Gestational Diabetes: Risks, Testing and Treatment

Gestational diabetes can develop during pregnancy in women who do not already have diabetes. Every year it affects 5% to 9% of pregnancies in the United States. Managing it helps ensure a healthy pregnancy and a healthy baby.

Symptoms

Often there are none. Any symptoms tend to be mild, such as being thirstier than usual or urinating more often. Only a test can tell for sure.

Who is at higher risk

You are at higher risk if you:

• had gestational diabetes in an earlier pregnancy;
• have given birth to a baby who weighed over 9 pounds;
• are overweight;
• have a family history of type 2 diabetes;
• have polycystic ovary syndrome (PCOS), a hormone disorder;
• are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian or Pacific Islander.

Why it happens

Insulin, a hormone made by the pancreas, works like a key that lets blood sugar into the body's cells to be used for energy. Gestational diabetes happens when the body cannot make enough insulin during pregnancy.

Pregnancy brings more hormones and other changes, such as weight gain, that make the body's cells use insulin less well: insulin resistance. That raises the body's need for insulin. Every pregnant woman has some insulin resistance late in pregnancy, but some women already have it before they conceive. They start pregnancy needing more insulin and are more likely to develop gestational diabetes.

Prevention

Before pregnancy, lifestyle changes may prevent it: losing weight if you are overweight, eating a healthy diet and getting regular physical activity. Once you are pregnant, do not try to lose weight; your baby needs you to gain some. Ask your doctor how much weight to gain.

Testing

Testing matters, so that treatment can start and protect both you and your baby. Gestational diabetes usually develops around the 24th week of pregnancy, and you will probably be tested between weeks 24 and 28. If you are at higher risk, your doctor may test you earlier. Blood sugar that is higher than normal early in pregnancy may mean type 1 or type 2 diabetes rather than gestational diabetes.

Treatment

Go to all your prenatal appointments and follow your treatment plan:

• check your blood sugar, to keep it in a healthy range;
• stay active, which lowers blood sugar and makes you more sensitive to insulin;
• eat healthy food in the right amounts at the right times.

If diet and activity are not enough, your doctor may prescribe insulin, metformin or another medicine.

Afterwards

About half of women who have gestational diabetes go on to develop type 2 diabetes. Ask your doctor how to lower your risk, and how often to have your blood sugar checked.

Sources

• Centers for Disease Control and Prevention, "Gestational Diabetes." https://www.cdc.gov/diabetes/about/gestational-diabetes.html
• A stock photograph of a pregnant woman is not reproduced here.