Diabetes in Pregnancy

WHAT IS IT?

Gestational Diabetes Mellitus (GDM) is a type of diabetes that develops during pregnancy. It occurs when the body cannot produce enough insulin to meet the increased needs during pregnancy, leading to high blood sugar levels. This is caused by the placenta and genetics. 

WHY IS IT IMPORTANT?

  • GDM can lead to complications for both the mother and the baby if left untreated. You are at a higher risk for developing GDM if you have a BMI over 25, advanced maternal age, have a history of GDM or have had a baby that was large for their gestational age, or have a parent or sibling with diabetes.  

    • Complications for the mother include an increased risk of high blood pressure, preeclampsia, and a higher likelihood of developing type 2 diabetes later in life.

  • Complications for the baby include an increased risk of excessive birth weight (macrosomia), preterm birth, respiratory distress syndrome, and a higher risk of developing obesity and type 2 diabetes in the future.

HOW IS IT DIAGNOSED?

  • Glucose Challenge Test (GCT): Usually performed between 24 and 28 weeks of pregnancy. The mother drinks a glucose solution, and blood sugar levels are measured after one hour. If results are high, a follow-up test is done.

  • Oral Glucose Tolerance Test (OGTT): If the initial test is positive, this more definitive test is conducted. It involves fasting overnight, drinking a glucose solution, and measuring blood sugar levels at multiple intervals.

MANAGEMENT AND TREATMENT

  • If you are diagnosed with Gestational Diabetes you will be offered a referral to a Gestational Diabetes Clinic which will follow you to help you manage your blood sugars through diet and exercise. If medications or insulin are needed in your pregnancy you will be referred to an OB.

STATISTICS AND BENEFITS

  • About 2-10% of pregnancies are affected by GDM.

    • Roughly 1% of people younger than 21 develop GDM, compared to 9% of those older than 35

  • If your blood sugars are well managed during pregnancy then your baby is not at higher risks for complications during childbirth.

  • Most women with GDM return to normal blood sugar levels after delivery, but they are at higher risk for developing type 2 diabetes later.

ALTERNATIVES

The HBA1C is a blood test that measures the average blood sugar levels over the past 2-3 months by assessing the amount of glucose attached to hemoglobin in the blood. The Glucose Challenge Test is more accurate for diagnosing GDM due to its focus on short-term glucose levels, whereas HbA1c provides an average over months, potentially missing pregnancy-specific glucose intolerance.

Click Here for a Guide on Healthy Eating for Gestational Diabetes