Are You at Risk for Gestational Diabetes?

Gestational diabetes is a condition that affects thousands of pregnant individuals each year, posing unique challenges for both maternal and fetal health. Understanding the causes, risk factors, and management strategies for gestational diabetes is crucial for ensuring a healthy pregnancy and long-term well-being. 

Here, Dr. Clementina Asamoah, OB-GYN with Riverside Women's Health, shares the essentials of gestational diabetes, including how it is diagnosed, ways to manage it effectively, and what women can expect after giving birth.

The Unique Characteristics of Gestational Diabetes

Unlike other forms of diabetes, gestational diabetes develops during pregnancy, typically in the second or third trimester, and often resolves after delivery. However, its impact can be far-reaching, increasing the risk of complications such as preterm birth, high birth weight, and future diabetes for both the parent and child. 

For example, mothers are at higher risk of developing preeclampsia, future diabetes, and may require a C-section during delivery. For babies, risks include hypoglycemia after birth, stillbirth, and birth trauma, such as shoulder dystocia.

Risk factors for gestational diabetes include having a first-degree relative with diabetes, such as a parent or sibling, as well as a personal history of hypertension, high cholesterol, polycystic ovary syndrome (PCOS), coronary artery disease, obesity, or a sedentary lifestyle.

How Is Gestational Diabetes Diagnosed?

Every pregnant woman is screened between 24 and 28 weeks with a one-hour glucose test. “If the test is normal, we can rule out gestational diabetes,” states Dr. Asamoah. “However, if that one-hour test is abnormal, we move on to a three-hour test. In the three-hour test, we check fasting at one-hour, two-hour, three-hour increments. If two of the four values are elevated, we can say you have gestational diabetes.”

If the one-hour level is severely high, the three-hour test becomes moot and OB-GYNs can confidently diagnose a woman with gestational diabetes.

How Is Gestational Diabetes Managed?

Once gestational diabetes is diagnosed, the first step is lifestyle modifications; specifically diet and exercise. “In regards to diet, we usually refer women to nutrition counseling where they meet with a licensed dietitian who helps comes up with a nutrition plan that works for their needs,” explains Dr. Asamoah. “The goal is to limit carbohydrates to at least thirty to forty percent.”

Exercise is also very important. The recommendation is at least two and a half hours per week of moderate intensity exercise. “Even something simple as taking a twenty-minute walk after a meal is beneficial,” she adds.

If blood sugar levels are still elevated with lifestyle modifications, the next step is medication. The first line in standard therapy is insulin. Insulin has been shown to be beneficial in getting blood sugars under control among gestational diabetes patients.

The good news is that gestational diabetes often resolves after giving birth. However, women who experience it are advised to undergo diabetes screening four to twelve weeks postpartum and continue testing every few years. This is because about one-third of those with gestational diabetes eventually develop type-2 diabetes later in life.

For more information about Women's Health services at Riverside click here.