What is gestational diabetes?

This is a form of diabetes that affects some people during pregnancy. Like "regular" diabetes, it affects how the body uses sugar.

All the cells in the body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. If there is not enough insulin, or if the body stops responding to insulin, sugar builds up in the blood. That is what happens to people with diabetes.

Pregnancy increases the body's need for insulin, but the body cannot always make enough. This is what causes gestational diabetes in some people. Most of the time, the diabetes goes away after the person is no longer pregnant.

What problems can gestational diabetes cause?

Many of the problems that can happen are related to having high blood sugar levels during pregnancy.

For example:

• Your baby can get too big (heavier than 9 pounds, or about 4 kilograms). This is a problem, because a big baby can get hurt if they cannot fit easily through the birth canal. Giving birth to a big baby can also cause tearing around the vagina.

  Babies born to mothers with gestational diabetes might also be at higher risk of having excess body weight later in life.

• Right after birth, your baby can have blood sugar levels that are too low. Babies can sometimes have other health problems, too.

• Gestational diabetes also increases your risk of "preeclampsia." This is a serious problem that can happen during pregnancy. It causes high blood pressure and other problems.

Will I get gestational diabetes during my pregnancy?

It is hard to predict who will get gestational diabetes. But some people are more likely to get it than others.

You are more likely to get gestational diabetes if you:

• Had it before

• Have excess body weight

• Have a family history of diabetes

• Are older than 25, and especially if you are older than 40

• Are Hispanic American, Native American, South or East Asian, or Pacific Islander

Some healthy lifestyle habits might reduce your risk of gestational diabetes. These include losing weight before pregnancy if you have excess body weight, eating a healthy diet, exercising regularly, and not smoking.

Will I be tested for gestational diabetes?

Yes. All pregnant people are tested for gestational diabetes.

There are a few ways to test for it. They all involve having you drink a special, sweet drink. A lab technician draws your blood 1 or more hours later. That way, they can see how high your blood sugar gets after you eat sugar. You have diabetes if your blood sugar measurements are above certain levels.

The timing of the test depends on your doctor and whether you are at risk for diabetes:

• Some people are tested early in pregnancy. If the test shows normal blood sugar levels, it is repeated when the person is about 6 or 7 months pregnant. (That's the same as 24 to 28 weeks pregnant.)

• Other people are only tested when they are 6 or 7 months pregnant.

How is gestational diabetes treated?

The goal of treatment is to keep your blood sugar from getting too high. To do this, you need to check your blood sugar often. You can do this on your own with an easy-to-use machine. Your doctor or nurse will teach you how to do this and what your blood sugar level should be.

If your blood sugar level is high, treatment can include:

• Diet changes – Most people can manage their blood sugar by changing what they eat and drink. It can help to work with a registered dietitian (food expert). They can teach you how to change your diet and make sure you get the right nutrition for you.

  Everyone is different, so there is no single diet that is right for everyone. In general, most people should:

  • Avoid sweets, sugary drinks, and fatty foods.

  • Choose bread, pasta, and rice made with whole grains.

• Exercise – Daily exercise helps manage your blood sugar and weight. If you already exercise, you can usually keep doing what you have been doing or possibly increase your physical activity. If you have not been exercising and want to start, ask your doctor or nurse what kind of activity is safe for you. Even gentle forms of exercise like walking can help your health.

• Medicines – Some people also need insulin shots or other diabetes medicines.

How often do I need to see the doctor or nurse?

If you have gestational diabetes, you need to see your doctor or nurse more often than other pregnant people. How often you go depends on how you are doing at each visit, and on whether you use insulin.

During these visits, the doctor or nurse will:

• Check on your baby

• Ask about your diet

• Make sure your blood sugar levels are well managed

• Adjust your dose of insulin or other medicines

Can I have a vaginal birth?

Chances are good you can have a vaginal birth, especially if your blood sugar levels have been close to normal. But if your baby is very big, you might need to have a "cesarean birth" (also called a "c-section"). This is surgery to get the baby out. The goal is to avoid problems like the baby getting stuck on the way out.

What happens after I give birth?

Your diabetes will probably go away, and your blood sugar will probably go back to normal. If you were taking insulin or another medicine, you probably will not need it anymore. Even so, your doctor or nurse will check your blood sugar to make sure your levels get back to normal and stay normal.

People who have gestational diabetes are at very high risk of getting "regular" diabetes later in life. Get checked for diabetes either when you are in the hospital after giving birth or 6 to 12 weeks later, then every few years for the rest of your life.