While most women are able to accommodate the hormonal changes associated with gestation, some can develop high blood sugar, even if their levels were previously normal before pregnancy. When the body no longer adequately responds to insulin, also called insulin resistance, women can develop a condition called gestational diabetes mellitus, or GDM.
Who is at risk?
Certain risk factors may put women at a higher probability of developing gestational diabetes, but it can also occur in women without any risk factors. For this reason, says Anna Parizh, DO, OB-GYN with Kettering Physician Network, “all women need to get tested for gestational diabetes between 24 and 28 weeks of gestation.” Dr. Parizh notes a woman may be more likely to develop gestational diabetes if she has any of the following:
- Is older than 25
- Is Hispanic, African American, Native American, Asian, or Pacific Islander
- Is overweight or obese
- Has gained too much weight during pregnancy
- Has prediabetes or family history of diabetes
- Has high blood pressure
- Has polycystic ovarian syndrome (PCOS)
- Has a history of gestational diabetes
- Has previously delivered a large baby, i.e. > 9 lbs.
- Has a history of a stillborn
How do OB-GYNs test for it?
When women are between 24 and 28 weeks pregnant, they should be assessed for GDM with a screening test called a glucose challenge test. If your doctor thinks you may be more likely to develop gestational diabetes based on your risk factors, you may have the glucose challenge test earlier in your pregnancy. In this test, you will be asked to drink a 50-gram syrupy drink and then your blood levels will be checked one hour later to measure how well your body is responding to this glucose load.
If the blood levels meet or exceed the standard cut-off value, then you’ll be scheduled for a follow-up oral glucose tolerance test. This testing is more extensive—you’ll have to fast overnight; in the morning you will get your blood level tested, drink a 100-gram syrupy solution, and then your blood sugar levels will be evaluated every hour for three hours. If at least two of the blood sugar levels are higher than normal, you will be treated for gestational diabetes.
What can you do to treat it?
Dr. Parizh shares that it’s important women be aware that gestational diabetes can cause a range of health issues to both mom and baby, including preeclampsia, premature delivery, and health complications to the baby after delivery such as breathing issues, low blood sugar, jaundice, or even NICU admission. If you are diagnosed with gestational diabetes, it’s important to follow the treatment plan your doctor lays out for you.
Treatment may include more frequent visits with your OB-GYN, meeting with a registered nutritionist or dietitian, checking your blood sugar levels throughout the day, keeping a food log, increasing exercise, oral medication or injectable insulin if diet and exercise changes are not enough to control your glucose levels, and possibly earlier delivery if your blood levels are not well-controlled.
What can you do to prevent it?
Though some risk factors may make certain patients more susceptible to developing gestational diabetes, certain health habits can lower your risk of developing the condition. These lifestyle changes include eating a healthy diet that focuses on whole grains, lean protein, vegetables, and fruits; a regular exercise routine aiming for 30 minutes of moderate-intensity aerobic exercise 5 days a week, or 150 minutes per week; and maintaining a healthy weight.