What is gestational diabetes?
This is a type of diabetes that some women get during pregnancy. Between 2 and 10 percent of expectant mothers develop this condition, making it one of the most common health problems of pregnancy.//
Diabetes is complicated, but in a nutshell it means you have abnormally high levels of sugar in your blood. Here's what happens:
When you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then, with the help of insulin (a hormone made by your pancreas), your cells use the glucose as fuel. However, if your body doesn't produce enough insulin – or your cells have a problem responding to the insulin – too much glucose remains in your blood instead of moving into the cells and getting converted to energy.
When you're pregnant, hormonal changes can make your cells less responsive to insulin. For most moms-to-be, this isn't a problem: When the body needs additional insulin, the pancreas dutifully secretes more of it. But if your pancreas can't keep up with the increased insulin demand during pregnancy, your blood glucose levels rise too high, resulting in gestational diabetes.
Most women with gestational diabetes don't remain diabetic after the baby is born. Once you've had gestational diabetes, though, you're at higher risk for getting it again during a future pregnancy and for developing diabetes later in life.
How will I know if I have gestational diabetes?
Gestational diabetes usually has no symptoms. That's why almost all pregnant women have a glucose-screening test between 24 and 28 weeks.
However, if you're at high risk for diabetes or are showing signs of it (such as having sugar in your urine), your caregiver will recommend this screening test at your first prenatal visit and then repeat the test again at 24 to 28 weeks if the initial result is negative.
By the way, if you get a positive result on a glucose-screening test, it doesn't necessarily mean that you have gestational diabetes. It does mean that you'll need to take a longer follow-up test (a glucose tolerance test, or GTT) to find out.
How can I tell whether I'm at high risk for gestational diabetes?
According to the American Diabetes Association, you're considered at high risk for this condition (and should be screened early) if:
- You're obese (your body mass index is over 30).
- You've had gestational diabetes in a previous pregnancy.
- You have sugar in your urine.
- You have a strong family history of diabetes.
Some practitioners will also screen you early if you have other risk factors, such as:
- You've previously given birth to a big baby. Some use 8 pounds, 13 ounces (4,000 grams, or 4 kilos) as the cutoff; others use 9 pounds, 14 ounces (4,500 grams, or 4.5 kilos).
- You've had an unexplained stillbirth.
- You've had a baby with a birth defect.
- You have high blood pressure.
- You're over 35.
In addition, a study published in the March 2010 issue of Obstetrics & Gynecology found an association between excessive weight gain during pregnancy – particularly in the first trimester – and the risk of gestational diabetes. Researchers found the risk highest in women who were overweight to begin with and in nonwhite women.
Keep in mind that many women who develop gestational diabetes don't have any risk factors. That's why most practitioners will order the screening at 24 to 28 weeks for all their pregnant patients as a matter of course.
That said, a small number of women might be considered at such low risk that they might not have to get tested. You're part of this group if you meet all of the following criteria:
- You're younger than 25.
- Your weight is in a healthy range.
- You're not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
- None of your close relatives have diabetes.
- You've never had a high result on a blood sugar test.
- You've never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.
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