You’ve heard of other expectant moms who’ve failed the test. Will it be you too? Gestational diabetes (GDM), which the International Diabetes Foundation says affects 1 in 7 births, is a form of diabetes that develops in women for the first time during pregnancy.

Very much like type 2 diabetes, it happens when your body does not make enough insulin, or can’t use insulin well, to regulate blood glucose (sugar) levels. Essentially, you end up with too much sugar in your blood.

Gestational diabetes can cause fear, disappointment and confusion during pregnancy. Before you panic, know that if you develop it, it’s not your fault! Also, it’s not the diabetes that can cause long-term complications for you and your baby, but rather uncontrolled high blood glucose levels — which your doctor can help you manage.

Now let’s address some more questions about gestational diabetes:

1. How do women get it?
   According to the American Diabetes Association, while hormones from the placenta help the baby develop, they also block the action of the mother's insulin in her body. Without enough insulin, glucose builds up in the blood to high levels, leading to gestational diabetes.
   
   
2. Am I at risk?
   While there are many women who develop insulin resistance and GDM who do not have any risk factors, gestational diabetes is more likely in women who are overweight, older than 25, have a close relative with diabetes, or are of certain ethnicity. Also, if you have had GDM before, or have had a baby who was very large or was stillborn, your risk is higher.
   
   
3. What symptoms should I be aware of?
   Women with gestational diabetes often have no symptoms. If there are symptoms, they can be subtle and often mistaken for typical side effects of pregnancy.
   
   
4. When and how will I be screened?
   All pregnant women are screened for gestational diabetes, usually in the second trimester, between 24 weeks and 28 weeks of pregnancy (or earlier if you have risk factors). Screening typically consists of drinking a sugary drink, and then getting your blood drawn an hour later to measure your blood glucose levels. Based on the results, you may need to get another, more involved 2-3 hour glucose tolerance test to diagnose GDM.
   
   
5. Will gestational diabetes affect my labor and delivery?
   Uncontrolled GDM can be risky to both you and your baby. Most women with gestational diabetes are able to have a vaginal birth, but are more likely to have a c-section than women without diabetes. High blood pressure, premature delivery and preeclampsia are more common in women with gestational diabetes.
   
   
6. How does it affect my baby?

   Too much glucose in the blood can cause macrosomia, a condition in which your baby grows too big, which may result in shoulder damage during birth. GDM can also cause health complications for your baby after birth, including breathing problems, low blood sugar, jaundice, and a higher likelihood of childhood obesity and type 2 diabetes.

7. How can I keep my blood glucose levels under control during pregnancy?
   Untreated or poorly controlled GDM can hurt you and your baby, so controlling your blood sugar levels is key. You’ll need to track your glucose levels four times daily. GDM can often be controlled with diet and exercise, but you may need to give yourself insulin to control your blood glucose levels. If so, it’s not your fault! Many women do all they can and still need insulin.
   
   
8. Will I still have diabetes after my baby is born?
   Gestational diabetes often goes away after childbirth, but you (and your child) will be more likely to develop diabetes later in life. (More than 50 percent of women who have gestational diabetes will get type 2 diabetes 5-10 years later). It’s important to get screened 6-8 weeks after your baby is born, and again every year thereafter.
   
   
9. How can I lower my risk of diabetes?
   While you can’t control how your cells respond to your pregnancy hormones, lifestyle changes may help reduce your risk of GDM. Before you get pregnant, lose excess weight, start exercising, and eat more high-fiber, low-fat foods. After you have your baby, changes in diet, weight loss, exercise and breastfeeding my help prevent or delay diabetes in your future.

Here are some other ways to help lower your risk of gestational diabetes:

• Exercise. Regular exercise, like going for a walk 30-90 minutes after eating, can help lower blood sugar levels. One study found that women who got roughly four hours a week of physical activity before and during their pregnancy lowered their risk of gestational diabetes by about 70 percent or more.
• Get to and maintain a healthy weight. Are you more than 20 percent over your ideal body weight? Losing even a few pounds can help you avoid developing type 2 diabetes.
• Make healthy food choices. Check out the American Diabetes Association’s Create Your Plate interactive tool to learn how to build a healthy plate for each meal. Learn what’s OK and not OK to eat while pregnant.
  • Balance the amount of carbohydrates in your meals. Have 3 balanced meals and 2-3 snacks a day.
  • Eat lots of vegetables and fruits. Enjoy fresh fruit in moderation.
  • Eat protein with every meal. Increase lean protein intake (e.g., tofu, chicken, fish).
  • Limit fat intake to 30 percent or less of daily calories, and watch your portion size.
  • Eat more fiber. Choose 100 percent whole grains, fresh fruits and vegetables, and beans.
  • Avoid white and processed foods, sugary drinks (no juice!), fried or fast foods, and simple, refined carbohydrates (e.g., white rice, white bread, potatoes).
  • Choose probiotic-rich foods (e.g., yogurts, kefir, pickles, artichokes, oats).

Despite living healthy, eating right and exercising regularly, some women still develop gestational diabetes, and type 2 diabetes later in life. It happens. If it does, you and your healthcare team can work together to manage it and make a healthy start for you and your baby.

Learn more about pregnancy and baby services at Edward-Elmhurst Health.

Edward-Elmhurst Health offers small group classes for women who develop gestational diabetes during pregnancy. Learn more about diabetes services at Edward-Elmhurst Health.