GESTATIONAL DIABETES

(Gestational Carbohydrate Intolerance)

 Basic information

description

Gestational diabetes (GD) is a type of diabetes that occurs only in pregnant women (2% to 5% of all pregnancies).

FREQUENT SIGNS & SYMPTOMS

• Usually no symptoms are apparent. A prenatal exam may find that the fetus is larger than normal for the stage of pregnancy.
• Diagnosis is based on glucose testing done during the 24th to 28th week of pregnancy for nondiabetic mothers. Earlier testing is often done for patients diagnosed with GD in a previous pregnancy, a birth weight over 9 pounds in a previous infant, or for other risk factors.

causes

Your body isn't able to use the sugar (glucose) in your blood as well as it should, so the level of sugar in your blood becomes higher than normal. Why gestational diabetes develops is unknown.

risk increases with

• Previous pregnancy with GD.
• Obesity (especially if excess fat is around the waist).
• Mother over age 30.
• Polycystic ovarian syndrome (PCOS).
• Family history of diabetes.
• Excess weight gain in pregnancy.
• Previous birth of a baby weighing over 9 pounds.
• Four or more previous pregnancies.
• History of an unexplained fetal death or stillbirth.
• Some population groups, such as Native Americans, Mexican-Americans, Asians, and East Indians.

PREVENTIVE MEASURES

There are no specific preventive measures. Weight loss in overweight women prior to pregnancy may help. Careful attention to diet and exercise in pregnant women with risk factors may help.

expected outcomes

• Successful treatment and a healthy baby often depend on the mother's motivation and ability to change her lifestyle. For some, dietary control is sufficient. Others may require drug therapy.
• In most cases, labor occurs naturally, and the birth is usually vaginal. Cesarean section may be required if the fetus is considered too large for vaginal birth.
• Gestational diabetes usually clears up with delivery.

possible complications

• Excess amniotic fluid (polyhydramnios).
• Premature labor.
• May need to have labor induced.
• Preeclampsia.
• Miscarriage (rare).
• Risk of diabetes in the future for mother.

 diagnosis & treatment

general measures

• Your obstetric provider will do a glucose test.
• Treatment will include diet changes, moderate exercise program, and drug therapy, if needed.
• You will learn how to monitor your glucose levels. At first, glucose checks may need to be done up to 4-6 times daily. Once glucose levels are in the desired range and diet changes are made, glucose checks may be reduced with your obstetric provider's approval.
• To learn more: Contact the local or national office of the American Diabetes Association, Attention: National Call Center, 1701 Beauregard St., Alexandria, VA 22311; (800) 342-2383; website: www.diabetes.org.

medications

• Drugs are usually not needed if glucose control is achieved with diet and exercise.
• Insulin injections or oral antidiabetic drugs may be prescribed for some patients.

activity

A program of moderate, non-weight-bearing exercise is usually recommended. Exercising for even small time periods can have major benefits. Follow any prescribed exercise program carefully.

diet

• Diet changes are an important part of the treatment. Specific diet instructions will be provided. Following this diet will decrease the risks to the mother and her unborn child.
• The diet changes will involve increased fiber intake, fat limits, avoiding sweets, and monitoring caloric intake to prevent excess weight gain.

 notify our office if

• You are 24 to 28 weeks pregnant and have not had a screening test for gestational diabetes.
• After diagnosis, you develop any new signs or symptoms that cause you concern.

Special Notes: