- Gestational Diabetes and Pregnancy
- Gestational Diabetes
- Nearly 10 percent of pregnancies in the U.S. are affected by gestational diabetes every year. So know that you’re not alone.
- What Is Gestational Diabetes?
- Gestational Diabetes Care After Childbirth
- Gestational Diabetes and Your Health After Your Baby is Born
Gestational Diabetes and Pregnancy
Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy.
Often gestational diabetes can be controlled through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin.
Problems of Gestational Diabetes in Pregnancy
Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby:
An Extra Large Baby
Diabetes that is not well controlled causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-Section to deliver the baby. The baby can be born with nerve damage due to pressure on the shoulder during delivery.
C-Section (Cesarean Section)
A C-section is an operation to deliver the baby through the mother’s belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth.
High Blood Pressure (Preeclampsia)
When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesn’t go away, she might have preeclampsia. It is a serious problem that needs to be watched closely and managed by her doctor. High blood pressure can cause harm to both the woman and her unborn baby. It might lead to the baby being born early and also could cause seizures or a stroke (a blood clot or a bleed in the brain that can lead to brain damage) in the woman during labor and delivery. Women with diabetes have high blood pressure more often than women without diabetes.
Low Blood Sugar (Hypoglycemia)
People with diabetes who take insulin or other diabetes medications can develop blood sugar that is too low. Low blood sugar can be very serious, and even fatal, if not treated quickly. Seriously low blood sugar can be avoided if women watch their blood sugar closely and treat low blood sugar early.
If a woman’s diabetes was not well controlled during pregnancy, her baby can very quickly develop low blood sugar after birth. The baby’s blood sugar must be watched for several hours after delivery.
5 Tips for Women with Gestational Diabetes
- Eat Healthy Foods
Eat healthy foods from a meal plan made for a person with diabetes. A dietitian can help you create a healthy meal plan. A dietitian can also help you learn how to control your blood sugar while you are pregnant.Tasty Recipes for People with Diabetes and Their Families “external iconTo Find a Dietitian:
American Dietetic Association
www.eatright.orgexternal icon (click on “Find a Nutrition Professional”)
- Exercise Regularly
Exercise is another way to keep blood sugar under control. It helps to balance food intake. After checking with your doctor, you can exercise regularly during and after pregnancy. Get at least 30 minutes of moderate-intensity physical activity at least five days a week. This could be brisk walking, swimming, or actively playing with children.Learn more about physical activity during pregnancy ”
- Monitor Blood Sugar Often
Because pregnancy causes the body’s need for energy to change, blood sugar levels can change very quickly. Check your blood sugar often, as directed by your doctor.
- Take Insulin, If Needed
Sometimes a woman with gestational diabetes must take insulin. If insulin is ordered by your doctor, take it as directed in order to help keep blood sugar under control.
- Get Tested for Diabetes after Pregnancy
Get tested for diabetes 6 to 12 weeks after your baby is born, and then every 1 to 3 years.For most women with gestational diabetes, the diabetes goes away soon after delivery. When it does not go away, the diabetes is called type 2 diabetes. Even if the diabetes does go away after the baby is born, half of all women who had gestational diabetes develop type 2 diabetes later. It’s important for a woman who has had gestational diabetes to continue to exercise and eat a healthy diet after pregnancy to prevent or delay getting type 2 diabetes. She should also remind her doctor to check her blood sugar every 1 to 3 years.
Gestational Diabetes and Pregnancy pdf icon
View, download, and print this brochure about gestational diabetes and pregnancy.
For more information on gestational diabetes, visit the American Diabetes Association’s websiteexternal icon.
Nearly 10 percent of pregnancies in the U.S. are affected by gestational diabetes every year. So know that you’re not alone.
And know that it doesn’t mean that you had diabetes before you conceived or that you will have diabetes after you give birth. It means that, by working with your doctor, you can have a healthy pregnancy and a healthy baby. No matter what, you have all the support you need for both you and your baby.
We don’t know what causes gestational diabetes …
But we know that you are not alone. It happens to millions of women. We do know that the placenta supports the baby as it grows. Sometimes, these hormones also block the action of the mother’s insulin to her body and it causes a problem called insulin resistance. This insulin resistance makes it hard for the mother’s body to use insulin. And this means that she may need up to three times as much insulin to compensate.
Gestational diabetes can also start when the mother’s body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose can’t leave the blood and be changed into energy. When glucose builds up in the blood, it’s called hyperglycemia.
Whatever the cause, you can work with your doctor to come up with a plan and maintain a healthy pregnancy through birth. Ask questions. Ask for help. There are many ways to combat gestational diabetes.
About nine percent of pregnant women have gestational diabetes, which usually goes away after they give birth. But about half these women will develop Type 2 diabetes later in life. A new study suggests two ways to significantly reduce the risk.
Researchers studied 350 women with a history of gestational diabetes, comparing them with 1,416 women with previous live births but no history of gestational diabetes. The women randomly received one of three treatments: an intensive exercise and diet program, the diabetes drug metformin or a placebo.
Over all, women with a history of gestational diabetes had a 48 percent higher risk of developing Type 2 diabetes over the 10-year study compared with women who had stayed healthy during pregnancy. Metformin reduced the post-pregnancy risk of diabetes by 40 percent, while the lifestyle program lowered risk by 35 percent. Among the women who had never had gestational diabetes, the drug was not effective, but the lifestyle program also significantly reduced the risk for Type 2 diabetes. The study is online in The Journal of Clinical Endocrinology and Metabolism.
Women with gestational diabetes “are still at high risk even many years later,” said the lead author, Dr. Vanita R. Aroda, a physician investigator at the MedStar Health Research Institute, “and those risks can be reduced with metformin or lifestyle changes. This has significant public health benefits.”
What Is Gestational Diabetes?
I’m not diabetic, but my doctor told me that I have gestational diabetes. What does that mean? And will it last beyond my pregnancy?
Gestational diabetes is a kind of diabetes that comes on during pregnancy. When a woman has it, her blood sugar levels are high. That makes the unborn baby’s blood sugar levels higher too. Most pregnant women have a glucose screening for gestational diabetes at 24 to 28 weeks.
A big worry about gestational diabetes is what it can do to a baby. Babies born to mothers who have gestational diabetes are more likely to:
- be born early (prematurely)
- grow very large
- have breathing problems
- have jaundice
- have low blood levels of calcium or glucose just after they’re born
These and other kinds of problems from gestational diabetes can make babies need to stay in the hospital longer for extra treatment.
If you have gestational diabetes, your doctor will probably start you on a treatment plan. Most women can get their blood sugar levels under control with a healthy food plan and daily exercise. Some women also need to take daily insulin shots and test their blood sugar until they give birth.
Gestational diabetes usually goes away after a baby is born. A mom may get it again during future pregnancies, though. Some women who have it will develop diabetes when they’re older.
Sometimes a woman may have had diabetes before the pregnancy but not know it. When that happens, the diabetes does not go away after the baby is born.
Reviewed by: Armando Fuentes, MD Date reviewed: October 2018
Gestational Diabetes Care After Childbirth
If you were diagnosed with gestational diabetes, you were probably relieved to learn that 90 percent of the time, gestational diabetes goes away after you give birth.
But there are still some important issues and risks you need to be aware of.
The first few days, weeks, and months after delivery can be a time when you are at risk for both emotional and physical problems. Being aware of the risks and knowing what you can do about them can help.
Typically, your blood sugar will be checked several times before you are discharged from the hospital after giving birth, so that you can be sure your gestational diabetes has resolved.
“Medical follow-up for all women who have had gestational diabetes is very important. In 2 to 3 percent of women, diabetes continues after delivery. All women should have their glucose checked at between six and eight weeks,” advises Robert O. Atlas, MD, chairman of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore.
“Emotionally, the first several months after giving birth can be stressful for many new mothers. Depression after childbirth peaks at three to four months. We can’t say that gestational diabetes causes postpartum depression, but studies indicate that the risks may be higher for these women,” warns Linda Chaudron, MD, a psychiatrist at University of Rochester Medical Center in New York.
What Are the Risks After Gestational Diabetes?
Some women will continue to have trouble with blood sugar after giving birth. There are also emotional issues and long-term concerns you need to know about:
- Type 2 diabetes. This is the most common type of diabetes. After having gestational diabetes, you are at higher risk for type 2 diabetes. The American Diabetes Association recommends that all women with a history of gestational diabetes have a two-hour glucose tolerance test at six weeks and at least every three years after giving birth.
- Weight control. Women with gestational diabetes who fail to control their weight after giving birth have a higher risk of having gestational diabetes again in their next pregnancy and of developing type 2 diabetes later in life, according to a 2010 study in the American Journal of Obstetrics and Gynecology.
- Depression. Mothers who have gestational diabetes may have a significantly higher risk of developing postpartum depression than mothers who did not have diabetes during pregnancy, Atlas says.
- Breastfeeding. Breastfeeding is recommended for mothers who had gestational diabetes. But since producing breast milk requires the body to use energy and burn calories, some women with gestational diabetes may be more likely to have trouble regulating their blood sugar after giving birth. Most women will be able to breastfeed without difficulty.
What Can You Do to Reduce Your Risks After Gestational Diabetes?
Knowing what the risks are is a start. Now you can take steps to stay safe after gestational diabetes:
- Know the symptoms of postpartum depression. Some sadness and even anger are not unusual in the first few weeks after giving birth. If you continue to have problems sleeping, have overwhelming exhaustion, loss of appetite, constant anxiety, or any thoughts of harming yourself or your baby, you need help. Talk to your doctor — postpartum depression is treatable.
- Continue all your follow-up medical care. Remember you are at risk for type 2 diabetes. Make sure to follow through with all recommended doctor visits and blood tests.
- Stick to a diet and exercise program. Reaching and maintaining a healthy weight, following a diet high in fruits, grains, and vegetables, and getting at least 30 minutes of exercise every day can lower your risk for future health problems.
- Breastfeed your baby. If you are getting enough calories and eating wisely, breastfeeding is safe for you. There is some evidence that breastfeeding can lower your baby’s chance of being overweight as an adult. Breastfeeding can also help you lose weight after your pregnancy, and may lower your risk for type 2 diabetes, although more research is needed to confirm this.
The first days, weeks, and months after gestational diabetes are a time when you are at some risk for physical and emotional problems, but they are also the time when you can start to establish the good habits that will help you stay healthy in the future. Stay close to your medical team and make sure to keep all your appointments. Try to reach and maintain a healthy weight. Eat well and exercise regularly. You managed your gestational diabetes; now is the time to start managing your future.
Gestational Diabetes and Your Health After Your Baby is Born
Your healthcare provider will check your blood sugar level after you deliver. For most women, blood sugar levels go back to normal quickly after having their babies.
Six to twelve weeks after your baby is born, you should have a blood test to find out whether your blood sugar level is back to normal. Based on the results of the test, you will fall into one of three categories.
|If your category is…||You should…|
|Impaired Glucose Tolerance or Pre-iabetes||
The test also checks your risk for getting diabetes in the future. Women who have had gestational diabetes have a 40 percent higher chance than women who have not had gestational diabetes of developing type 2 diabetes later in life.
Getting checked for diabetes is important because type 2 diabetes shows few symptoms. The only way to know for sure that you have type 2 diabetes is to have a blood test that reveals a higher-than-normal blood sugar level. You should also tell your healthcare provider right away if you notice any of these things:
- Increased thirsty
- Urinating often
- Feeling constantly or overly tired
- Losing weight quickly and/or without reason
Having one or more of these symptoms does not mean you have diabetes, but your healthcare provider might want to test you to make sure. Finding type 2 diabetes early can help you avoid problems, like early heart disease and damage to your eyes, kidneys, or nerves. If you choose to use birth control methods in the future, talk with your health care provider about a method that won’t increase your risk of developing diabetes.
Can I breastfeed even though I have gestational diabetes?
Like all mothers, women with gestational diabetes should breastfeed their babies, if possible. Breastfeeding provides many benefits for you and your baby. It provided extra immunity for your baby and it helps your body to lose the weight from pregnancy which lowers your risk of developing diabetes.
Am I going to develop diabetes in the future?
If you have one or more of the following, you may be at a higher risk of getting type 2 diabetes within 5 years after having your baby:
- You developed gestational diabetes before your 24th week of pregnancy.
- Your blood sugar level during pregnancy was consistently on the high end of the healthy range.
- Your blood sugar levels after the baby was born were higher-than-average
- You have a history of impaired glucose tolerance or prediabetes
- You are obese (BMI>30)
- You have diabetes in your family.
- You belong to a high-risk ethnic group (Hispanic, African American, Native American, South or East Asian, Pacific Islander, Indigenous Australian).
- You have had gestational diabetes with other pregnancies.
If you have any of these risk factors, it is even more important that you get tested yearly for diabetes and take steps to lower your risk, such as eating a healthy diet, losing extra weight, and getting regular physical activity.
Plan your next pregnancy
If you know that you want to get pregnant in the future, have a blood sugar test up to three months before becoming pregnant to make sure you have a normal blood sugar level. High blood sugar early in the pregnancy (within the first eight weeks) can affect the developing body and organ systems of the fetus. It’s important to get your blood sugar level under control before you get pregnant.
If you do get pregnant again, make sure your health care provider knows that you had gestational diabetes with your last pregnancy. If you had gestational diabetes with one pregnancy, your risk of getting it with another pregnancy is about 36 percent.