to a Marshfield Clinic Health System provider.
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