Your Amazing Body

Your incredible pregnant body adapts in many ways to feed and provide for your growing baby. Your placenta brings nutrition and oxygen to baby while it removes carbon dioxide and waste. You and your baby receive energy from glucose, what we often think of as “blood sugar,” carried to your body’s cells via insulin. Your pancreas produces insulin and releases it into your bloodstream; still, it doesn’t move through the placenta to baby.

Your baby’s pancreas produces its own insulin. During pregnancy, your body has circulating hormones that resist the effects of insulin, which slows how fast glucose enters your cells, and this helps baby receive glucose for their developing body.

Your body adapts to provide the glucose your baby needs to grow and develop.

How Does Gestational Diabetes Develop?

Gestational diabetes develops when your pancreas can’t produce the extra insulin needed to balance the insulin resistance created by pregnancy hormones. This leaves more glucose circulating in your blood than normal, which is known as high blood sugar or hyperglycemia. Approximately 2-10% of pregnancies are complicated by gestational diabetes.

How is Gestational Diabetes Diagnosed?

There are two types of laboratory tests used to diagnose gestational diabetes, a screening test, and a confirmation test.

Laboratory screening test: Your healthcare provider will likely order a glucose screening test, otherwise known as a glucose challenge test, between 24 and 28 weeks gestation to check for gestational diabetes.

For this test, you’ll be given a flavored glucose drink and then have your blood glucose levels measured one hour later. You don’t need to fast before this test. If your blood glucose level is less than 140, you don’t have gestational diabetes. If your blood glucose is 140 or more, this is considered a positive screening test, which will compel your pregnancy care provider to request a confirmation test to learn if you have gestational diabetes.

Confirmation test: For a confirmation test, oral glucose is given after at least 8 hours of fasting. A fasting blood glucose blood level is drawn first, and then you’ll be given a flavored glucose drink. After finishing the drink, your blood glucose levels will be tested every hour for three hours. High glucose levels for two or more of the blood draws is considered a positive test, and it’s likely your provider will diagnose you with gestational diabetes.

Gestational Diabetes: Am I at Risk?

Federal health experts have developed a short quiz of questions to help you learn if you‘re at risk for developing gestational diabetes. These questions include:

  • Are you older than 25?
  • Are you related to anyone who has or has had diabetes?
  • Do you have high blood pressure, high cholesterol, or heart disease?

Will I Have to Take Insulin?

If diagnosed with gestational diabetes, your pregnancy care provider will likely ask you to monitor your blood sugar and your diet. Many pregnant people with gestational diabetes manage their blood sugar by adjusting their diet, increasing physical activity, and reducing stress.

Gestational diabetes can often be managed by lifestyle changes.

Your healthcare provider may prescribe medication if your blood glucose level remains high despite lifestyle changes. Medication (pill or insulin injection) is typically used as a last option but may be needed to keep your blood sugar in normal range.

Are There Any Complications?

Gestational diabetes can cause preterm birth, kidney infection, and damage to your retinas. Your baby could be affected by neural tube defects, enlarged organs, or abnormal growth. You both will have an increased risk of developing Type 2 diabetes later in life.

Peace of Mind

For peace of mind, it’s important to follow your pregnancy care provider’s recommendations to keep your glucose level in a normal range. Ask your provider questions to learn all that you can; you and your baby’s health is worth it.

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Jamie Vincent, MSN, RNC-OB, C-EFM, is a nurse expert adviser to Healthy Mom&Baby.

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