Gestational Diabetes Explained

With November being National Diabetes Month, we wanted to take the opportunity to talk about Gestational Diabetes Mellitus (GDM), a condition that affects 2-10% of all pregnancies in the United States annually, according to the CDC. GDM is a condition in which too much glucose (sugar) stays in the blood rather than being used for energy during pregnancy. Hormonal changes due to pregnancy can impact insulin levels, leading to GDM.

How long does gestational diabetes last?

GDM goes away after childbirth, but women who develop this condition have a higher risk for developing diabetes later in life. However, women who have undiagnosed diabetes prior to the pregnancy may continue to be diabetic after childbirth.

How is gestational diabetes screened?

Between weeks 24 and 28 of pregnancy, women are screened for GDM using the glucose challenge test. For this test, patients come into the office in the morning to drink a sugary solution. About an hour later, their blood is drawn to assess blood glucose levels.

Who is at risk for developing GDM?

Several risk factors are linked to GDM. This condition can also occur in women who have no risk factors, but is more likely in women who are overweight, physically inactive, have previously been diagnosed with GDM, had a very large baby in a previous pregnancy (9.5 pounds or more), have high blood pressure, have a history of heart disease and/or have polycystic ovary syndrome.

How can GDM impact a pregnant woman and her pregnancy?

GDM can lead to a larger baby (9.5 pounds or more) due to higher levels of sugar being passed to the fetus during pregnancy. This can cause an increase in the baby’s blood sugar, insulin and growth hormone, which causes increased fat deposition. A larger fetus can lead to certain delivery complications and ramifications, including labor difficulties, cesarean delivery, heavy bleeding after delivery and severe tearing during a vaginal birth. GDM can also increase a woman’s risk for developing other problematic conditions during pregnancy, including high blood pressure and preeclampsia.

How is GDM managed during pregnancy?

GDM is managed through more frequent doctor appointments, blood sugar tracking, healthy eating and regular exercise. Sometimes medications are also recommended for controlling blood sugar.

Does GDM affect the baby?

As we discussed above, GDM can lead to larger fetuses. There are several risks associated with delivering babies that weigh 9.5 pounds or more. A shoulder dystocia can lead to a fracture of a baby’s arm or shoulder during delivery, and more concerning, can lead to a nerve injury. (There is actually a 10 times greater risk of a clavicle fracture (shoulder bone breaking) and a 20 times greater risk of nerve injury if a baby weighs more than 9.5 pounds at birth.) Larger babies also have a higher chance of blood sugar problems in the first few days of life and require multiple glucose evaluations with bloodwork. In addition, there is a higher chance of admission to the neonatal intensive care unit. Larger babies also have a lifetime greater risk for obesity.

Please know, when we monitor your weight, ask about your exercise routine and nutrition habits, and require a GDM test during your pregnancy, it’s because we care about you and your baby and want what is best for you. We know this is a sensitive topic for women (after all, many of our doctors are women, too!). But, it is our job to ensure your pregnancy and delivery process are optimized and risks are minimized.

If you have any questions or concerns about gestational diabetes, be sure to ask your doctor at your next appointment or call us anytime.