Diabetes and Pregnancy

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.

What is gestational diabetes?

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.

What causes gestational diabetes?

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.

What is my risk of gestational diabetes?

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/Latino, 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 risk factors, 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.

When will I be checked for gestational diabetes?

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.

How is gestational diabetes diagnosed?

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.

Read more about gestational diabetes in this booklet from the National Institute of Diabetes and Digestive and Kidney Diseases

What if I already have diabetes and become pregnant?

You have type 1 or type 2 diabetes and you are pregnant or hoping to get pregnant soon. You can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy.

Pregnancy and new motherhood are times of great excitement, worry, and change for any woman. If you have diabetes and are pregnant, your pregnancy is automatically considered a high-risk pregnancy. Women carrying twins-or more-or who are beyond a certain age are also considered to have high-risk pregnancies. High risk doesn't mean you'll have problems. Instead, high risk means you need to pay special attention to your health and you may need to see specialized doctors. Millions of high-risk pregnancies produce perfectly healthy babies without the mom's health being affected. Special care and attention are the keys.

Taking Care of Your Baby and Yourself

Keeping your blood glucose as close to normal as possible before you get pregnant and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby. Your health care team can help you learn how to use meal planning, physical activity, and medications to reach your blood glucose goals. Together, you'll create a plan for taking care of yourself and your diabetes.

Pregnancy causes a number of changes in your body, so you might need to make changes in the ways you manage your diabetes. Even if you've had diabetes for years, you may need changes in your meal plan, physical activity routine, and medications. In addition, your needs might change as you get closer to your delivery date.

How Diabetes Can Affect You and Your Baby

High blood glucose levels before and during pregnancy can
  • worsen your long-term diabetes complications, such as vision problems, heart disease, and kidney disease
  • increase the chance of problems for your baby, such as being born too early, weighing too much or too little, and having low blood glucose or other health problems at birth
  • increase the risk of your baby having birth defects
  • increase the risk of losing your baby through miscarriage or stillbirth
  • However, research has shown that when women with diabetes keep blood glucose levels under control before and during pregnancy, the risk of birth defects is about the same as in babies born to women who don't have diabetes.

Glucose in a pregnant woman's blood passes through to the baby. If your blood glucose level is too high during pregnancy, so is your baby's glucose level before birth.

Your Diabetes, Before and During Your Pregnancy

As you know, in diabetes, blood glucose levels are above normal. Whether you have type 1 or type 2 diabetes, you can manage your blood glucose levels and lower the risk of health problems.

A baby's brain, heart, kidneys, and lungs form during the first 8 weeks of pregnancy. High blood glucose levels are especially harmful during this early part of pregnancy. Yet many women don't realize they're pregnant until 5 or 6 weeks after conception. Ideally, you will work with your health care provider to get your blood glucose under control before you get pregnant.

If you're already pregnant, see your health care provider as soon as possible to make a plan for taking care of yourself and your baby. Even if you learn you're pregnant later in your pregnancy, you can still do a lot for your baby's health and your own.

For a checklist of things to do for your baby, and more information about diabetes and pregnancy, see this article from the National Institute of Diabetes and Digestive and Kidney Diseases.

You might also want to see the related HealthyNJ pages on: Diabetes, Diabetes and Fitness, Diabetes and Nutrition, Diabetic Eye Problems, Diabetic Foot Problems, Diabetic Kidney Problems, Diabetic Nerve Problems, Diabetic Retinopathy, Insulin Resistance, Metabolic Syndrome and Pre-Diabetes.

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