Gestational diabetes, like other forms of diabetes, is a defect in the way the body processes sugars or glucose. According to the American Diabetes Association, gestational diabetes affects 18 percent of pregnancies and is among the most common health problems during pregnancy.
While the exact cause is unknown, it is believed that hormones from the placenta, which help the baby develop, can also block the action of insulin in the mother's body. There are several risk factors for gestational diabetes, such as age, weight, family history and race. Women are more at risk for gestational diabetes if:
■ They are over age 25
■ Had slightly elevated blood sugar prior to pregnancy
■ Have a parent or sibling who had type 2 diabetes
■ They are significantly overweight with a body mass index of 30 or higher
■ They are part of an ethnic population with a higher risk, including black, Hispanic, American Indian or Asian
■ They have experienced gestational diabetes during a previous pregnancy
■ They have high blood pressure or were overweight prior to pregnancy
It's important for women to be aware of the risk factors and take steps to prevent gestational diabetes for themselves and their baby. The following tips can help women guard against gestational diabetes:
■ Choosing foods that are high in fiber and low in fat and calories. Fresh fruits, vegetables and whole grains are important to a healthy diet.
■ Exercising before and during pregnancy for approximately 30 minutes a day most days of the week.
■ Losing excess weight before becoming pregnant. Weight loss, even as little as 10 percent, is also thought to improve fertility in overweight women.
If left untreated or uncontrolled, gestational diabetes can negatively affect babies.
Gestational diabetes causes the pancreas to work overtime to produce insulin. That extra insulin does not reach the baby, but glucose and other nutrients do, which causes high glucose levels in utero. Those increased levels of glucose in turn cause the baby's pancreas to increase insulin production.
This chain of events can also result in low glucose levels, or hypoglycemia at birth. Because the brain depends on blood glucose as its main source of fuel, severe or prolonged hypoglycemia can impair the brain's ability to function. In addition, hypoglycemia is often caused by excess insulin. Babies born with excess insulin have an increased risk of obesity as children and type 2 diabetes as adults.
Fetal effects of gestational diabetes also include:
■ Macrosomia at birth, also called big baby syndrome
■ Increased risk of shoulder dystocia, where the infant's anterior shoulder fails to deliver shortly after the head, which is an obstetric emergency
■ Higher risk of C section
■ Delayed fetal pulmonary maturity
Gestational diabetes also poses a lifetime risk for women. In fact, for women who had gestation diabetes, two out of three will likely experience gestational diabetes again in future pregnancies. In addition, many women with gestational diabetes will develop type 2 diabetes later.
These risks are scary, but many women are able to control their blood sugar and avoid harm to themselves or their baby.
If you have a family history of gestational or type 2 diabetes, notify your doctor early in your pregnancy to develop a proactive screening and monitoring plan.