What is gestational diabetes? All moms develop some level of insulin resistance during pregnancy, which is important to allow the baby to drawn nutrition from mom’s blood, but some moms are overachievers :) When we begin to see excess glucose (sugar) in the mother’s blood, that’s what happens with gestational diabetes.
When do we test for it? Generally, screening occurs between 24-28 weeks of pregnancy, but early screening is indicated for those with a history of gestational diabetes, insulin resistance and with some other risk factors. For those tested early who don’t pass the screening, we can initiate treatment sooner. For those who pass the early screening, they aren’t totally off the hook until they also pass the screening between 24-28 weeks.
How do we test for it? There are a couple of testing regimens, but they all involve drinking a prepackaged sugary drink (sorry, they’re generally kind of gross) and checking blood sugar levels at appointed times after you’ve finished the drink.
So, why are you making me drink that nasty drink again? Gestational diabetes can lead to excessive birth weight. While that little marshmallow is certainly cute with all of those rolls, larger babies increase the risk for both cesarean section and for birth-associated trauma while in the birth canal. This is often associated with the baby’s shoulders being stuck in the vagina. Additionally, there is increased risk of preterm birth and respiratory distress for babies with mom with gestational diabetes. There is also a greater chance for both short term (requiring admission to the NICU) and long term (developing diabetes later in life) issues with your baby’s glycemic control. Maternal glucose control that requires medicine may also increase the risk of late pregnancy loss and is also often an indication for fetal monitoring during the latter part of pregnancy.
But I really like my sweets... Gestational diabetes not only affects your baby, but it can also increase your risk of preeclampsia (high blood pressure in pregnancy that can threaten the lives of both mom and baby) as well as maternal development of diabetes later in life.
In short, diabetes in pregnancy does matter, to both mom and baby. Be sure to talk to your doctor about how to reduce your risk and how best to control it if you do develop gestational diabetes.