Gestational diabetes

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Overview

Gestational diabetes occurs as a result of insulin resistance during pregnancy. Adequate blood glucose control is important in helping prevent complications in the mother, such as preeclampsia, and in the fetus, such as macrosomia and stillbirth. Nonpharmacologic measures, including diet and exercise, are often sufficient for many women to maintain appropriate glycemic control. However, some women may require additional pharmacologic therapy including insulin, metformin, or glyburide. Additionally, women with gestational diabetes should be screened postpartum because they are at increased risk for developing overt diabetes after pregnancy.

Symptoms

Increased, frequent urination.

Increased thirst.

Fatigue.

Nausea and vomiting.

Weight loss even with increased appetite.

Blurred vision.

Yeast infections.

Causes

When you eat, your pancreas releases insulin, a hormone that helps move a sugar called glucose from your blood to your cells, which use it for energy.


During pregnancy, your placenta makes hormones that cause glucose to build up in your blood. Usually, your pancreas can send out enough insulin to handle it. But if your body can’t make enough insulin or stops using insulin as it should, your blood sugar levels rise, and you get gestational diabetes.

Risk factors

Being overweight or obese.

Not being physically active.

Having prediabetes.

Having had gestational diabetes during a previous pregnancy.

Having polycystic ovary syndrome.

Having an immediate family member with diabetes.

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Complications

If you have gestational diabetes, your baby may be at increased risk of:


Excessive birth weight. If your blood sugar level is higher than the standard range, it can cause your baby to grow too large. Very large babies — those who weigh 9 pounds or more — are more likely to become wedged in the birth canal, have birth injuries or need a C-section birth.

Early (preterm) birth. High blood sugar may increase the risk of early labor and delivery before the due date. Or early delivery may be recommended because the baby is large.

Serious breathing difficulties. Babies born early may experience respiratory distress syndrome — a condition that makes breathing difficult.

Low blood sugar (hypoglycemia). Sometimes babies have low blood sugar (hypoglycemia) shortly after birth. Severe episodes of hypoglycemia may cause seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.

Obesity and type 2 diabetes later in life. Babies have a higher risk of developing obesity and type 2 diabetes later in life.

Stillbirth. Untreated gestational diabetes can result in a baby's death either before or shortly after birth.

Complications that may affect you

Gestational diabetes may also increase your risk of:


High blood pressure and preeclampsia. Gestational diabetes raises your risk of high blood pressure, as well as preeclampsia — a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten both your life and your baby's life.

Having a surgical delivery (C-section). You're more likely to have a C-section if you have gestational diabetes.

Future diabetes. If you have gestational diabetes, you're more likely to get it again during a future pregnancy. You also have a higher risk of developing type 2 diabetes as you get older.


Prevention

There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. If you've had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes in the future.


Eat healthy foods. Choose foods high in fiber and low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition. Watch portion sizes.

Keep active. Exercising before and during pregnancy can help protect you from developing gestational diabetes. Aim for 30 minutes of moderate activity on most days of the week. Take a brisk daily walk. Ride your bike. Swim laps. Short bursts of activity — such as parking further away from the store when you run errands or taking a short walk break — all add up.

Start pregnancy at a healthy weight. If you're planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy. Focus on making lasting changes to your eating habits that can help you through pregnancy, such as eating more vegetables and fruits.

Don't gain more weight than recommended. Gaining some weight during pregnancy is typical and healthy. But gaining too much weight too quickly can increase your risk of gestational diabetes. Ask your health care provider what a reasonable amount of weight gain is for you.