What every pregnant woman needs to know about diabetes.
Gestational diabetes is a form of diabetes that begins during pregnancy in a woman who did not have type 1 or type 2 diabetes before getting pregnant. Risk factors for gestational diabetes include being older than 25, having a family history of diabetes or gestational diabetes, being overweight, or having African American, Hispanic, or Asian American ethnicity.
Gestational diabetes often has no present symptoms, so around 24-28 weeks of the pregnancy, doctors do a routine screening for this, known as glucose tolerance testing. The test involves drinking a glucose solution (the taste … not so great), then getting your blood sugar tested an hour later. If the result is positive, you do a repeat glucose tolerance test on a different day, where you drink a glucose solution and have your blood sugar tested once an hour for three hours.
“If you’re pregnant, your main concern is your baby,” says certified diabetes educator Sandra Arévalo, RDN. “Your baby is going to be safe, but there’s going to have to be a little bit of work.”
For a safe and healthy pregnancy, treatment for gestational diabetes includes changes in diet, an increase in physical activity, and taking medication (often insulin) if needed. The goal is to keep blood sugar levels similar to those of pregnant women without gestational diabetes, according to the American Diabetes Association.
Of course, eating a nutrient-packed diet and managing cravings and aversions while pregnant is already difficult—even without the added worry of managing blood sugar levels—so it’s great if you can work with a registered dietitian or a diabetes educator to simplify making healthy eating choices.
If it all sounds overwhelming, here’s a simple tip: “You want to get a mix of carbohydrate, protein, and healthy fats at each meal and preferably at each snack,” says registered dietitian Frances Largeman-Roth, RDN. (Here are more tips for eating a healthy diet to manage diabetes.)
Gestational diabetes typically goes away after pregnancy; however, it may likely return in future pregnancies, and you’ll have a higher chance of developing type 2 diabetes later in life. Because of this risk, doctors suggest a follow-up glucose tolerance test within a few months of delivery.
“After the baby comes, keep up with your healthy eating and exercise,” says Largeman-Roth, “and hopefully you can prevent diabetes down the road.”
Learn more about managing diabetes and blood glucose levels here.
Dr. Chaudhry is an endocrinologist at NYU Langone Health in New York City.Sandra Arevalo
Sandra Arevalo is a spokesperson for the American Association of Diabetes Educators and Academy of Nutrition and Dietetics and director of nutrition services and community outreach at South Bronx Health Center.Frances Largeman-Roth
Frances Largeman-Roth is a nutritionist and cookbook author in New York City.
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Gestational diabetes is
diabetes that develops during
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pregnancy in a person who did not have
diabetes before they became pregnant.
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So risk factors for developing
gestational diabetes include being older
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than the age of 25,
having a family history of diabetes,
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having a history of gestational
diabetes in a prior pregnancy,
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being overweight, and
if you're from a high risk ethnic group.
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If you're of African-American,
Hispanic origin or
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Asian origin, your risk is increased.
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Typically patients who have gestational
diabetes have no symptoms, so
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doctors screen for this.
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They may screen earlier in the pregnancy
if you're considered very high risk.
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But routinely doctors will screen for
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gestational diabetes anywhere
from 24 to 28 weeks.
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And that screening entails glucose
tolerance testing, where you drink 50
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grams of glucose and your blood
sugar is measured an hour later.
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If your blood sugar exceeds 130,
it's a positive screening test and
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you'll be asked to do subsequent testing.
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You'll be asked to do a three
hour glucose tolerance test.
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Here you'll drink 100 grams of glucose and
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your blood sugar will be
measured hourly for 3 hours.
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And if your blood sugar exceeds
normal on more than two occasions,
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that's consistent with the diagnosis
of gestational diabetes.
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If you're pregnant,
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your main concern is your baby.
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What are the implications for my baby?
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Is my baby going to be safe?
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The answer is yes, your baby is going
to be safe but there is gonna have to
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be a little bit of work.
Gestational diabetes is treated
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with a combination of approaches.
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Changes in diet,
increased physical activity, and
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medications if needed.
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a lot of women get overwhelmed when
they're not only pregnant, but they've
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just been diagnosed with gestational
diabetes cuz you have cravings to manage.
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You have all these extra nutrients that
you have to get in, more omega 3s,
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more fiber, more calcium, all this stuff.
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So it's great if you can work
with a registered dietician or
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a diabetes educator to help you
plan out meals and plan out snacks.
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But the basic thing to keep in mind is
that you wanna get a mix of carbohydrate,
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protein and healthy fats at each meal and
preferably at each snack as well.
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Because that's gonna really
help manage your blood glucose.
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patients who have a history of
gestational diabetes should do
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a formal glucose tolerance test within
a couple of months of delivery.
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If that testing is normal, they should
continue to be screened at least annually.
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When you have gestational diabetes,
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that gives you a greater risk of
developing type 2 diabetes down the road.
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So after the baby comes, keep up with
your healthy eating and your exercise.
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And hopefully you can prevent
diabetes down the road.
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How to treat gestational diabetes. Arlington, VA: American Diabetes Association, 2020. (Accessed on January 1, 2021 at http://www.diabetes.org/diabetes-basics/gestational/how-to-treat-gestational.html.)Patient education: Gestational diabetes mellitus (beyond the basics). Waltham, MA: UpToDate, 2020. (Accessed on January 1, 2021 at https://www.uptodate.com/contents/gestational-diabetes-mellitus-beyond-the-basics.)