Gestational diabetes affects about five percent of pregnant women in the United States, with prevalence rates higher in African-American, Latino,
Native American, and Asian women.  But many women are unaware of what it is or what it means to their health
and the health of their baby. Knowing the risks and treatment of gestational
diabetes can help you prepare for a healthier pregnancy. 
What is gestational diabetes? 
Gestational diabetes occurs when a woman who has never had diabetes before has high blood sugar (glucose) levels during her pregnancy. This is different than when a woman who has diabetes becomes pregnant.  
While the exact cause of gestational diabetes is not well understood, we do know that it is likely related to certain pregnancy hormones that create insulin resistance.  Insulin plays an important role in helping your body get the energy it needs. It pulls glucose from your blood and takes it to the cells in your body. When a pregnant woman lacks insulin, her cells can’t use insulin as they should. She and her baby risk not getting the energy they need from the food the mother eats. 
A woman with gestational diabetes may not experience symptoms. But, if poorly managed, the condition can be dangerous to her and her baby. Gestational diabetes can cause extra blood glucose to be given to the baby. This extra energy is stored as fat, which can lead to macrosomia, or excessive birth weight. Macrosomia can contribute to a difficult delivery, increased risks of a Caesarean section delivery, as well as low blood sugar and difficulty breathing for the baby after birth. 
Gestational diabetes can also contribute to future complications. One-third to two-thirds of women with gestational diabetes will have a recurrence in subsequent pregnancies. In addition, at least ten percent of women who have gestational diabetes will develop type 2 diabetes in the future.  Babies of mothers with gestational diabetes are also at a higher risk for obesity and developing type two diabetes. 
How is it treated? 
Fortunately, gestational diabetes can be managed, reducing the risk of health problems for you and your baby. And, in most cases, gestational diabetes goes away after pregnancy. 
If you have gestational diabetes, your healthcare provider may suggest a special meal plan and scheduled physical activity to help manage blood glucose levels. Meal plans may include limited sweets; smaller, scheduled meals; limited carb-rich foods; and plenty of foods with fiber, such as fruits, vegetables and whole grains. Treatment may also include regular blood glucose testing and insulin injections. 
Ultrasound exams and kick counts, which track the baby’s movement, may also be used to monitor the health of your baby during pregnancy. 
What’s your risk? 
Although there is no one cause for gestational diabetes, there are risk factors that may make you more susceptible to developing it. The following questions can help you determine your risk for developing gestational diabetes: 
■ Do you have a parent, brother or sister with type 2 diabetes?
■ Are you African-American, Latino, Native American, or Asian ?
■ Are you 25 years or older? Are you overweight?
■ Have you ever had gestational diabetes or given birth to at least one baby weighing more than nine pounds?
■ Have you been told you have prediabetes, i.e. blood glucose levels that are higher than normal? 
Your healthcare team will help you decide when and how you need to be screened for gestational diabetes during your pregnancy. If you have questions about gestational diabetes, your health history or screening options, talk with your healthcare provider to determine the best plan for you.  
Stacy Beck, MD, is a board-certified obstetrician and gynecologist and a member of ProMedica Physician Group. For more information, please visit www.ppgdocs.org.