Monitoring is the key to good health both before and after birth.
By Laura Corio, MD
When I told my patient, L.C., “You have gestational diabetes,’’ I was quick to add: “…now let’s manage it so you have a healthy pregnancy and baby.’’ L.C. went on to give birth to a beautiful baby girl weighing in at 6lbs and 10oz.
With a diagnosis of gestational diabetes, I do a lot of explaining and reassuring. I want my patients to understand that it can be well managed so that both she and her baby will continue to be healthy throughout the pregnancy and afterwards. My patients ask me many questions about the implications of this condition.
What is gestational diabetes?
Gestational diabetes is the development of diabetes during pregnancy. It is specific to the pregnancy. Women who develop it did not have diabetes before becoming pregnant, and they will not necessarily continue to have diabetes after they give birth.
How is it diagnosed?
Obstetricians test every pregnant woman for gestational diabetes between the 24th and the 28th week of pregnancy. It’s a simple test in which a pregnant woman drinks glucose and then has her blood taken to measure glucose levels one hour later. If this test reveals high glucose, a second test is given called a glucose tolerance test (GTT). The results of this test determine whether or not the patient has gestational diabetes.
It’s important to carefully monitor gestational diabetes. When blood glucose is not well controlled during pregnancy, the baby may be bigger than it would otherwise be, and may have complications both during pregnancy and after the birth.
How common is gestational diabetes?
Up to 10% of women will develop gestational diabetes during pregnancy. Placental hormones can affect glucose metabolism and make a pregnant woman more prone to diabetes.
This condition can produce no symptoms, which is why it’s so important to do a glucose test.
How is gestational diabetes managed?
I make sure my patients understand the recommendations we give them, and I encourage them to ask any questions they may have. I advise my patients to:
Learn to test blood glucose: I send my gestational diabetes patients to specially trained nurses who teach them how to test their blood glucose with a finger stick 4 times a day. This monitoring tells them how well their diabetes plan is working.
Follow a healthy diet: The nurses also advise our patients on diet. We recommend having 3 meals plus 2-to-4 snacks throughout the day. Frequent small meals can help keep blood glucose at a steady level. We recommend that the makeup of their meals be as follows: 40% carbohydrates, 20% protein, and 40% fat.
Exercise moderately: I advise my patients to exercise moderately.
Control weight gain: We stress to patients that they need to stay within the recommended weight gain limits of 25 to 35 pounds.
Special tests and screenings: We monitor gestational diabetes patients closely by performing sonograms and fetal testing to make sure that all is going well with the development of the baby. After the baby is born, the new mother will take another glucose tolerance test.
Does having gestational diabetes increase my risk of getting diabetes again later in life?
It does. Gestational diabetes increases your risks of developing diabetes in the future (see column on the right). Children of women with gestational diabetes may also have increased risk for obesity and type 2 diabetes.
Consider these statistics as a warning sign for you to be alert and follow good health practices. Stay at a normal weight. Eat well and be active. Pay attention to the results of your checkups and blood screenings. Keep in mind that children learn best very early in life, and you will be their role model for good health.
This is the best way to prevent diabetes in you and your family’s future!
Laura E. Corio, MD practices in New York City and is board-certified by the American Board of Obstetrics and Gynecology and the National Board of Medical Examiners.