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Gestational Diabetes: Signs, Causes, and Treatment

Gestational diabetes

Gestational diabetes is a type of diabetes diagnosed during pregnancy. It affects approximately 10% of pregnancies, and millions of women, in the U.S. every year. Like all types of diabetes, the condition involves complications with the body’s production of insulin, a hormone that converts sugar into energy. If untreated, it can lead to high levels of blood glucose, which can lead to complications for both you and your baby.

While gestational diabetes can be an upsetting diagnosis to receive, it is very manageable.  With an effective treatment plan, including a healthy diet, exercise, and, if needed, medication, you can manage your blood sugar levels and have a healthy pregnancy.

Causes and signs of gestational diabetes

During your pregnancy, hormone level changes can affect how your body processes sugar. The placenta — an organ in your uterus that forms by week 12 of the pregnancy to deliver nutrients to your baby — produces a variety of hormones. Gestational diabetes occurs when some of these hormones, specifically estrogen, cortisol, and human placental lactogen, interfere with insulin function, causing blood sugar levels to rise.

Gestational diabetes typically develops in the middle of pregnancy, and most doctors test for it between weeks 24 and 28. There often aren’t any noticeable symptoms, and some of the key signs of gestational diabetes overlap with other changes that occur during pregnancy like being thirstier or hungrier and urinating more frequently than usual.

Most women who develop gestational diabetes are over 25. In addition, you are more likely to develop gestational diabetes if you:

  • Were overweight before you became pregnant
  • Are Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander
  • Have prediabetes, a condition in which blood sugar levels are elevated but still below the official threshold for a diabetes diagnosis
  • Have a family member with diabetes
  • Have had gestational diabetes during a previous pregnancy or gave birth to a baby over nine pounds
  • Have polycystic ovary syndrome (PCOS) or another health condition linked to problems with insulin
  • Have high blood pressure, high cholesterol, heart disease, or other medical complications

If any of these risk factors apply to you, you should consult with your doctor early on in your pregnancy to assess your risk and determine which preventative measures to take, if needed.

Testing for gestational diabetes

Your doctor will screen for gestational diabetes between weeks 24 and 28 of your pregnancy with a glucose tolerance test (or earlier if you have one or more of the key risk factors). During this test, you will drink a sweet beverage that contains 50 grams of glucose to raise your blood sugar. An hour later, your blood glucose levels will be checked to see how your body responded to the sugar in the drink.

If your blood sugar is higher than a certain threshold after the one-hour glucose tolerance test, your doctor will order additional testing. The most common follow-up is a three-hour glucose tolerance test. For this test, you will fast for eight hours and have your fasting blood sugar measured. You will then drink a beverage that contains 100 grams of sugar. Afterwards, your blood glucose will be tested one, two, and three hours later.

Your doctor may screen you again for gestational diabetes if your results are normal but you are at high risk.

Potential complications of gestational diabetes

Without prompt treatment, high blood sugar levels in a pregnant woman can affect the health of both her and her baby. For instance, unmanaged gestational diabetes can increase the baby’s blood sugar levels, which in turn increases its weight. A woman carrying an overweight baby may have to deliver it via a C-Section, which involves a longer recovery from childbirth.

Another complication that can potentially affect a pregnant woman as a result of gestational diabetes is preeclampsia, a condition characterized by high blood pressure and damage to the liver, kidneys, or other organs.

Despite these potential health risks, gestational diabetes is highly manageable. Your doctor can advise you on appropriate steps to keep your blood sugar levels in a normal range so that you can experience a healthy pregnancy. However, it’s critical to take action as soon as possible if you receive a diagnosis.

Treatment for gestational diabetes

Eating healthy foods and exercising regularly play a big role in managing your blood sugar levels and controlling your gestational diabetes. Your doctor will advise you on specific dietary considerations.

In general, swapping sugary snacks for sources of natural sugar such as fruits and carrots and adding vegetables and whole grains to your diet can help keep you and your baby healthy. Portion control is also important, and it is often recommended to eat three small meals throughout the day along with several snacks.

Staying active is also key. Try to aim for about thirty minutes of moderate activity several days throughout the week. Opt for gentle workouts like swimming, or try a yoga class specifically tailored to pregnant women. Not only will this help manage your blood sugar levels, but it has the added bonus of helping you avoid fatigue and backaches during pregnancy.

Your doctor may advise you to check your blood sugar levels several times throughout the day using a blood glucose meter. The American Diabetes Association suggests the following blood sugar targets for pregnant women:

  • Before a meal: 95 mg/dl or less
  • One hour after a meal: 140 mg/dl or less
  • Two hours after a meal: 120 mg/dl or less

Depending on your specific blood sugar levels, your doctor may advise you to take insulin. If taking insulin, it’s important to pay regular attention to your blood sugar as insulin therapy can lead to hypoglycemia, or dangerously low blood sugar. Hypoglycemia often happens as a result of not eating enough or exercising too much.

Common hypoglycemia symptoms include shakiness, anxiety, feeling lightheaded, hunger, nausea, headaches, and seizures. The only way to confirm that you are experiencing hypoglycemia is to check your blood sugar with a blood glucose meter or a continuous glucose monitor (CGM). 

Your doctor can help you develop your blood sugar targets and identify specific numbers to watch for when checking for hypoglycemia. However, if you are experiencing signs of low blood sugar and unable to check blood sugar levels, treat symptoms with high-sugar foods or drinks.

Getting tested for diabetes after pregnancy

For most women with the condition, gestational diabetes typically goes away soon after delivery. However, 5-10% of women with gestational diabetes develop type 2 diabetes after giving birth. And about 50% of the new mothers whose blood sugar levels return to normal after delivery will develop type 2 diabetes later in life.

If you have had gestational diabetes, it’s important to regularly monitor your blood sugar and continue with exercise and a healthy diet after giving birth to avoid health complications. You should also get screened again for diabetes 6 to 12 weeks after giving birth, and then every 1 to 3 years.

We’re here to support your gestational diabetes treatment

Alto is here to help you manage your gestational diabetes, by consolidating medications into streamlined monthly deliveries, setting up automatic refills, and offering free same-day delivery. And if insulin therapy is a part of your treatment plan, our pharmacists are available to walk you through your first doses and discuss any symptoms or side effects.

Learn how we can support your gestational diabetes treatment plan by contacting us via text or phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.