1.What is gestational diabetes?
If you’re pregnant, have never had diabetes before, and have high blood glucose (sugar) levels (usually in the second or third trimester) as assessed by a health care professional, you are said to have gestational diabetes. The insulin, a hormone your body makes, isn’t working enough to move the glucose from your blood into the cells where it can provide energy. Most women with gestational diabetes don’t continue to have diabetes immediately after their baby is born. For this reason, it is thought that hormones from pregnancy are behind it all.
2. How do women get gestational diabetes?
Scientists don’t really know the definitive answer to this one. What they do know is that you may be at higher risk of developing gestational diabetes if you:
- are overweight or obese
- have a family history of diabetes (such as mom, dad, or a sibling with diabetes)
- already have children who weighed more than 4 kg at birth
- had gestational diabetes in a previous pregnancy or other pregnancy complications
- are aged 35 or older
- belong to a high risk group (Aboriginal, Latin American, Asian, Arab or African).
3. How common is gestational diabetes?
Between 3 to 20% of pregnant women develop gestational diabetes. Around the world, the number of women with gestational diabetes is increasing. Scientists don’t know why, but some racial and ethnic groups tend to have higher rates of gestational diabetes. The increasing number of women who are obese when they get pregnant might be partly responsible.
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4. Can I do anything to reduce my chances of developing gestational diabetes?
Yes. While some factors, such as your age or family history, are beyond your control, the good news is that there are steps you can take to help reduce your risk of developing gestational diabetes.
Maintain a healthy weight. Before you get pregnant, check that you are at a healthy weight, and once you are pregnant, work with your health care professional to monitor your weight gain so you stay within recommended guidelines. Leading scientists agree that gaining too much weight during pregnancy isn’t healthy for you, or your baby, and can directly influence the size of your baby at birth. Some women who gain excessive weight during pregnancy may think they’re doing the best thing for their baby, but studies have found that extra weight gain during pregnancy may increase your chances of developing gestational diabetes. Learn about the recommended weight gain during pregnancy.
Stay active. Even if you weren’t particularly active before pregnancy, it’s never too late to think about exercise when you’re pregnant. The latest Canadian guidelines recommend pregnant women maintain a moderately active lifestyle. As always, if you’re not sure what’s safe for you, check with your healthcare provider. Read more about exercising during pregnancy.
Eat a balanced diet. Think about what’s on your plate, as well as portion sizes. Eating the appropriate quantities from the five food groups (fruits, grains, vegetables, meat/fish, and dairy) will provide the calories and nutrients your body needs to prepare for pregnancy and for your future baby’s health. See our tips for a healthy pregnancy diet here.
5. Will I be tested?
Yes, all pregnant women should undergo a routine blood screening test at 24 to 28 weeks to check for gestational diabetes. This is because many women don’t have any of the risk factors above and show no symptoms. The screening test starts with you drinking a sugary liquid containing glucose, followed by a blood test after to measure blood sugar levels. If you are at a higher risk, your healthcare provider may recommend testing earlier.
6. If I develop gestational diabetes, will I have to take medication?
Not necessarily. It’s important to know that gestational diabetes can be successfully managed and changes to your diet and exercise might be enough to keep your blood glucose levels in a healthy range, although sometimes medication is needed too. Your healthcare provider will be able to advise you.
7. Will gestational diabetes harm me or my baby?
Not if it’s successfully controlled. When blood glucose levels are under control, most moms and babies can stay healthy. However, if gestational diabetes is uncontrolled and your blood glucose levels remain too high, the extra glucose passes through the placenta to your developing baby. The extra glucose in your baby’s blood forces their body to make more insulin. This extra blood glucose and insulin make fat, and can result in a baby growing too big, especially in the upper part of their body. High blood sugar levels could also lead to preeclampsia (high blood pressure during pregnancy).
8. But isn’t a big baby a sign of good health?
No, that’s a common misconception. There are serious health risks if your baby is too large. Large babies can have difficulty while in the womb, entering your birth canal, and during delivery due to their size. After birth, some large babies are at an increased risk of breathing problems. Ask your health care professional if you have questions about the size of your baby.
9. Can gestational diabetes affect my baby as she grows up?
A: If it’s not controlled, it might. If you have high blood glucose during pregnancy, you’re more likely to have a large baby. Babies who are considered large at birth have an increased risk of growing up to be overweight children. In turn, overweight children face an increased risk of obesity in adulthood. You and your baby may also be a higher risk of health problems later in life, such as type 2 diabetes and heart disease.
10. If I do develop gestational diabetes, what can I do about it?
Follow this 6-step plan to help take control of your gestational diabetes.
1. Know your blood glucose levels. Ask your doctor about how to monitor your blood glucose and what your desirable blood glucose range is before you eat in the morning and after meals.
2. Eat a healthy diet. We’re all different so ask your doctor to refer you to a registered dietitian. They can help you learn about healthy eating during your pregnancy, so you’re eating the right amount of calories and nutrients (especially carbohydrate, protein, and fat) your body needs.
3. Gain an appropriate amount of weight during pregnancy. Consult with your health care provider to understand what this means for you.
4. Keep up moderate exercise, under the advice of your doctor.
5. Take any medications you’ve been prescribed.
6. Attend all your appointments so your doctor can measure and monitor your baby’s growth.
Crowther CA, Hiller JE, Moss JR et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. N Engl J Med 2005; 352:2477-86.
Diabetes Canada. Gestational diabetes. Available at: https://www.diabetes.ca/recently-diagnosed/gestational-diabetes-toolkit
Hod M, Kapur A, Sacks D et al. The international federation of gynecology and obsetetrics (FIGO) initiative on gestational diabetes metllitus: A pragmatic guide for diagnosis, management and care. Int J Gynaecol and Obstet 2015; 131:S173-S211.
IOM (Institute of Medicine) and NRC (National Research Council) (2009). Weight Gain During Pregnancy: Reexamining the Guidelines. Washington DC: The National Academies Press.
Metzger BE, Gabbe SG, Persson B et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33:676-82.
Muktabhant B, Lumbiganon P, Ngamjarus C et al. Interventions for preventing excessive weight gain during pregnancy. Cochrane Database Syst Rev 2014; doi: 10.1002/14651858.CD997145.pub2.
Muktabhant B, Lawrie TA, Lumbiganon P et al. Diet or exercise, or both, for preventing excessive weight gain in pregnancy (Review). Cochrane Database Syst Rev 2015; doi: 10.1002/14651858.CD007145.pub3.
The Society of Obstetricians and Gynaecologists of Canada. Glucose testing - screening for gestational diabetes. Available at: https://www.pregnancyinfo.ca/your-pregnancy/routine-tests/glucose-testing/
World Health Organization. Diagnostic criteria and classification of hyperglycemia first detected in pregnancy. World Health Organization 2013.
World Health Organization. Diabetes Fact Sheet. World Health Organization 2016.
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