Testing for Gestational Diabetes & Your Baby's Health

During your 24th- 28th week of pregnancy, your doctor will screen you for gestational diabetes. Gestational diabetes mellitus (GDM) is a type of diabetes that occurs only during pregnancy, characterized by high blood glucose (sugar) levels, and almost always vanishes after delivery.

Here’s the lowdown on this special type of diabetes, how it affects you and your baby, and what you should look out for:

What’s Going On in There?

Pregnancy brings about hormonal changes in all pregnant women. However, increased levels of certain hormones made in the placenta interfere with the ability of insulin to control glucose. This insulin resistance increases as the placenta grows larger in pregnancy. Usually a woman’s pancreas can produce more insulin to overcome this; however, if the pancreas doesn’t produce enough insulin to overcome the effect of the increased hormones, sugar levels will rise and give way to gestational diabetes.

Am I at Risk?

About 3-5% of pregnant women in the United States develop gestational diabetes. The risk is higher for those who have the following conditions:

• Family history of diabetes
• Over the age of 30
• Weight is 20% more than ideal weight
• Previous pregnancy complications
• Diagnosed with prediabetes
• Given birth to a stillborn baby
• Previously given birth to a baby over 9 pounds

How Does GDM Affect My Baby?

Although GDM doesn’t usually pose a threat to expectant moms, it can cause problems for the baby if it isn’t treated properly or controlled. The major risk is delivering a baby that weighs 9 pounds, 14 ounces or more. This can cause shoulder dystocia, meaning the shoulders are too wide to come through the birth canal, preventing vaginal delivery. Other problems that can develop if GDM is not treated are low blood sugar in the baby shortly after birth, jaundice, breathing problems, and high insulin levels.

Babies born with excess insulin run a greater risk of obesity in childhood and adulthood, which could make them prone to Type 2 diabetes later in life.

Drink This, Please

An oral glucose tolerance test will be the first step to test for GDM. You’ll drink a sweetened liquid, which contains glucose. The body absorbs this quickly, causing blood sugar levels to rise with 30-60 minutes. Next, blood will be drawn from a vein in your arm. The blood test determines how the glucose solution was metabolized. If the test shows abnormal levels, then you’ll take another test that requires you to fast before drinking the sweetened drink. If the second test results in abnormal levels, then you have gestational diabetes.

Managing GDM

You’ll start by monitoring your blood sugar levels. You can purchase a diabetes kit which includes needles to prick your finger and a small machine that will show the blood sugar number. The needles are tiny, so no need to feel squeamish. Check your blood when your doctor suggests, usually first thing in the morning. You may also need to check it an hour after each meal to make sure your blood sugar level stays in the range your doctor suggested.

Next, you’ll want to follow your doctor’s plan for eating a healthy diet. You may even consider meeting with a dietician to help you make good choices for eating a low sugar and low carb diet.

Finally, get moving. Walking, prenatal yoga, swimming, or Pilates are some good choices. Just avoid any contact sports. When you make good food choices and stay active, it will show on your blood sugar readout and keep you motivated!

It may seem like a daunting daily task to prick your finger, but testing your blood sugar at specific times of the day will help verify if your exercise and eating patterns are keeping your blood sugar levels in control, or if you need extra insulin to protect your developing baby.

You’re in Control

Careful management of monitoring, diet, and exercise – all things you can knock out on your own– are often enough to control GDM. If your levels become abnormal, your doctor may suggest supplementary insulin to control it. This may be in the form of a shot or an oral diabetes medication that helps the pancreas produce insulin.

Are you at risk for, or do you currently have gestational diabetes? What are you doing to keep your blood sugar levels under control?