1. How is gestational diabetes diagnosed?
Glucose test – remember that terrible drink that no one likes? The blood test or tests showed that your sugar levels were high and have diagnosed you with gestational diabetes. Gestational diabetes is NOT Type 1 diabetes but is potentially a risk factor for future Type 2 diabetes development.
2. Why are blood sugar levels high?
- In pregnancy, your body makes extra hormones including human placental lactogen from the placenta, and increased levels of estrogen, progesterone, cortisol, and prolactin.
- These hormones that are in your blood, can cause insulin to not work as well in controlling your blood sugars and some patients are more prone to have this insulin resistance. The more insulin resistance, the higher your blood sugar will be.
3. What is the concern for high blood sugar levels in pregnancy?
- Your health: If your blood sugars are very high in pregnancy and you need high doses of insulin to control them, this may be an indication that you have a higher risk of developing Type 2 diabetes in the future. Lifestyle modifications such as diet changes and maintaining a healthy weight are two ways to prevent this.
- Blood Pressures: There is also a slight, increased risk of getting high blood pressures in pregnancy when you have gestational diabetes.
- Baby’s health: Big sugars can cause big babies. Your body’s reaction to high sugars and insulin resistance is to make more insulin. Insulin crosses the placenta and is a growth factor that causes babies to put extra weight on their bellies and shoulders. Big babies may cause an increase in caesarean section rates. They also may have a more difficult time with their shoulders being delivered safely during a vaginal birth, may have low sugar levels at birth and may need extra supplementation and monitoring.
4. How do you prevent having a big baby when you have been diagnosed with gestational diabetes?
- Diet control – you will meet with a group of expert diabetes educators to see if changes in your diet will help control the sugar levels. Often this is enough.
- Insulin – some patients may need insulin therapy. This will be ordered by an endocrinologist that specializes in diabetes and pregnancy. It may only be once a day or multiple times a day that you will have to take injections (tiny needle). There may be other options of medications prescribed as well such as oral Metformin.
5. Will I need to be delivered earlier than my due date?
- If your sugars are controlled by diet alone? NO
- If you take insulin? Possibly, depending on sugar control and baby’s size
- If you develop high blood pressure? YES, usually at 37 weeks, but may depend on the circumstances.
6. Will I need a Caesarean Section?
No – Many women with gestational diabetes deliver vaginally, though gestational diabetes may cause an increase in caesarean section rates
7. Will I have Gestational Diabetes in my next pregnancy?
There is a higher chance of having it in subsequent pregnancies and earlier testing may be offered.
8. How do I know I do not have Type 2 diabetes already?
You will have a follow up blood sugar level test similar to the screening test 3 months after your delivery. This can be ordered by your family physician.