Gestational Diabetes
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Gestational (jes-TAY-shun-ul) diabetes is diabetes that is found
for the first time when a woman is pregnant. Out of every 100
pregnant women in the United States, three to eight get gestational
diabetes. Diabetes means that your blood glucose (also called blood
sugar) is too high. Your body uses glucose for energy. But too much
glucose in your blood can be harmful. When you are pregnant, too
much glucose is not good for your baby.
This booklet is for women with gestational diabetes. If you have
type 1 or type 2 diabetes and are considering pregnancy, call the
National Diabetes Information Clearinghouse at 1-800-860-8747 for
more information and consult your health care team before you get
pregnant.
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Changing hormones and weight gain are part of a healthy
pregnancy. But both changes make it hard for your body to keep up
with its need for a hormone called insulin. When that happens, your
body doesn't get the energy it needs from the food you eat.
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To learn your risk for gestational diabetes, check each item that
applies to you. Talk with your doctor about your risk at your first
prenatal visit.
- I have a parent, brother, or sister with diabetes.
- I am African American, American Indian, Asian American, Hispanic American,
or Pacific Islander.
- I am 25 years old or older.
- I am overweight.
- I have had gestational diabetes before, or I have given birth to at least
one baby weighing more than 9 pounds.
- I have been told that I have "pre-diabetes," a condition in which blood
glucose levels are higher than normal, but not yet high enough for a diagnosis
of diabetes. Other names for it are "impaired glucose tolerance" and "impaired
fasting glucose."
If you checked any of these items, ask your health care team
about testing for gestational diabetes.
- You are at high risk if you are very overweight,
have had gestational diabetes before, have a strong family
history of diabetes, or have glucose in your urine.
- You are at average risk if you checked one or
more of the risk factors.
- You are at low risk if you did not check any of
the risk factors.
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Your doctor will decide when you need to be checked for diabetes
depending on your risk factors.
- If you are at high risk, your blood glucose level may
be checked at your first prenatal visit. If your test results are
normal, you will be checked again sometime between weeks 24 and 28
of your pregnancy.
- If you have an average risk for gestational diabetes,
you will be tested sometime between weeks 24 and 28 of
pregnancy.
- If you are at low risk, your doctor may decide that you
do not need to be checked.
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Your health care team will check your blood glucose level.
Depending on your risk and your test results, you may have one or
more of the following tests.
Your doctor may check your blood glucose level using a test
called a fasting blood glucose test. Before this test, your doctor
will ask you to fast, which means having nothing to eat or drink
except water for at least 8 hours. Or your doctor may check your
blood glucose at any time during the day. This is called a random
blood glucose test.
These tests can find some people with gestational diabetes, but
other tests are needed to be sure diabetes is not missed.
For this test, you will drink a sugary beverage and then have
your blood glucose level checked an hour later. This test can be
done at any time of the day. If the results are above normal, you
may need further tests.
If you have this test, your health care provider will give you
special instructions to follow. For at least 3 days before the test,
you should eat normally. Then you will fast for at least 8 hours
before the test.
The health care team will check your blood glucose level before
the test. Then you will drink a sugary beverage. The staff will
check your blood glucose levels 1 hour, 2 hours, and 3 hours later.
If your levels are above normal at least twice during the test, you
have gestational diabetes.
Above-Normal Results for the
Oral Glucose
Tolerance Test* |
| Fasting |
95 or higher |
| At 1 hour |
180 or higher |
| At 2 hours |
155 or higher |
| At 3 hours |
140 or higher |
Note: Some labs use other numbers for
this test.
*These numbers are for a test using a drink with
100 grams of glucose. |
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Untreated or uncontrolled gestational diabetes can mean problems
for your baby, such as
- being born very large and with extra fat; this can make
delivery difficult and more dangerous for your baby
- low blood glucose right after birth
- breathing problems
If you have gestational diabetes, your health care team may
recommend some extra tests to check on your baby, such as
- an ultrasound exam, to see how your baby is growing
- "kick counts" to check your baby's activity (the time between
the baby's movements) or special "stress" tests
Working closely with your health care team will help you give
birth to a healthy baby.
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Often, women with gestational diabetes have no symptoms.
Gestational diabetes may
- increase your risk of high blood pressure during
pregnancy
- increase your risk of a large baby and the need for cesarean
section at delivery
The good news is your gestational diabetes will probably go away
after your baby is born. However, you will be more likely to get
type 2 diabetes later in your life. You may also
get gestational diabetes again if you get pregnant again.
Some women wonder whether breastfeeding is OK after they have had
gestational diabetes. Breastfeeding is recommended for most babies,
including those whose mothers had gestational diabetes.
Gestational diabetes is serious, even if you have no symptoms.
Taking care of yourself helps keep your baby healthy.
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Treating gestational diabetes means taking steps to keep your
blood glucose levels in a target range. You will learn how to
control your blood glucose using
- a meal plan
- physical activity
- insulin (if needed)
You will talk with a dietitian or a diabetes educator who will
design a meal plan to help you choose foods that are healthy for you
and your baby. Using a meal plan will help keep your blood glucose
in your target range. The plan will provide guidelines on which
foods to eat, how much to eat, and when to eat. Choices, amounts,
and timing are all important in keeping your blood glucose levels in
your target range.
You may be advised to
- limit sweets
- eat three small meals and one to three snacks every
day
- be careful about when and how much carbohydrate-rich food you
eat; your meal plan will tell you when to eat carbohydrates and
how much to eat at each meal and snack
- include fiber in the form of fruits, vegetables, and
whole-grain crackers, cereals, and bread in your meals
For more about meal planning, call the National Diabetes Information Clearinghouse
for a copy of What I Need to Know About Eating and Diabetes or you
can read it online.
Physical activity, such as walking and swimming, can help you
reach your blood glucose targets. Talk with your health care team
about the type of activity that is best for you. If you are already
active, tell your health care team what you do.
Some women with gestational diabetes need insulin, in addition to
a meal plan and physical activity, to reach their blood glucose
targets. If necessary, your health care team will show you how to
give yourself insulin shots. Insulin is not harmful for your baby.
It cannot move from your bloodstream to the baby's.
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Your health care team may ask you to use a small device called a
blood glucose meter to check your levels on your own. You will
learn
- how to use the meter
- how to prick your finger to obtain a drop of blood
- what your target range is
- when to check your blood glucose
You may be asked to check your blood glucose
- when you wake up
- just before meals
- 1 or 2 hours after breakfast
- 1 or 2 hours after lunch
- 1 or 2 hours after dinner
The following chart shows blood glucose targets for most women
with gestational diabetes. Talk with your health care team about
whether these targets are right for you.
| Blood Glucose Targets for Most Women With
Gestational Diabetes |
| On awakening |
less than 105 |
| 1 hour after a meal |
less than 155 |
| 2 hours after a meal |
less than 130 |
Each time you check your blood glucose, write down the results in
a record book. Take the book with you when you visit your health
care team. If your results are often out of range, your health care
team will suggest ways you can reach your targets.
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Your health care team may teach you how to test for ketones
(KEE-tones) in your morning urine or in your blood. High levels of
ketones are a sign that your body is using your body fat for energy
instead of the food you eat. Using fat for energy is not recommended
during pregnancy. Ketones may be harmful for your baby.
If your ketone levels are high, your health care providers may
suggest that you change the type or amount of food you eat. Or you
may need to change your meal times or snack times.
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You will probably have a blood glucose test 6 to 12 weeks after
your baby is born to see whether you still have diabetes. For most
women, gestational diabetes goes away after pregnancy. You are,
however, at risk of having gestational diabetes during future
pregnancies or getting type 2 diabetes later.
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You can do a lot to prevent or delay type 2 diabetes.
- Reach and maintain a reasonable weight. Even if you stay above
your ideal weight, losing 5 to 7 percent of your body weight is
enough to make a big difference. For example, if you weigh 200
pounds, losing 10 to 14 pounds can greatly reduce your chance of
getting diabetes.
- Be physically active for 30 minutes most days. Walk, swim,
exercise, or go dancing.
- Follow a healthy eating plan. Eat more grains, fruits, and
vegetables. Cut down on fat and calories. A dietitian can help you
design a meal plan.
Remind your health care team to check your blood glucose levels
regularly. Women who have had gestational diabetes should continue
to be tested for diabetes or pre-diabetes every 3 years. Diagnosing
diabetes or pre-diabetes early can help prevent complications such
as heart disease later.
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Dietitians
Health Information
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