• Gestational Diabetes

    Also referred to as GDM, Gestational Onset Diabetes Mellitus (GODM) and Glucose Intolerance During Pregnancy)

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    In this brief video, Alison Sullivan, DO, an OBGYN physician with Wellmont Medical Associates Women's Health, explains what gestational diabetes is and why it's important to monitor. Learn more below.

    What is gestational diabetes?

    Diabetes occurs when there is a higher level of glucose in the blood than normal. Glucose comes from the breakdown of the food you eat. It travels through your body in the blood.

    A hormone called insulin then helps glucose move from your blood to your cells, where it can be used for energy.

    When there's a problem with making or using insulin, the glucose can't move into your cells. Instead, it builds up in your blood. The build-up of glucose is called hyperglycemia.

    Gestational diabetes is a type of diabetes that occurs during pregnancy or is first recognized during pregnancy.

    The extra glucose can affect the mother and the baby.

    Large Baby Due to Gestational Diabetes

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    Copyright © Nucleus Medical Media, Inc.

    Causes of gestational diabetes

    Gestational diabetes is caused by reduced sensitivity to insulin during pregnancy.

    Gestational diabetes risk factors

    Gestational diabetes is more common in women who are 25 years and older.

    It's also more common in women of Hispanic, African-American, Native-American, Asian-American, Indigenous Australian, or a Pacific Islander descent.

    Factors that may increase the risk of gestational diabetes include:

    • Obesity or being overweight – This can affect the body's ability to use insulin.
    • Gestational diabetes in a previous pregnancy
    • Family history of type 2 diabetes
    • Previous delivery of a large baby
    • Sleep-disordered breathing – abnormal breathing during sleep ranging from snoring to sleep apnea
    • History of polycystic ovary syndrome
    • Previous stillbirth or too much fluid surrounding a baby during pregnancy
    • Multiple pregnancy – carrying 2 or more babies

    Also, hormones that help the baby's growth may interfere with insulin.

    Gestational diabetes symptoms

    This condition usually does not cause any symptoms. If symptoms do occur, they may include:

    Diagnosing gestational diabetes

    As part of your prenatal screening, you'll be tested for gestational diabetes.

    If you don't have a history of diabetes, the test will be done at 24–28 weeks of gestation.

    If you have any risk factors – especially if you are high risk for gestational diabetes or already have symptoms – you will likely be tested earlier in your pregnancy.

    How the test works

    For your test, you'll be given a drink that has a special glucose solution in it.

    The level of glucose in your blood will then be measured.

    Some tests your doctor might use require fasting (not eating or drinking anything).

    Gestational diabetes treatment

    The goal of treatment is to return your blood glucose levels to normal.

    Treatment may include:

    Diet

    A dietitian can help you develop a healthy meal plan.

    In general, you should follow these guidelines:

    • Eat a balanced diet. Do not skip meals.
    • Eat plenty of fruits, vegetables and high-fiber foods.
    • Limit the amount of fat you eat.
    • Avoid foods high in sugar such as soda, candy and cookies.
    • Manage your portion sizes at each meal.
    • Plan a bedtime snack each night. It should include protein and complex carbohydrates such as legumes, potatoes, corn, or rice.
    • Keep a record of your food intake, and be sure to share this information with your doctor.

    Do not gain more weight during pregnancy than your doctor advises. Excess weight can increase the number or severity of complications in your pregnancy. It will also make it more difficult to control your diabetes.

    Exercise

    Physical activity can make it easier for your body to use glucose. There are some precautions you may need to take or certain exercises you may need to avoid. Ask your doctor about an exercise plan.

    Blood sugar testing

    A blood glucose monitor will help you check your glucose levels throughout the day.

    Knowing your glucose level will help you plan your meals, activities and medication.

    Please keep a record of your results and discuss them with your doctor at your visits.

    Medication

    You may need to give yourself insulin injections to control diabetes. For some pregnant women, oral medication is recommended.

    For most women, glucose levels usually return to normal after delivery. Your glucose levels will be checked to make sure that you no longer have diabetes.

    Preventing gestational diabetes

    The following may help prevent gestational diabetes:

    • Not gaining more weight than recommended during pregnancy.
    • Eating a healthy diet.
    • Exercising regularly. Talk to your doctor before starting an exercise program.
    • Not smoking. If you do you smoke, talk to your doctor about ways to quit.

    Also, talk to your doctor about whether you should take probiotics to reduce your risk of gestational diabetes.


    RESOURCES

    American Diabetes Association – www.diabetes.org

    Gestational diabetes FAQ from the American College of Obstetricians and Gynecologists – www.acog.org

    References

    Gestational diabetes. ACOG practice bulletin No. 30. Obstet Gynecol. 2001;98:525-538.

    Gestational diabetes mellitus (GDM). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116237/Gestational-diabetes-mellitus-GDM. Updated July 7, 2016. Accessed September 28, 2016.

    Hillier TA, Pedula KL, Vesco KK, et al. Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose. Obstet Gynecol. 2008;112:1007-1014.

    How to treat gestational diabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/gestational/how-to-treat-gestational.html. Updated April 29, 2014. Accessed October 7, 2015.

    2/5/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116237/Gestational-diabetes-mellitus-GDM: Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey AB. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes. Obstet Gynecol. 2008;112:1015-1022.

    4/1/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116237/Gestational-diabetes-mellitus-GDM: Dhulkotia JS, Ola B, Fraser R, Farrell T. Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2010;203(5):457.e1-9.

    3/17/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116237/Gestational-diabetes-mellitus-GDM: Luoto R, Laitinen K, et al. Impact of material probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: a double-blind, placebo-controlled study. Br J Nutr. 2010. Jun;103(12):1792-1799.

    6/9/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116237/Gestational-diabetes-mellitus-GDM: Qin JZ, Pang LH, et al. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2013;11:56

    10/13/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116237/Gestational-diabetes-mellitus-GDM: Zhang C, Tobias DK, et al. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study. BMJ. 2014 Sep 30;349.

    Revision Information

    This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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