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Source: To Your Health
Author: Betsy Hornick, M.S., R.D., L.D.N.

What Every Pregnant Woman Should Know

Pregnancy is an exciting time, but it can also be a trying time if mothers-to-be develop a condition known as gestational diabetes, caused by hormonal changes that occur during pregnancy.

Gestational diabetes affects about 7 percent of pregnant women or more than 200,000 mothers a year in the United States. If you or someone you know is diagnosed with gestational diabetes, rest assured that with proper treatment, both mom and baby can have excellent health.

The Cause

Hormones produced in the placenta that help the baby develop can interfere with the action of insulin in the mother’s body requiring her to produce extra insulin. Gestational diabetes develops when her body can’t produce enough insulin to keep blood glucose levels within a normal range. Symptoms include blurred vision, an increased thirst, urination, and hunger. However, these symptoms may not be present or can go unnoticed as common conditions of pregnancy.

The Effects

Gestational diabetes generally develops later in pregnancy, after the baby’s body has formed but while it’s still growing. If the condition is not treated, high levels of glucose in the mother’s blood can pass to the baby. The extra glucose provides more energy than the baby needs, so it gets stored in the bay’s body as fat and the baby gains extra weight. A larger baby is at risk for injury during delivery and may have very low blood glucose levels at birth, as well as breathing problems. Having a big baby also can increase a mother’s chances of a cesarean section delivery. In addition, larger babies tend to become children with a greater likelihood of weight problems and a greater risk for type 2 diabetes later in life.

The Diagnosis

It’s difficult to predict who may develop gestational diabetes. A glucose challenge test is usually administered to check for it. This test involves drinking a sugary liquid and taking a blood test. If the result is high, the mother will need to take a 3-hour glucose tolerance test, If, the fasting blood glucose level is high, or if the results of the 3-hour test are high, then she has gestational diabetes.

The Treatment

It’s very important to treat gestational diabetes as early as possible to bring the blood glucose level into a normal range. If you’re diagnosed with gestational diabetes, you’ll need to eat a balanced diet with a controlled amount of carbohydrates. A registered dietician can help you develop a meal plan that provides the right amount of nutrients for you and your baby. Getting regular physical activity helps to keep blood glucose levels from rising too high and may prevent the need for insulin injections. To monitor your blood glucose levels, you’ll need to check you blood levels with a home test. In some cases, you may need to take insulin injections to keep blood glucose levels within a safe range.

The Lasting Effect

Gestational diabetes usually disappears after the baby is born. However, once you’ve had gestational diabetes, you have a greater chance of developing the condition again in a future pregnancy. You also face the risk for developing type 2 diabetes as early as five years after delivery, so be sure to tell your physician and any obstetricians you see during any pregnancies that you’ve had gestational diabetes and you’ll need to have your blood glucose checked.

Rate Your Risk

1. Are you a member of a high-risk ethnic group, including Hispanic, African American, Native American, South or East Asian, Pacific Islander or indigenous Australian?

2. Are you overweight?

3. Are you related to anyone with diabetes or someone who has had gestational diabetes?

4. Are you older than 25?

5. Have you had gestational diabetes in a past pregnancy?

6. Have you had a stillbirth or very large baby with a past pregnancy?

High risk: If you answered YES to two or more questions, you should get tested as soon as you know you’re pregnant. If your first test is negative, you should get tested again when you are between 24 and 28 weeks pregnant.

Average risk: If you answered YES to only one of these questions, you should get tested when you are between 24 and 28 weeks pregnancy.
 
Low risk: If you answered NO to all of these questions, your doctor or nurse will tell you whether you need to be tested.

Source: National Institute of Child Health & Human Development; National Institutes of Health 2000