Understanding Gestational Diabetes

At first, gestational diabetes sounds innocuous. It occurs in about 2 to 5 percent of pregnant women during the second half of gestation (usually in the third trimester) as hormones guiding fetal development in the placenta interfere with normal insulin function.

Basic symptoms mirror those of other forms of diabetes, but when the baby arrives, gestational diabetes — or GDM — usually goes away.

But don’t be lulled into thinking that gestational diabetes is strictly temporary or isn’t worth taking seriously. GDM increases the risk of miscarriage (although it makes a child no more likely to have birth defects or diabetes) and, because it often causes the child to grow large before birth, can contribute to complications at delivery. (Having given birth in the past to a child weighing nine pounds or more suggests you’re at risk for GDM.) Just as important, most women who develop GDM do so because their pancreas is already weak (they’re often overweight), making them vulnerable to getting full-blown diabetes later on — which occurs in a third to a half of cases.

Protecting Your Pregnancy
GDM isn’t considered a severe form of diabetes, but it does require treatment, which is why obstetricians routinely test for it. In fact, blood-sugar goals with GDM are fairly tight — you’re shooting for the normal glucose levels found in a healthy woman who isn’t pregnant. Fortunately, this usually isn’t difficult because the pancreas still makes insulin and glucose levels remain fairly stable. Your doctor may recommend that you:

  • Ease insulin demand on the pancreas by spreading calorie intake out in smaller, more frequent meals. Of course, you still need enough calories to maintain a healthy weight.
  • Lower blood-glucose levels with mild exercises like walking or swimming.
  • Make use of insulin injections if you have trouble controlling blood sugar through diet and exercise.

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