Understanding Gestational Diabetes: FAQs and Insights

Curious about gestational diabetes and how it can impact you and your baby? We’re here to provide you with valuable insights and answer common questions surrounding gestational diabetes. It’s important to understand this condition as an expectant mother, as it can have significant implications during pregnancy and beyond.

From exploring risk factors and diagnosis to uncovering potential complications and recommended lifestyle changes, we’ve got you covered every step of the way. Join us as we dive into the world of gestational diabetes, empowering you with the knowledge you need for a healthy and confident pregnancy journey.

1 – What is gestational diabetes and what are the risk factors associated with it?

During pregnancy, the growing baby and placenta produce hormones that can cause the mother to have insulin resistance. Usually, the mother’s pancreas will effectively produce more insulin to assist with this normal change. However, when this does not happen, the blood sugars remain elevated, and the mother develops gestational diabetes mellitus (GDM).

There are a few notable risk factors for gestational diabetes. Women with GDM may give birth to larger babies (macrosomia), increasing the risk of complications such as shoulder dystocia or the need for cesarean section. These babies also have an increased incidence of NICU admissions to control their blood sugars, which can drop rapidly after birth. It is important to note that these risks are heightened when blood sugars are poorly controlled.

2 – How is gestational diabetes diagnosed and what tests are used to confirm it?

Gestational diabetes is diagnosed by conducting a glucose screening test between 24-28 weeks of gestation. The initial screening involves a non-fasting glucose drink followed by a blood draw one hour later. If a patient fails the 1-hour test, they will then complete a fasting 3-hour glucose test.In some cases, if a patient has a significantly high 1-hour test or their first lab draw on the 3-hour test exceeds a certain parameter, the diagnosis is made without further assessment.

3 – What are the potential complications of gestational diabetes for both the mother and the baby?

Women who have had gestational diabetes have a higher incidence of developing it again in future pregnancies. Additionally, they are at an increased risk of developing type 2 diabetes in the future. A history of gestational diabetes combined with obesity raises this risk to 50-75%. Women with a normal BMI have a risk of less than 25% for developing type 2 diabetes. Women who have had GDM are also at an increased risk of cardiovascular diseases such as stroke and heart attack.

The risks for the baby include potential birth injuries or NICU admissions due to difficulties in maintaining normal blood glucose levels. Other risks associated with pregnancy complicated by GDM include increased amounts of amniotic fluid (polyhydramnios), which can make it harder for mothers to monitor fetal kick counts. GDM is also associated with an increased risk of early rupture of membranes, umbilical cord prolapse (when the cord comes out before the baby when the water breaks), placental abruption (partial or complete detachment of the placenta from the uterine wall), and postpartum hemorrhage.

4- What are the recommended dietary and lifestyle changes for managing gestational diabetes?

Dietary recommendations for managing gestational diabetes include eating regularly scheduled meals and snacks throughout the day, including a healthy bedtime snack. It is helpful to maintain a consistent schedule by adhering to normal sleeping and waking hours. Generally, three small meals and three to four healthy snacks per day are needed, with a meal or snack every 2-3 hours. The diet should include lean proteins (such as chicken, fish, nuts, peanut butter, and eggs), low-sugar and low-carbohydrate vegetables, moderate portions of whole grains and natural starches/carbohydrates.

Additionally, exercise is a great way to help maintain normal blood sugar levels.

5 – When is medication or insulin therapy typically recommended for women with gestational diabetes?

If good glucose control is not achieved within a few weeks of implementing modifications such as dietary changes, consulting with a nutritionist, and exercise, and blood sugars remain persistently elevated, then we will discuss options for oral medications or insulin therapy to assist in improving glucose levels.

6- How often should women with gestational diabetes be monitored throughout their pregnancy?

Typically, appointments for women with gestational diabetes follow a regular timeline. They are scheduled every 4 weeks until 28 weeks gestation, every 2 weeks from 28 to 36 weeks, and then weekly until delivery. Starting at 32 weeks gestation, weekly surveillance or antenatal testing, including a non-stress test (NST) and biophysical profile (BPP) ultrasound, is recommended. The frequency of these tests may vary depending on whether the patient is diet-controlled or requires medication (oral or insulin). Your healthcare provider will determine the best approach. The increased monitoring is important due to the heightened risk of stillbirth.

7- What is the likelihood of developing type 2 diabetes after having gestational diabetes, and what can be done to prevent it?

As mentioned earlier, women who have had gestational diabetes are at an increased risk of developing type 2 diabetes in the future. The risk is further elevated for those with a history of gestational diabetes and obesity, ranging from 50% to 75%. Women with a normal BMI have a lower risk of less than 25% for developing type 2 diabetes. Adopting a healthy lifestyle by staying physically active, maintaining a balanced diet, and achieving or maintaining a healthy weight is one of the most effective ways to reduce the risk of future development of type 2 diabetes.

8 – Can gestational diabetes have an impact on labor and delivery? If so, how?

Gestational diabetes can indeed influence the course of labor and delivery. It may result in changes to the birth plan, such as recommending or necessitating an induction of labor before the due date (often around the 39th week) or even a cesarean section. These interventions may be planned if the estimated size of the baby poses an increased risk of birth injuries, or they may be implemented during labor if progress is not as expected. Additionally, a larger baby increases the risk of more severe lacerations and injury to the vagina and surrounding structures. During this time, extra caution is required for patients with polyhydramnios (as mentioned earlier) and the associated risks.

9 – How does gestational diabetes affect the baby’s growth and development during pregnancy?

When a baby is exposed to high glucose levels in the mother’s bloodstream, it triggers the baby’s pancreas to produce more insulin to process the excess glucose.As a result, the excess glucose is converted into fat, leading to increased fetal size or macrosomia.

10 – What kind of follow-up care is typically recommended for women after giving birth who had gestational diabetes?

Usually, after giving birth, mothers can return to their normal diet and do not need to monitor their glucose levels daily. However, at the postpartum visit or shortly after, a fasting 2-hour glucose test is typically conducted. Women with a history of gestational diabetes should inform their primary care physician or gynecologist about their condition so that ongoing monitoring and appropriate screening for the development of type 2 diabetes can be provided.

If you’re pregnant and would like to learn more about your risks for gestational diabetes, call (972) 542-8884 or click here to make an appointment at our McKinney or Prosper location. For more information, follow the discussion around women’s health on social media.

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