Gestational

Gestational Diabetes

What is gestational diabetes?

Gestational diabetes (GDM) is a type of diabetes that occurs only during pregnancy. In this type of diabetes, women without a history of diabetes develop high blood glucose levels during pregnancy. About 3-8% of pregnant women develop gestational diabetes. The good news is that if gestational diabetes is well managed, mom and baby can have a healthy pregnancy and birth.
Am I at risk for gestational diabetes?

Risk factors for gestational diabetes include:

• Women over 25 years of age
• Having a close family relative with diabetes (mother, father, sibling)
• Previous history of gestational diabetes
• Overweight and obesity (body mass index greater than 25)
• Being a member of a high risk ethnic population (African-American, Hispanic/Latino American, Native American, Asian-American and Pacific Islander)

How do I know if I have gestational diabetes?

Gestational diabetes is diagnosed with a two-step lab test performed at 24-28 weeks of pregnancy.

• Step One- The glucose challenge test. You will be asked to drink a glucose solution and have your blood glucose tested one hour later. If your blood glucose is higher than 130 mg/dl you will need to take the second part of the test.
• Step Two- The glucose tolerance test. Your fasting blood glucose will be checked before you drink another higher glucose solution. Then, your blood glucose will be checked at one hour, two hours, and three hours after the drink. If two or more of the numbers are elevated you are diagnosed with gestational diabetes.

Above-normal results for the oral glucose tolerance test*

Fasting            95 or higher
At 1 hour         180 or higher
At 2 hours       155 or higher
At 3 hours       140 or higher

Note: Some labs use other numbers for this test.
*These numbers are for a test using a drink with 100 grams of glucose

What is the treatment for gestational diabetes?

The goal for gestational diabetes is to keep blood glucose levels as close to target as possible. The tools to reach this goal include:

• Blood glucose monitoring
• Ketone testing
• Meal planning
• Physical activity (with MD approval)
• Medications (if needed)

*Talk with your healthcare provider about your individualized target blood glucose levels

What are the complications of gestational diabetes?

Most women with gestational diabetes may have a normal healthy pregnancy and delivery. However, problems may arise with high blood glucose levels during this time. The risks of elevated blood glucose during pregnancy include:

• Large baby (macrosomia)
• Low blood sugar in baby at birth (hypoglycemia)
• Death of baby before delivery (stillbirth)
• Difficulty breathing in baby (respiratory distress syndrome)
• Yellowing of the baby’s skin (hyperbilirubinemia, jaundice)

Will I still have diabetes after pregnancy?

Women who have gestational diabetes tend to be at an increased risk for developing type 2 diabetes later in life and a higher risk for developing gestational diabetes again. Be sure to see your healthcare provider 6-12 weeks post delivery for a diabetes screening test. Once you have had gestational diabetes, your chances of developing it again are two in three future pregnancies. In addition, your risk for developing type 2 diabetes is 7 times higher than in women without gestational diabetes. Lifestyle changes after pregnancy may help reduce your risks. These lifestyle changes include:

• Maintaining a healthy body weight
• Making healthier food choices
• Getting regular exercise

How can Fit4d help me manage my gestational diabetes?

We know that all of this information can be overwhelming for a mom-to-be. Fit4d has many services that can help you and your baby have a healthy pregnancy. Services range from a one-time phone call with a diabetes coach for specific questions or a 16-week program that will help you throughout the rest of your pregnancy. We can even help you after delivery to focus on those all-important healthy lifestyle changes for your future. Fit4d coaches are here to help you in the capacity you choose.

Missy Mauderer RN, CDE
Fit4D Wellness Coach

References:

1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH http://www2.niddk.nih.gov/ http://diabetes.niddk.nih.gov/dm/pubs/gestational/#12  http://diabetes.niddk.nih.gov/dm/pubs/gestational/
2. American Diabetes Association http://www.diabetes.org/gestational-diabetes.jsp