Pregnancy can be an amazing event in a woman’s life, but sometimes complications occur. One such issue is gestational diabetes, in which the body’s insulin demands can’t keep up with the growing baby.
Abnormal glucose (commonly called blood sugar) levels are the result. In the later stages of pregnancy, the pancreas needs to make three times the normal amount of insulin to keep glucose levels normal. A glucose tolerance test is done around 24 to 28 weeks to see if gestational diabetes is present. Sometimes screening is done earlier in the pregnancy if risk factors are already present, like previous gestational diabetes, family history of diabetes or if the woman is overweight.
If glucose levels are elevated, often the first step is implementing an appropriate meal plan. Meeting with a registered dietitian or diabetes educator can help with this. Being physically active, with physician approval, is another essential step in managing glucose levels. The addition of a glucose-lowering medication, like insulin, may also be needed to keep levels normalized through pregnancy.
A home meter to test glucose is a valuable tool that tells the health care team how the eating plan, exercise and medicine are working. The goal is to keep the baby’s growing environment as healthy as possible.
Untreated high glucose levels can be dangerous for Mom and baby. For Mom, the possible risks can include high blood pressure, increased infections to kidney, bladder and vagina, shortness of breath and difficult labor and recovery.
For baby, risks can be large birth weight, making it difficult to pass through the birth canal, low blood glucose at delivery time and even stillbirth. The baby can also be born too early, before organs like the lungs have had time to fully develop.
Gestational diabetes is a warning sign for Type 2 diabetes. While glucose levels may go back to normal after delivery, continuing on the path of eating well and exercising will help prevent or delay diabetes later in life.
We have the technology and knowledge to significantly reduce or prevent complications of gestational diabetes, but it takes attention to meal planning, exercise and glucose monitoring to ensure Mom and baby stay safe.
Starting pregnancy with solid exercise and eating habits and normal body weight can be a safeguard against developing gestational diabetes.
Pam Noonan, MS, RN, CDE, is a diabetes educator with Sutter Gould Medical Foundation.