Gestational Diabetes

Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.



Alternative Names
Glucose intolerance during pregnancy


Causes, incidence, and risk factors

Risk factors for gestational diabetes include:

African or Hispanic ancestry
Being over age 25 when pregnant
Birth defect in a previous child
Obesity
Giving birth to a previous baby who weighed more than 9 pounds
Recurrent infections
Unexplained miscarriage or death of a newborn


Symptoms

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood glucose level returns to normal after delivery.

Symptoms may include:

Blurred vision
Fatigue
Frequent infections, including those of the bladder, vagina, and skin
Increased thirst
Increased urination
Nausea and vomiting
Weight loss in spite of increased appetite
However, high blood sugar levels in the mother can cause problems in the baby. These problems can include:

Birth trauma
Jaundice
Large size at birth
Low blood sugar (hypoglycemia)
Rarely, the fetus dies in the womb late in the pregnancy.



Signs and tests

Gestational diabetes is usually diagnosed during the 24th - 28th weeks of pregnancy. All pregnant women should receive an oral glucose tolerance test during this time period to screen for the condition.



Treatment

The goals of treatment are to keep blood glucose levels within normal limits during the pregnancy, and to make sure that the fetus is healthy.

Your health care provider should closely check both you and your fetus throughout the pregnancy. You also can self-monitor your blood glucose levels. Fetal monitoring to check the size and health of the fetus may include ultrasound and nonstress tests.

A nonstress test is a very simple, painless test for you and your baby. A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen. When the baby moves, its heart rate normally increases 15 - 20 beats above its regular rate.

Your health care provider can look at the pattern of your baby's heartbeat compared to its movements and find out whether the baby is doing well. The health care provider will look for 3 increases of 15 beats per minute over the baby's normal heart rate, occurring within a 20-minute period.

Managing your diet can give you the calories and nutrients you need for your pregnancy and to control blood glucose levels. You should have nutritional counseling with a registered dietician.

Diabetes diet

If managing your diet does not control blood glucose levels, you should start insulin therapy. You will need to self-monitor your blood glucose levels during insulin treatment.