Gestational diabetes mellitus is impaired insulin sensitivity during the later trimesters of pregnancy. It is marked by high blood glucose levels (hyperglycemia).
While this metabolic condition develops during pregnancy, it can occur among pregnant women who’ve had no previous issues with diabetes or hyperglycemia. The Centers for Disease Control and Prevention (CDC) states that gestational diabetes occurs in roughly two to 10 percent of pregnancies annually.
What Causes Gestational Diabetes?
Gestational diabetes is under the umbrella of metabolic disorders known as diabetes mellitus. While other types of diabetes — type 1 diabetes and type 2 diabetes — tend to be chronic, gestational diabetes develops specifically during pregnancy.
According to the American College of Obstetricians and Gynecologists (ACOG), gestational diabetes represents the most common pregnancy complication.
Most experts believe it results from a combination of lifestyle factors and higher levels of hormones during pregnancy. This is due to things like weight gain and placental hormone production. These changes can contribute to insulin resistance.
Insulin Resistance and Blood Sugar
According to the American Diabetes Association, insulin resistance is marked by a tolerance to insulin that makes it less effective, especially regarding blood glucose.
Glucose is an essential nutrient and energy source for the body’s cells and is a byproduct of metabolism by the digestive and endocrine systems. More specifically, glucose is the result of the breakdown of carbohydrates.
In the body, glucose (blood sugar) enters the bloodstream and is driven into the cells by insulin, a naturally-occurring hormone produced in the pancreas by beta cells. Insulin production rises when the blood sugar gets too high to regulate levels.
High Blood Sugars Levels
Under normal conditions, insulin and blood sugar act as a feedback loop, rising and falling to maintain homeostasis. However, sometimes this process is disrupted.
For many reasons, the body can build up a tolerance to insulin (insulin resistance) or become unable to keep up with the glucose in the blood. The outcome is high blood sugar levels. Over time, sustained high blood sugar levels can lead to chronic conditions like type 2 diabetes, a serious risk factor for heart disease, stroke, and kidney disease.
When insulin resistance and higher than normal blood sugar levels occur during pregnancy, it is called gestational diabetes. Blood sugar is measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).
For pregnant women, the ADA recommends the following target blood sugar levels:
- Blood sugar before a meal – 95 mg/dL or below
- Blood sugar one hour after a meal – 140 mg/dL or below
- Blood sugar two hours after a meal – 120 mg/dL or below
What Are the Risk Factors for Gestational Diabetes?
While insulin resistance can develop during any otherwise healthy pregnancy, certain factors can raise the risk of gestational diabetes. These higher risk factors include:
- Maternal age, women over the age of 25
- Obesity or being overweight (BMI 25 or more)
- History of prediabetes
- Family history of type 2 diabetes
- Previous gestational diabetes diagnosis
Also, certain health problems, like high blood pressure (preeclampsia), can contribute to gestational diabetes. A hormone disorder known as polycystic ovary syndrome (PCOS) can also increase insulin resistance during pregnancy.
Certain ethnic groups are more susceptible to gestational diabetes. These high-risk ethnic groups include Hispanic or Latino Americans, Asian Americans, American and Alaska Natives, Pacific Islanders, and African Americans.
What Are the Complications of Gestational Diabetes?
In many cases, gestational diabetes has no noticeable symptoms, and general pregnancy symptoms can mask mild symptoms like fatigue. However, for some women, symptoms can include excessive thirst, increased urination, and increased weight gain.
In terms of pregnancy complications, gestational diabetes can lead to the following issues if left unmanaged and untreated:
- Excessive birth weight (infant macrosomia)
- Infant low blood sugar (hypoglycemia) at birth
- Higher risk for cesarean section (c-section)
- Postpartum type 2 diabetes
How Is Gestational Diabetes Treated?
Thankfully, many gestational diabetes care plans can help manage and treat this condition; most involve simple lifestyle changes. Let’s look at some of the most effective ways to manage and treat gestational diabetes.
Stick to a Healthy Diet
A healthy diet is one of the most effective ways to manage and treat gestational diabetes. You can manage high blood sugar in the kitchen by sticking to a few important tips.
Firstly, meal plans should focus on healthy foods like cruciferous vegetables, high-fiber fruits, and lean proteins. Also, try and choose complex carbohydrates over simple carbs.
Complex carbs are high in fiber and digest slower. This helps avoid spikes in blood sugar and includes foods like whole grains (brown rice, whole wheat cereals, etc.).
- Lean protein from chicken, fish, lean beef, and beans.
- Healthy fats, including olive and coconut oils, avocados, nuts, and seeds.
- Low-sugar fruits and non-starchy, cruciferous vegetables.
Refined carbs, processed foods, and foods with artificial sweeteners and added sugars should be avoided whenever possible. This includes sugary drinks like juice and soda.
If unsure where to start, ask your obstetrics healthcare professional or consult a registered dietitian to help you sort out an effective meal plan. Also, many health care providers enlist diabetes care specialists to help patients create meal plans based on their needs.
Other healthy dietary tips:
- Spread out your meals throughout the day to avoid spikes in blood sugar.
- Avoid high carbohydrate foods before bed that can raise fasting blood sugar levels.
- Stay hydrated by drinking at least eight to 12 cups of water a day.
The importance of physical activity for managing gestational diabetes cannot be overstated. Your muscles need glucose to function.
Regular exercise raises this demand and can help lower blood sugar levels. Daily aerobic exercise is the goal.
Moderate exercise includes low-impact exercises like brisk walking, swimming, and yoga. It can also include things like hiking or simply playing with the kids. Aim for 30 minutes of physical activity a day.
Aside from helping to lower glucose levels, daily exercise can also help you sleep better at night and help you avoid other pregnancy issues like swelling and muscle cramps.
Before diving into a new workout plan, consult your gynecology healthcare team to determine which exercises are safe or should be avoided.
Get Good Sleep
As hard as it may be, it is important to aim for seven to eight hours of sleep at night because poor sleep and insulin resistance may be connected.
Regularly Monitor Glucose
One of the most important management practices for gestational diabetes is regular blood sugar monitoring. For many people, it will become a part of their daily routine.
In many cases, your healthcare provider will want you to check and log your glucose levels daily. This usually occurs first thing in the morning (fasting blood sugar level) and after meals.
Checking and tracking blood sugar can help ensure your levels are staying within the preferred ranges set by your doctor.
Attend Prenatal Care Appointments
In addition to daily glucose monitoring, it is important to attend all ultrasounds and screening exams to help catch any warning signs that the condition is worsening.
A screening exam may include an oral glucose tolerance test. This glucose challenge test helps monitor the effectiveness of insulin in the body before and after a sugary solution.
Before your appointment, it is also vital to list the symptoms you’re experiencing that could be related to gestational diabetes. This can help give your healthcare professional clues about how the condition progresses.
This can also include any major stresses or recent changes in your life. Stress hormones can impact blood sugar levels.
Are There Medications for Treating Gestational Diabetes?
In some cases, diet and exercise fall a bit short in helping to manage gestational diabetes. If so, interventions like insulin injections may be needed.
Also, it is not uncommon for healthcare providers to prescribe oral medications like metformin as part of a gestational diabetes treatment plan.
These interventions and therapies are often employed alongside the diabetes management strategies above.
The Bottom Line
Gestational diabetes is a metabolic condition that affects insulin sensitivity and glucose management during pregnancy. It is marked by high blood sugar levels and can lead to pregnancy complications if left untreated.
Thankfully, there are some effective ways to help manage and treat the effects of gestational diabetes. They involve important lifestyle factors like a healthy diet and regular exercise.
Before starting a new diet or workout regime, consult your healthcare professional to ensure it’s safe for you.
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Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Camille Frekin and medically reviewed by Dr. Angel Rivera.
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