Gestational Diabetes

What is gestational diabetes?

Gestational diabetes means that you have high blood sugar (hyperglycemia) during your pregnancy.   This happens because your body tries to prevent you from getting low blood sugar by making insulin (whose job is to bring your blood sugar down) less effective.  Gestational diabetes can affect 8-18% of women and usually is diagnosed in the third trimester.

The good news is:

  • it usually goes away after your baby is born
  • it doesn’t mean that your baby will get diabetes
  • if you have good control over your blood sugars, you can prevent many complications

What are the risk factors?

You are more likely to get gestational diabetes if:

  • You had gestational diabetes in your last pregnancy
  • You had a high birth weight baby (greater than 9 lbs)
  • You are Aboriginal, Hispanic, South Asian, Asian or African
  • You are 35 or older
  • Are obese (BMI of 30 more). See Healthy Weight Gain to Calculate your BMI
  • Have a history of polycystic ovary syndrome (PCOS)
  • Have acanthosis nigricans (a skin disorder characterized by the appearance of darkened patches of skin)
  • Use corticosteroids

*Even if you don’t have the above risk factors, you will usually be screened for gestational diabetes when you are 24-28 weeks pregnant.  If you are concerned, talk to your doctor, nurse, or Regional CPNP nutritionist for more information.

How is it diagnosed?

There are a number of ways to diagnose gestational diabetes. The protocols may be different in different hospitals and between doctors, so talk to your doctor or nurse if you have questions.

  • It can be a simple blood test that checks your fasting glucose (where you don’t eat anything for at least 8 hours before your blood is taken)
  • There is also another test that takes a few more steps.  First, you will have your blood drawn.  Then, you will get a sugar drink to drink.  Finally, one hour later, you will have another blood sample drawn.  This test measures how fast the sugar in your blood comes back down to normal.  If the amount of sugar in your blood is 10.3 mmol/L or higher, it usually means you have gestational diabetes, but you will need your doctor to confirm it.

What can I do?

If you are diagnosed, it is important that you get the right support.  Your doctor may refer you to a nurse and/or a nutritionist who will talk to you about checking your blood sugars, your diet, exercise, and your overall lifestyle.  In some cases, you will be able to control your blood sugar just by making changes to your lifestyle, but in some cases, you may need some insulin to help you.  In either cases, if you are able to keep your blood sugar under good control, you should be able to prevent or avoid many complications.   

Some complications of uncontrolled blood sugar for the mom include:

  • Increased rate of miscarriages
  • Increased rate of C-section deliveries
  • Increased rate of trauma during delivery

Some complications of uncontrolled blood sugar for baby include:

  • Birth defects to the brain and heart
  • Low blood sugar at birth
  • Increased rate of trauma during delivery
  • Increased risk for long-term obesity

Do I need medication?

For some women, changing their diet and increasing the amount of exercise they do is enough, but for some women, it may not be enough.  If your blood sugar is still high even after trying lifestyle changes, your doctor may feel that you need insulin to help control your blood sugars.  Insulin helps your body use the sugar in your body better and as a result, your blood sugars will come down.  If your doctor feels you need insulin, you will be trained on how to use it properly and safely.
 
For more information on Gestational Diabetes, visit the Canadian Diabetes Association or talk to your doctor, nurse, or Regional CPNP nutritionist.