Being pregnant is an exciting time full of changes in your home, your life, and especially in your body. Something most pregnant women don’t realize is just how frequently they’ll visit their OB/GYN.
During your pregnancy, your healthcare provider is your resource for understanding the changes in your body, making sure your pregnancy is healthy and comfortable, and ensuring your baby is safe. Part of this involves regular blood draws, pelvic exams, ultrasounds, and the famous glucose test that is administered in the second trimester.
If you’re newly pregnant or thinking about becoming pregnant, you might have some questions about the glucose test and about gestational diabetes. Together, we’ll talk about what gestational diabetes is, as well as its symptoms, risks, and diagnosis.
We’ll also discuss how your perinatal care may change if you have gestational diabetes and help you understand how you may be at higher risk of developing other health conditions if you have gestational diabetes.
First, let’s talk about the different types of diabetes and explain how gestational diabetes differs from the rest.
The Three Main Types of Diabetes
Understanding diabetes begins with a basic understanding of how our bodies use the foods we eat. The majority of foods we eat are broken down into glucose, a simple sugar that our cells require to carry out cellular function.
Cellular function powers tissues that power muscles and entire systems, so having enough glucose to power our cells is important. When glucose is released into our bloodstream, our blood sugar levels rise, sending a signal to the pancreas to produce insulin.
Insulin is a hormone that acts like an escort, taking the glucose molecules to the cells that need them. Any leftover glucose that isn’t immediately needed by the cells is stored in the liver and muscles as glycogen. Glycogen can be changed back into glucose for later use. Some excess glucose is stored in lipid form in adipose tissue.
All forms of diabetes ultimately affect the way your body processes the glucose in your bloodstream. A person who has diabetes does not produce enough insulin to remove the glucose from their bloodstream, has cells that can’t use the glucose as effectively, or both.
Cells that cannot use insulin effectively have become insulin resistant. That means the glucose is carried by insulin to the cells, but the cells do not intake the glucose, and it remains in the bloodstream.
There are three different types of diabetes; type 1 diabetes, type 2 diabetes, and gestational diabetes.
Type 1 Diabetes
Most commonly diagnosed in early childhood or adolescence, type 1 diabetes is a type of autoimmune disorder wherein the body incorrectly attacks pancreatic cells. Because the pancreatic cells are damaged, the pancreas cannot produce insulin. This is why type 1 diabetics are sometimes referred to as insulin-dependent diabetics.
Someone who has type 1 diabetes will be insulin dependent for life. There is no cure for type 1 diabetes, but the disease can be well managed with daily insulin and adherence to a personalized diabetes care plan outlined by the individual’s primary care physician.
Advances in diabetic healthcare have made it possible for a type 1 diabetic to use an insulin pump that automatically administers insulin injections depending on the foods that are eaten, not to mention another device that can be attached to the arm to constantly relay data about blood sugar levels to a smart phone app.
Type 2 Diabetes
The most common form of diabetes is type 2 diabetes. This type of diabetes, also known as adult-onset diabetes, occurs over time — usually several years. There may be no symptoms of type 2 diabetes, and a blood test is required to diagnose the disease.
Type 2 diabetics usually have a two-fold problem; the pancreas does not produce enough insulin to keep up with the glucose in the bloodstream, and the cells that need glucose have become insulin resistant.
It’s unclear what causes type 2 diabetes, but two factors usually precede the diagnosis:
- Obesity. Carrying excess weight or having a BMI over 30 (considered obese) is a risk factor for developing type 2 diabetes.
- Sedentary lifestyle. Being inactive usually coincides with a diagnosis of type 2 diabetes.
There is no cure for type 2 diabetes, and it is not considered “truly” reversible. However, with diet, exercise, and medication like metformin (if needed), a type 2 diabetic can lower their risk of developing other negative health conditions that often develop from having type 2 diabetes, like:
- Heart disease
- High blood pressure
- Unhealthy cholesterol levels
- Nerve damage
- Kidney diseases
Type 2 diabetics can lead healthy lives and enjoy the convenience of new technologies that allow them to test their blood sugar levels with an app on their mobile devices.
Gestational Diabetes Mellitus
Only a pregnant woman who has never had diabetes can develop gestational diabetes. During pregnancy, hormonal changes triggered by the placenta cause the storage of additional glucose in the blood.
If the body cannot keep up with the additional glucose in the blood by producing more insulin to remove it, the pregnant woman’s blood sugar levels will be too high. In addition, the hormones released by the placenta also make insulin less effective, causing insulin resistance.
This condition refers to blood sugar levels that are high but not so high they are considered diabetic. In the United States, it is estimated that 1 out of 3 people have prediabetes and don’t know it.
Prediabetes increases your risk of developing type 2 diabetes, but prediabetes is considered a reversible condition. With diet, exercise, and lifestyle changes, you can reverse a diagnosis of prediabetes and lower your risk of developing type 2 diabetes.
How Is Gestational Diabetes Different?
Having type 1 diabetes or type 2 diabetes during pregnancy is different than having gestational diabetes. If you already have diabetes, it’s a good idea to plan ahead when trying to get pregnant and talk to your doctor about how to keep healthy while you are pregnant.
During pregnancy, it may be harder for someone with type 1 diabetes or type 2 diabetes to regulate their blood glucose levels as well as they did before they became pregnant. Many diabetes medications are considered safe for use during pregnancy, and your doctor is your best source of information on which ones are right for you.
What Are the Signs of Gestational Diabetes?
Just like type 2 diabetes, you may not have any symptoms of gestational diabetes, especially before you are diagnosed. Because an oral glucose tolerance test is performed in the second trimester (usually around 24 weeks of pregnancy), gestational diabetes is usually diagnosed early, before symptoms have a chance to develop.
Symptoms of gestational diabetes may include increased thirst and frequent urination. Because increased urination and thirst may also be common symptoms of pregnancy, it’s easy to overlook them.
How Is Gestational Diabetes Diagnosed?
A glucose tolerance screening is the only way to diagnose a pregnant woman with gestational diabetes. This test involves several hours of fasting, followed by consuming a glucose liquid in your doctor’s office or in a lab.
Your doctor or lab will then take a blood sample about 20 minutes after you’ve ingested the glucose solution. That sample will help determine whether or not a gestational diabetes diagnosis is appropriate.
There is no risk to your baby’s health or to your pregnancy when you have this test, although some pregnant women complain of nausea and gastrointestinal discomfort from the glucose solution.
Risk Factors for Gestational Diabetes
It isn’t clear why some pregnant women develop gestational diabetes while others don’t. However, you may be at higher risk of developing gestational diabetes if any of the following are true:
- You have PCOS. Polycystic ovary syndrome carries a higher risk for pregnancy complications, including the development of gestational diabetes.
- Family history of diabetes or gestational diabetes. Close relatives with any form of diabetes or who have had gestational diabetes increase your risk of gestational diabetes.
- Having prediabetes. Suppose you were diagnosed with prediabetes before you became pregnant. In that case, you are more likely to develop gestational diabetes while pregnant, even if you reversed your prediabetes condition with diet and exercise.
- Being of a certain race or ethnicity, including African American, Hispanic, Asian American, or Pacific Islander.
- Being overweight.
- Being inactive.
- Having had a baby over 9 pounds previously.
- Having had a diagnosis of gestational diabetes in a previous pregnancy.
Even if you have a higher risk of developing gestational diabetes, you may be able to avoid it with diet and exercise.
Complications of Gestational Diabetes
If you have gestational diabetes, you may have an increased risk of developing complications with your pregnancy, especially if your gestational diabetes is not well managed.
Having gestational diabetes places you at higher risk of developing high blood pressure. For pregnant women, unregulated high blood pressure can lead to preeclampsia, a condition that can be life-threatening for both you and your baby.
If you have gestational diabetes, you may be more likely to have a cesarean section delivery. This can be due to the size of your baby or because of other complications that may make a vaginal delivery unsafe.
Type 2 Diabetes
Gestational diabetes affects the way your body responds to insulin. Although your gestational diabetes will likely go away on its own after you deliver your baby, you carry a higher risk of developing type 2 diabetes later in life.
Type 2 diabetes leads to health problems that can make it harder for you to maintain your wellness.
Excessive Birth Weight
According to the American Diabetes Association, one of the most prominent risks of gestational diabetes is delivering a baby outside of a healthy weight range. Macrosomia is a condition wherein a baby is born weighing over 8 pounds 13 ounces.
Babies born in this weight range are more likely to face health problems later in life and may also risk being born with “birth trauma.” Birth trauma refers to issues that occur during your baby’s delivery, like trauma and damage to the shoulders and head.
Increased Risk of Diabetes for Your Baby
Babies born with macrosomia have a higher risk of developing type 2 diabetes later in life. They are also more likely to have trouble with excess weight gain later in life.
Having gestational diabetes increases your baby’s risk of having low blood sugar when they are born. Generally, this is easily remedied by immediate feedings and glucose to help stabilize their blood sugar levels.
Although rare, there is a higher chance of stillbirth if you have gestational diabetes.
Managing Gestational Diabetes
Your goal is a healthy baby and a healthy pregnancy, and you can have both even if you’ve been diagnosed with gestational diabetes. With your doctor’s help, you can make lifestyle adjustments to support your own health and the health of your baby. Here are four things you can do to help support a healthy pregnancy.
1. Adopt a Healthy Eating Plan
Making sure you eat plenty of healthy foods that don’t contain added sugar or empty carbohydrates will be key in lowering your high blood sugar. Opt for foods that are high in fiber, protein, and healthy fats. These foods will keep you full, help your baby grow and develop properly, and keep your pregnancy safe.
When you eat carbs, opt for whole grains, fresh fruit, or crunchy vegetables. These are great sources of complex carbohydrates, which contain vitamins and minerals essential to your body.
2. Get Moving
Your doctor will help you understand how much physical activity you need. Most obstetricians and gynecologists agree that walking is a pregnancy-safe and beneficial exercise. Just 30 minutes per day, five days a week is a great way to keep your body and your baby healthy.
3. Maintain Your Weight Goals
Many pregnant women will gain weight during their pregnancies. If you are already overweight before you become pregnant, your doctor may determine that you don’t need to gain much more.
Gaining too much weight during pregnancy can increase your risk of complications with your pregnancy and may have an impact on whether or not you develop gestational diabetes.
4. Get Prenatal Care
If you are pregnant but haven’t yet seen a doctor, make an appointment as soon as possible. If you don’t have the resources to see a doctor, contact your local health department to find out what options are available for you.
A healthy pregnancy and healthy baby depend on good prenatal education and care. In addition to screening tests for gestational diabetes, you will also have access to screening for certain birth defects, genetic conditions, and other issues that are important to maintaining the health of your body and your baby.
Having Happy, Healthy Pregnancies
Pregnancy is an amazing experience, and enjoying it means not having to worry that your baby or your body is at risk. Although gestational diabetes can mean you’ll have to make a few adjustments while you are pregnant, it is still possible to have an enjoyable and healthy pregnancy.
For more information, check out the blogs on gestational diabetes. Here, you’ll find answers to many commonly asked questions about pregnancy, diabetes, and maintaining your overall wellness. You’ll also find information about fertility and how certain conditions may affect your ability to become pregnant.
When you have a burning question, don’t wonder about the solution. Head to Diabetic.org to get a jumpstart on your research and learn the facts.
References, Studies and Sources:
Gestational Diabetes Mellitus (GDM) | Johns Hopkins Medicine
Type 1 or Type 2 Diabetes and Pregnancy | CDC
How Gestational Diabetes Can Impact Your Baby | American Diabetes Association
Fact Checked and Editorial Process
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 Freking and medically reviewed by Dr. Angel Rivera.
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