Diagnosing Gestational Diabetes

What is gestational diabetes?

When diabetes starts during pregnancy, it is called gestational diabetes. Women with diabetes (whether or not it is classified as gestational diabetes) need special care during pregnancy.

Diabetes is a condition that prevents the body from using food properly. The body receives its major source of energy from a sugar known as glucose. Insulin, a hormone manufactured in the pancreas, must be available for glucose to be used in the tissues. During pregnancy, some of the hormones produced by the placenta have a blocking effect on insulin. Gestational diabetes occurs when the pancreas produces its maximum amount of insulin, yet that is not enough to overcome the effect of the placenta’s hormones.

What are the risk factors for gestational diabetes?

Gestational diabetes is more common in women who

  • are overweight or obese
  • are older than 25
  • have had gestational diabetes in a prior pregnancy
  • are African American, American Indian, Asian American, Hispanic, Latina or Pacific Islander
  • have a family history of diabetes
  • have previously given birth to an infant that weighed more than 10 pounds
  • had excess amniotic fluid in a prior pregnancy
  • had an unexplained stillbirth or miscarriage in a prior pregnancy

How is gestational diabetes diagnosed?

At Virginia Women’s Center, we screen for gestational diabetes at 28 weeks of pregnancy. You will have to drink a syrupy glucose solution and then have your blood sugar level measured one hour later. If your blood sugar level is higher than normal, you will have to do a follow-up glucose test. The follow-up test involves drinking another glucose solution and having your blood sugar level checked every hour for a three hour period. If at least two of the blood sugar readings are higher than normal, you will be diagnosed with gestational diabetes.

What if I am diagnosed with gestational diabetes?

If you are diagnosed with gestational diabetes, you will work closely with our nurse practitioners to create an individualized food plan. You will not have to give up foods you love, but you may have to limit them or eat them with other foods so that your blood sugar isn’t negatively affected. During pregnancy, you will have to manage your blood sugar so that it stays in the optimal range and reduces your risk for complications. Usually, this can be done through diet and exercise. You will also work closely with our physicians and may need additional testing to monitor the baby’s health and reduce the risk of complications throughout your pregnancy.

For most women, once the baby is delivered, gestational diabetes will go away. You will be tested again at your postpartum visit. If it does not go away, it is reclassified almost always as type II diabetes. Women who had gestational diabetes are at high risk of having diabetes later in life. Choosing to pursue a healthy lifestyle by eating nutritiously and exercising regularly may help prevent or postpone diabetes.

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