If you've just been diagnosed with gestational diabetes, you are probably full of questions and concerns. Gestational diabetes is a pregnancy-induced condition that occurs in up to 9% of women (so you are definitely not alone). While hearing the words "gestational diabetes" during your pregnancy may seem daunting or perhaps even scary at first, keep in mind that with proper attention and treatment, most of those pregnancies result in healthy mothers and babies. Let's answer some of your most pressing questions about gestational diabetes and see if we can help you embrace this diagnosis with as much self-love as possible.

What is gestational diabetes?

Gestational diabetes occurs when a pregnant woman's body cannot process glucose effectively. The placental hormones, especially towards the end of pregnancy, can sometimes cause insulin resistance. For some pregnant women, the pancreas cannot make enough insulin, leading to high blood sugar, or hyperglycemia—both can be detrimental to both mother and child. Thankfully, it can often be managed through a low-carbohydrate diet and moderate exercise. In some cases, drug therapies, such as insulin or Glucophage, are also taken throughout the pregnancy after a woman is diagnosed with gestational diabetes.

What happens during gestational diabetes testing?

Most women who test positive for gestational diabetes will usually do so between weeks 24 and 28 of pregnancy, or toward the end of the second trimester or beginning of the third trimester. This is when women usually take the oral glucose tolerance test (OGTT). The OGTT consists of drinking a glucose-laden beverage and then having one's blood drawn an hour after the test. If your blood sugar is over 140 mg/dL, you may need to return to your healthcare provider for additional testing. If your blood glucose is over 200 mg/dL, you may have type 2 diabetes. Moreover, women who are at-risk for developing gestational diabetes may be tested earlier in the pregnancy, often in the first trimester.

Who is at risk for gestational diabetes?

According to the American College of Obstetricians and Gynecologists, there are several probable risk factors for gestational diabetes. Keep in mind, however, that in some instances, gestational diabetes may occur in women with none of the following risk factors:
  • Age greater than 25 years
  • Family or personal health history, including whether you had prediabetes before becoming pregnant
  • Overweight or obesity
  • Physical inactivity
  • Gestational diabetes in a previous pregnancy
  • A very large baby (9 pounds or more) in a previous pregnancy
  • High blood pressure
  • History of heart disease
  • Polycystic ovary syndrome (PCOS)
  • African American, Asian American, Hispanic, Native American or Pacific Island background

Why is it important to manage gestational diabetes during pregnancy?

The more controlled a woman's blood sugar is during pregnancy, the better. By maintaining well-regulated glucose control, pregnant women are more likely to have healthier pregnancies and babies. Untreated or poorly managed gestational diabetes, however, can result in preterm birth and respiratory distress syndrome, congenital disabilities, macrosomia (or large babies), and the increased likelihood that your future son or daughter may develop type 2 diabetes down the road. Newborns are also at risk of being born with low blood sugar (hypoglycemia) at birth, jaundice or more serious complications. Being proactive in managing gestational diabetes through a combination of diet, exercise, blood sugar monitoring and possibly medication are essential steps toward a healthy pregnancy. Working regularly with your healthcare team providers is important to take care of yourself during a gestational diabetes pregnancy optimally. For a woman who has been diagnosed with gestational diabetes, her care team will often include her ob/gyn or midwife, a certified diabetes educator, and a fetal care specialist who is trained to closely monitor mothers-to-be who are deemed "high risk," including women with type 1, type 2, and gestational diabetes. While few, if any, women want to hear the phrase "high risk" as a way to describe their pregnancy, keep in mind that women who have preexisting diabetes, regardless of type, and those with gestational diabetes are monitored carefully to ensure strict blood sugar control. This greatly increases the chances of the healthy development of the fetus and minimizes the serious health risks to the mother. Extra precaution is taken throughout the pregnancy as a preventative measure to improve the labor and delivery outcomes for the mother and child.

Why is it important to advocate for postpartum screening after having gestational diabetes?

The main reason it is important for women to be monitored beyond a gestational diabetes pregnancy is that over half of the women who have had gestational diabetes end up developing type 2 diabetes within 10 years of giving birth. Unfortunately, many times, women who had gestational diabetes are likely only to be tested immediately after birth, even though the Centers for Disease Control and Prevention recommend that women get tested for diabetes four to 12 weeks postpartum or every one to three years after birth. The important thing to remember is that with thorough attention and care, outcomes can be great. Hang in there. You will get through this! This article was originally shared on diabetesdaily.com.