Gestational Diabetes

Our Obstetrics Clinic has a program dedicated to caring for women with diabetes during pregnancy, including gestational diabetes. Diabetes affects approximately 8 percent of pregnant women. Gestational diabetes is the most common form.
 
Women with gestational diabetes do not have diabetes before pregnancy. During pregnancy, they have an elevated glucose level and other diabetic symptoms. In most cases, these disappear after delivery.
 
The numbers of women with gestational diabetes continues to grow, largely due the number of overweight reproductive-aged women in the United States. Learn more about gestational diabetes.
 

Visits

During a typical gestational diabetes visit, we will:

• Review your home blood glucose results and diet records
• Decide whether insulin is necessary based on how carbohydrates are affecting your blood sugar levels (glycemic control). We may consider oral medications in selected patients.
• Provide counseling and teaching to help you manage your gestational diabetes

If you are seeing Dr. Jeffrey Faig or Erlinda Stern, NP, for your general prenatal care, we will coordinate your gestational diabetes and prenatal care appointments.
 
Patients who are taking insulin
If you are taking insulin, or if your gestational diabetes requires additional care, you:

• Will meet with the diabetes team weekly
• May see Dr. Jeffrey Faig in the General Obstetrics Clinic on a Friday. Dr. Faig will:
  • Adjust your insulin dosages
  • Speak with you about your diet
  • Speak with you about any problems with low blood sugar (hypoglycemia), a common side effect from taking insulin
  • Listen to your baby’s heart beat
  • Address any routine obstetric issues and/or questions you may have

 

Diagnosing Gestational Diabetes

A glucose screening test is usually performed between 24-28 weeks of pregnancy. Women with certain risk factors may be screened in their first trimester.
 
You will drink a glucose drink and your blood sugar level is measured one hour later. If this test shows an increased blood sugar level, a three hour glucose tolerance test may be performed after a few days of following a special diet. If these results are in the abnormal range, gestational diabetes is diagnosed.
 
 

Treating Gestational Diabetes

The complications of gestational diabetes are usually manageable and preventable. It is important to carefully control blood sugar levels immediately after the gestational diabetes diagnosis is made.
 
Common treatments include:

• Dietary changes, focusing on the amount of carbohydrates you eat
• Mild exercise, such as walking after meals
• Monitoring your blood glucose at home
• Insulin injections
• Oral medications

 

Effects of Gestational Diabetes

If gestational diabetes is not managed properly, it can increase the risk for problems for:

• Your baby
  • Macrosomia - a baby that is considerably larger than normal. The baby may be injured during birth due to the baby's large size and difficulty being born.
  • Hypoglycemia - Low blood sugar in the baby immediately after delivery. If the level is too low, it may be necessary to give the baby glucose intravenously.
  • Respiratory distress - Too much insulin or glucose in a baby's system may delay lung development and cause breathing difficulties. This is more likely if your baby is born before 37 weeks of pregnancy.
  • Traumatic birth
  • Children have a higher risk of developing diabetes later in life if their mothers had gestational diabetes
    
    
• You
  • Women with gestational diabetes have an increased risk of developing Type 2 diabetes in the long term. The risk can be as much as 50 percent greater in 15 years. If not controlled properly, Type 2 diabetes can lead to complications including insulin resistance, vision problems (retinopathy), kidney problems (nephropathy), nerve damage (peripheral neuropathy), and circulatory problems (peripheral vascular disease). 
  • Cesarean section
  • Pre-eclampsia