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Pregnancy Complications

Gestational Diabetes

Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is high blood sugar diagnosed during pregnancy. During pregnancy your body produces a new group of hormones. Some of these hormones cause your blood sugar to rise slightly to help provide nutrients for your baby. However, if blood sugar climbs too high during pregnancy, the risk of complications will increase. Excessively high blood sugars during pregnancy are always treated because they increase risks for both mother and baby at time of birth.

Problems For Infants Caused By High Blood Sugar
  • A birth weight of more than 9 pounds
  • Shoulders too large for a comfortable delivery
  • Low blood sugar after delivery
  • Jaundice

About three out of every one hundred pregnant women will develop gestational diabetes, however, some woman are at higher risk for it.

Women At Risk Of Gestational Diabetes
  • Overweight or Obese
  • Age 25 or older
  • Family history of diabetes
  • Gestational diabetes in a previous pregnancy
  • Previous baby weighing more than 9 pounds

A blood sugar test is the only way to tell if you have GDM. If you are at higher risk for GDM your doctor may order blood sugar testing more than once in your pregnancy. Most pregnant women are screened for GDM once during the last half of their pregnancy, between 24 and 28 weeks gestation. This test involves drinking a sweet beverage and having a laboratory blood test afterward to check blood sugar levels. Normal blood sugar levels for pregnant women are about 60 - 130. Occasionally, a very high blood sugar result may suggest that you had diabetes mellitus before you became pregnant. If pre-existing diabetes is suspected, your physician will discuss this possibility with you and adjust medical care plans for your pregnancy.

Treatment For Gestational Diabetes
Maintaining blood sugar within the normal range is the goal of treatment for GDM. Meeting this objective greatly reduces the risks of complications. Once GDM is diagnosed, your physician should send you to educators specializing in diabetes management. These diabetes specialists, usually a nurse educator and a clinical dietitian, will help you develop the tools you need to manage gestational diabetes. These tools include learning to monitor your blood glucose using a home glucometer. You will also learn some diet guidelines that will help keep your blood sugar in the normal range.

Core Diet Guidelines for Gestational Diabetes
  • Avoiding concentrated sugar sources:
    including fruit juice, some cereals and sweets
  • Eating smaller more frequent meals
  • Eating smaller portions of carbohydrate rich foods.

For most women with GDM, blood sugar monitoring and following guidelines to manage dietary carbohydrate are the only treatments needed. For some women, insulin treatment may be necessary to achieve desired blood sugar targets.

After Delivery
For women with Gestational Diabetes, high blood sugar usually ends after the baby is born. As a way to confirm this, your doctor will probably order a blood sugar test at the time of you postpartum check-up, about six weeks after your baby is born. If you have GDM with one pregnancy, you are likely to have it if you get pregnant again. GDM does not interfere with a your ability to breastfeed.

It is important to note, however, that up to 60% of women who have GDM will develop Type 2 Diabetes Mellitus within 10 years. Maintaining weight in a normal range and exercising regularly can reduce this risk. Women who have had GDM should have their blood sugar checked regularly and before they become pregnant again.

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