Enjoying A Healthy Pregnancy: How To Prevent Gestational Diabetes

Every year, up to 10% of pregnant women¹ in the United States develop gestational diabetes (also known as gestational diabetes mellitus or GDM).

This type of diabetes can affect the mother and baby's health. By taking control of this condition, it's possible to prevent complications, carry to term, and deliver a healthy baby.

Some women are more likely to develop GDM than others. Keeping risk factors in mind, you can work out effective preventive strategies during your pregnancy. Let's take a closer look at how to prevent gestational diabetes.

What is gestational diabetes?

Gestational diabetes is a condition that occurs during pregnancy. It affects the way your cells turn glucose into energy.

During pregnancy, your body starts making extra hormones and undergoes numerous changes. These changes cause your cells to use insulin produced by the body less effectively than when you aren't pregnant.

Eventually, you can develop insulin resistance such that your cells can't use insulin properly to get glucose from the blood and turn it into energy.

There are two types of gestational diabetes:

• Class A1 –Gestational diabetes that can be controlled with diet and exercise

• Class A2 – Gestational diabetes that can be controlled with oral medications or subcutaneous insulin

Pregnant women usually develop gestational diabetes around the 24th week of pregnancy. Once you give birth, the condition is likely to go away. However, you will still have a higher risk of developing type 2 diabetes in the future.

Symptoms of gestational diabetes

The key issue with gestational diabetes is that it doesn't usually present any symptoms. Many mothers-to-be don't know about the problem until it starts causing complications. That's why it's important to test blood sugar levels during pregnancy.

Sometimes, you may experience mild symptoms that include:

• Fatigue

• Excessive thirst

• Excessive hunger

• Frequent need to urinate

• Yeast infections

These symptoms can occur during pregnancy even if you don't have GDM. That's why women rarely suspect something is wrong until their doctors receive glucose test results.

Causes of gestational diabetes

Scientists are yet to discover the cause of gestational diabetes. However, it probably has something to do with the way your body produces excess hormones during pregnancy.

As your placenta grows to support the fetus, it also secretes numerous hormones to sustain the pregnancy. Some of these hormones (human placental lactogen, cortisol, and estrogen) have a blocking effect on insulin.

As the baby becomes bigger and needs more support from your body, the placenta starts producing even more of these hormones, and the risk of insulin resistance increases.

In some cases, a woman's body can compensate for this resistance and produce enough insulin for the cells to convert glucose to energy. When it can't, the mother-to-be develops gestational diabetes.

Risk factors for gestational diabetes

Some women are at a higher risk of developing gestational diabetes than others. That's why it's important to speak to your doctor at the pregnancy planning stage. If the doctor decides that your risks of developing this condition are high, you can start taking preventive measures.

The common risk factors for gestational diabetes are:

• Excess weight – Overweight and obese women are more likely to develop this type of diabetes than those with a normal BMI (Body Mass Index). Those who gain excessive weight during pregnancy are also at increased risk for GDM.

• Insufficient physical activity – Women who lead a sedentary lifestyle before pregnancy may be at a higher risk of gaining excess weight and developing GDM.

• Previous GDM or prediabetes – Previous cases of GDM and prediabetes could increase the risk of developing GDM during future pregnancies.

• Polycystic ovary syndrome (PCOS) - A study² of 9.1 million pregnancies demonstrated women with PCOS are twice as likely to develop gestational diabetes than women without this condition.

• Heredity - GDM doesn't have a clear pattern as an inherited condition. However, if an immediate member of your family (parent or sibling) suffers from any type of diabetes, you are more likely to develop gestational diabetes.

• Race – Asian Americans, American Indians, Blacks, and Hispanics have a higher risk of developing GDM. The lowest prevalence of GDM is in non-Hispanic white women.

• Age - GDM is much more common in pregnant women over 35.

You may also be at a higher risk of developing GDM if you have previously given birth to a large (over 9 pounds) baby or a child with birth defects.

How to diagnose gestational diabetes

Since gestational diabetes rarely presents symptoms, the only way to diagnose it is to run some tests. Your doctor should check for gestational diabetes between the 24th and 28th week of your pregnancy. If you are at risk of developing the condition, they could start running tests just after the 20th week.

Here are the tests used to diagnose gestational diabetes:

• Glucose challenge – You will drink 1.8 ounces (50 grams) of glucose to raise your blood sugar. In an hour, the doctor will do a blood glucose test to see how your body handles this excessive sugar. If the results are abnormal, you may need to do a glucose tolerance test.

• Glucose tolerance test – After you fast for at least eight hours, the doctor will draw your blood. Then you'll drink 3.5 ounces (100 grams) of glucose, and the doctor will redo the test every hour for three hours in a row.

If the results come back normal, but your risks of developing this condition are high, your doctor may decide to redo the tests a few weeks later.

How to treat gestational diabetes

The treatment for gestational diabetes depends on its severity. The majority of women with GDM can manage the condition by:

• Adjusting diet – A doctor and a dietitian can help you adjust your diet to prevent excessive blood sugar levels.

• Being active - Exercise is beneficial for improving pregnancy outcomes for women with GDM, including aerobic and resistance exercises of varying intensity for 30 to 60 minutes a day, three times a week.

Women with severe cases of gestational diabetes may need to take medications such as metformin or insulin. A doctor will recommend a dosage and explain how and when to take the medication.

Regardless of GDM's severity, mothers-to-be need to monitor blood sugar levels, often several times a day. A doctor will explain the frequency and teach you how to do this at home.

Complications of gestational diabetes

If left untreated, gestational diabetes could lead to various complications for both the mother and the baby. These include:

• High blood pressure – Studies show³ that women with PCOS and GDM are twice as likely to develop preeclampsia. This condition could lead to organ damage for the mother and health issues for the fetus. High blood pressure could also lead to preterm birth.

• Macrosomia (birth weight over 9 pounds) – 15%-45% of children born to mothers⁴ with GDM suffer from macrosomia. This could increase the chances of C-section, vaginal lacerations, and postpartum hemorrhage for the mother. The baby has a higher risk of developing obesity and type 2 diabetes.

• Low blood sugar – Babies born to mothers with GDM may have low blood sugar levels after birth. This could lead to seizures.

Even if you are getting treatment for gestational diabetes, you should still be testing your blood sugar levels regularly. Once you give birth, you need to continue monitoring these levels since GDM puts you at a higher risk of developing type 2 diabetes.

How to prevent gestational diabetes

Regardless of your risk factors, you can try to prevent gestational diabetes by:

• Eating healthy foods – A healthy diet can keep your blood sugar levels from spiking before and during pregnancy. A study found⁵ that overweight women who changed their diet decreased their chances of developing gestational diabetes by 10%.

• Staying active – Regular exercise can help you stay healthy before getting pregnant and prevent you from gaining excess weight.

• Losing weight – Since excess weight is a risk factor for GDM, losing extra pounds before pregnancy is an excellent way to reduce your chances of developing this condition. You shouldn't try to lose weight during pregnancy unless the process is closely monitored by your doctor.

• Watching your weight – Start monitoring your weight when you learn about your pregnancy. While it's normal to put on some extra pounds, an excessive gain could lead to GDM.

• Seeing your doctor regularly – Pregnant women need to consult their obstetrician regularly. During these routine visits, a doctor who monitors your pregnancy could notice the warning signs of certain conditions that may lead to GDM.

Keep in mind that even if you lead a healthy lifestyle, there is no guarantee that you won't develop GDM. However, it can definitely improve your chances of battling the problem and giving birth to a healthy baby.

The lowdown

Gestational diabetes is a condition that affects many American women. With timely diagnosis and treatment, it's possible to minimize adverse health consequences for the mother and baby.

If you learn how to prevent gestational diabetes early, you may be able to avoid this condition and reduce your risk of developing type 2 diabetes in the future.