How To Treat Gestational Diabetes

How To Treat Gestational Diabetes

Pregnancy brings about so many physical and emotional changes. Of course, some fluctuations are expected and healthy — such as gaining weight. However, it’s essential to monitor your blood sugar levels as your pregnancy progresses. If they get too high, it’s possible to develop gestational diabetes mellitus (GDM), also known as pregnancy-induced diabetes.  

Though a temporary form of diabetes, it’s essential to treat GDM to prevent health complications for you and your baby. If you're diagnosed with gestational diabetes, it's still possible to have a healthy pregnancy. However, managing your symptoms and implementing specific lifestyle changes will be essential.

Here's what you should know about screening for, treating, and coping with gestational diabetes.

What is gestational diabetes?

Gestational diabetes is a condition that occurs when a pregnant woman's blood sugar levels become too high. According to the Centers for Disease Control (CDC), pregnancy-induced diabetes tends to affect women around the 24th week of pregnancy but may occur earlier or later. It’s routine for doctors to screen for gestational diabetes between the 24th–28th week. Note Pregnant women with pre-existing Type 1 or Type 2 diabetes have separate health considerations that differ from women with gestational diabetes. It’s essential to manage any form of diabetes per your obstetrician or healthcare provider’s recommendations.

How common is gestational diabetes in pregnancy?

In the US, an estimated 2–10%¹ of pregnant women will develop gestational diabetes mellitus (GDM).  

One large retrospective cohort study² concluded that a 5.8% rise in GDM during 2008–10 was partially explained by trends to do with body mass index (BMI), race, smoking, and increased maternal age. 

What causes gestational diabetes?

Having gestational diabetes is different from being diabetic before pregnancy. Instead, the condition develops in response to pregnancy. 

Especially in the last months of pregnancy, the placenta (which forms in the uterus) contains hormones that can cause insulin resistance — a condition in which your body doesn’t use insulin well.

Insulin is a hormone. It's responsible for helping you use glucose for energy and keeps your blood sugar levels in a normal range. 

Some women have the capacity to produce more insulin and counteract insulin resistance. If your body is unable to keep up with making enough insulin, gestational diabetes develops.

Risk factors for developing gestational diabetes

In most cases, developing gestational diabetes is not preventable. However, Diabetic.org outlines multiple risk factors that may increase the possibility of GDM during pregnancy, including

• Over the age of 25

• Overweight

• High blood pressure before pregnancy

• Multiple previous pregnancies 

• History of gestational diabetes

• Excessive weight gained during a previous pregnancy

• Family history of Type 2 diabetes

• Polycystic ovarian syndrome (PCOS)

• Being  African American, Asian American, Pacific Islander, Native American, or Hispanic

• Being pregnant with twins or triplets

• A previous baby weighing over 9 lbs.

• A previous stillbirth 

• Taking glucocorticoids (steroid hormones sometimes used to treat inflammation, autoimmune disorders, and cancer)

• Previous blood sugar tests have been outside the normal range

What are the symptoms of gestational diabetes?

It's common that women with gestational diabetes don’t have symptoms, which is part of why it’s so important for pregnant women to undergo screening. This is true even if they lack the common risk factors listed above. 

If you have GDM, it’s possible that you’ll notice increased thirst, more frequent urination, or tiredness. But, since those latter two symptoms are quite common during any pregnancy, this again underscores the need for routine testing.

How is gestational diabetes diagnosed?

During your pregnancy, your healthcare provider will perform routine blood sugar tests to determine if you have gestational diabetes. These tests aim to evaluate your blood sugar levels and how fast you can metabolize glucose. Getting an accurate diagnosis could require two tests:

Why is it important to treat gestational diabetes?

Since GDM may not have apparent symptoms, it may not seem like a serious condition. But, when untreated, it can lead to severe complications for both you and your baby—both during and after pregnancy. 

Fortunately, with the right treatment, it can be effectively managed. Possible complications from gestational diabetes include:

• High birth weight Having a blood sugar level that is too high can cause your baby to gain too much weight before it's born. Babies that are larger than normal (over 9 pounds) have an increased risk of experiencing injuries during birth or needing to be delivered by C-section.

• Early labor High blood sugar levels could send you into early labor or require that you be induced early due to your baby's size.

• Low blood sugar In some cases, babies born to mothers with gestational diabetes have low blood sugar (hypoglycemia) at birth. In severe instances, this could lead to seizures. 

• Severe breathing problems Babies born to mothers with gestational diabetes sometimes have a condition known as respiratory distress syndrome, which makes breathing normally a challenge.

• Type 2 diabetes and obesity Babies born to mothers with gestational diabetes have a higher chance of developing Type 2 diabetes and obesity when they grow up.

• Pregnancy loss Gestational diabetes can lead to a baby dying before or soon after birth.

• High blood pressure Gestational diabetes makes you more likely to experience high blood pressure and preeclampsia (high blood pressure occuring during pregnancy) which can be life-threatenin for both the mother and baby.

• Post-pregnancy diabetes Gestational diabetes increases your chances of developing GDM again with a future pregnancy, or increases your risk of developing Type 2 diabetes later in life.

• C-section Gestational diabetes makes you more likely to deliver your baby by C-section. 

What is the treatment for gestational diabetes?

If you have been diagnosed with gestational diabetes, there are proactive steps you can take to manage the condition and reduce the risk of complications. Treating gestational diabetes involves:

Screening

One of the most important ways to treat gestational diabetes is to receive a diagnosis as soon as possible. The earlier you have an accurate diagnosis, the quicker you can begin managing your blood sugar levels and implementing healthy lifestyle changes.

Following a nutritious eating plan

What you’re eating during your pregnancy will have a significant effect on your blood sugar levels. 

Work closely with a dietitian or similarly qualified healthcare professional to create an eating plan that is appropriate for managing gestational diabetes. Women with gestational diabetes are generally advised to:

• Avoid skipping meals (aim for at least three meals a day)

• Eat foods with a low glycemic index such as beans, lentils, wholewheat pasta, and brown rice (they release glucose slower than high glycemic foods like white bread)

• Consume lots of fruits and vegetables

• Eat low-fat proteins

• Avoid sugary drinks

Monitoring your blood sugar

Your body will change quickly and often during pregnancy, which means that your blood sugar levels can do the same. Because of this, it's important to follow your doctor's guidelines on how often to check your blood sugar and what level you're aiming for.

Testing your blood sugar is as easy as pricking your finger and placing a small drop of blood on a testing strip. Most women are instructed to test their blood sugar level before eating breakfast, as well as one hour after eating each meal. 

Get more exercise

Staying active is an effective way to manage your blood sugar levels. Striving to get at least 30 minutes of moderate-intensity exercise at least five times a week by walking or swimming is a good way to incorporate more exercise into your regular routine. Be sure to check with your doctor before implementing new exercises while pregnant. 

Medication

It may be necessary for you to take medication during your pregnancy to maintain normal blood sugar levels. If this is the case, be sure to take your medication as directed by your doctor.

Two medications that are often used to treat gestational diabetes are metformin tablets or insulin injections. Metformin is a tablet that can be taken once to three times a day, typically during or after a meal. Insulin may be prescribed if:

• You can't take metformin

• Metformin doesn't work for you

• Your blood sugar is very high

• Your baby is very large

Your healthcare provider will advise you on how to inject insulin, how much you should take, and how often you should take it. Because blood sugar levels can increase over time, your insulin dosage may need to be increased as you get further along in your pregnancy. 

Coping and support

Getting a gestational diabetes diagnosis can be anxiety-provoking. Understandably, you may worry about your own health and your unborn baby's health. While gestational diabetes is a serious condition, knowing that you're not alone and can still have a perfectly healthy pregnancy is essential. To help you cope with the challenges of gestational diabetes and find the support to manage your condition as you should, keep these tips in mind:

Acceptance

No one wants to hear that they have gestational diabetes, but denying that you do and not treating it could lead to dangerous consequences, including premature birth. Work closely with your healthcare provider to treat your symptoms and keep yourself and your baby as healthy as possible.

Ask for help

You don’t have to bear the burden of making lifestyle changes alone. Don't hesitate to involve your partner, other children, parents, or friends in your healthy eating habits and exercise changes.

Find the right dietitian

A dietitian is an invaluable resource for managing gestational diabetes. Registered dietitians are adept at developing eating plans that accommodate food allergies or preferences.

Join a support group

Managing gestational diabetes alone can be an overwhelming experience. Recognizing that you're not alone can make a big difference in how you feel as you navigate your pregnancy. Finding other women who have been diagnosed with gestational diabetes or who have had it in the past can help. Ask your doctor for support groups available through your hospital or explore online gestational diabetes support groups. 

The lowdown

Gestational diabetes mellitus (GDM) is a serious condition that affects as many as 10% of pregnant women in the US. It occurs when the body cannot process insulin effectively during pregnancy, but the condition usually resolves after your baby is born. Being diagnosed with gestational diabetes doesn't mean that you can't have a normal pregnancy and delivery. 

Still, it does mean you'll have to make some critical lifestyle changes to prevent complications for yourself and your baby. These include monitoring your blood sugar, eating a healthy diet, exercising regularly, taking your medication as directed, and working closely with your doctor.

Choosing the right dietitian for your needs, getting your loved ones involved in living a healthier lifestyle, and finding a support group can make managing your gestational diabetes easier.  

The information provided in this article is designed to support, not replace, the relationship that exists between a patient/site visitor and their existing health care professional(s).