Diabetes During Pregnancy: What You Need to Know About Gestational Diabetes

Understanding the risks of diabetes in pregnancy (also known as gestational diabetes) can help you to take precautions to protect your health and the health of your little one.

A diagnosis of gestational diabetes can lead to anxiety during what’s supposed to be an exciting and joyful time. The condition, which develops during pregnancy, is just like type 1 or type 2 diabetes mellitus — it affects your body’s ability to break down glucose and move it into the cells to be used for energy.

The result: Elevated blood sugar levels, which can present serious risks to both you and your baby-to-be. For instance, left unchecked, this can lead to pre-eclampsia, a life-threatening condition in which a pregnant woman develops high blood pressure and protein in the urine. Your baby may be at an increased risk for preterm birth or a high birth weight, as well as low blood sugar or even type 2 diabetes later in life. These are just a few reasons why it’s important to identify gestational diabetes as early as possible and address it immediately.

Scientists don’t know why some women develop gestational diabetes and others do not. They do know that your risk for the condition may be elevated if you are older than 25, have a body mass index (BMI) higher than 30, or are a certain race, including African American, Asian, Hispanic or American Indian. If you had gestational diabetes during a previous pregnancy, if you have prediabetes, or if a close family member has type 2 diabetes, you are also at an increased risk.

Most women with gestational diabetes do not experience symptoms—fortunately, screening for the disease is part of routine prenatal care. Screening consists of:

  • Initial glucose screening test: You will drink a sugary solution containing 50 grams of glucose and have your blood tested one hour later. Normal blood sugar levels are approximately 130 to 140 milligrams per deciliter (mg/dL). If your levels are higher than this range, you’ll need to undergo a follow-up test (see below).

Glucose tolerance test: After an overnight fast, your blood sugar level will be checked in the morning. Next, you’ll drink a stronger glucose solution—containing 100 grams of glucose—and with this test, your blood sugar will be measured every hour for the next three hours. If at least two of the three measurements are higher than normal, you’ll be diagnosed with gestational diabetes. Abnormal glucose results are considered to be:

Fasting: 95 mg/dl or higher

1 hour: 180 mg/dl or higher

2 hours: 155 mg/dl or higher

3 hours: 140 mg/dl or higher

Getting your blood sugar levels under control can prevent complications during childbirth and protect the health of you and your baby in the long term. Managing gestational diabetes includes three keys:

• Regular prenatal care and follow-up visits

• Daily exercise

• A healthful diet

This last one plays a significant role not only in managing the disease, but in preventing it in the first place. Choosing the right foods in the right combinations can help control blood sugar and prevent excessive weight gain during pregnancy (Women at a healthy weight should gain between 25 and 35 pounds; overweight women need to gain less and should work with their physician to identify a personal goal.)

So, what are the “right” foods for blood sugar control? Many of these will look familiar: Vegetables and whole fruits; whole grains (such as quinoa, oats and brown rice); high-quality protein sources (like chicken, fish, lentils, eggs and beans); and healthy fats (such as avocado, olive oil, nuts and seeds). Limiting refined carbohydrates, such as cakes, pastries, candies, white bread, crackers, pretzels, white and yellow rice, fruit juices and regular soda, can also help you keep blood sugar from spiking.

If you’re doing all of the above and you are still having trouble managing your blood sugar, you may need to take insulin. You may also need to self-monitor blood glucose levels and visit your doctor more frequently, especially during the last three months of your pregnancy.

Blood sugar levels typically return to normal soon after delivery for many women with gestational diabetes. Your doctor will likely check your blood sugar levels immediately after the birth of your baby and again six to 12 weeks later. However, keep in mind that having gestational diabetes places you at a higher risk for developing type 2 diabetes in the future. For this reason, you should continue to work with your physician, endocrinologist, certified diabetes educator and/or registered dietitian. Also, you should be tested for type 2 diabetes at least every three years.

Click here for more information about how different foods affect diabetes and check out these snack, breakfast, dinner, and dessert ideas to keep blood sugar levels in check.