How to Prevent Gestational Diabetes – Cleveland Clinic

When you’re pregnant, you get used to urinating in cups, like every prenatal checkup. One thing your doctor monitors is glucose (sugar). It may be normal for some to appear in your urine, but if they appear repeatedly or in large amounts, you may have high blood sugar during pregnancy, known as gestational diabetes.

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It is a common disease that is on the rise in the United States. A study showed that rates of gestational diabetes increased among pregnant women of all races and ethnicities from 2011 to 2019. And because it poses a variety of health risks, it’s important to know what causes it. this condition and what you can do about it.

Here’s what you need to know about gestational diabetes, including risk factors, screening, treatment and prevention.

What are the risk factors for gestational diabetes?

The American College of Obstetricians and Gynecologists recommends that pregnant women be screened for gestational diabetes between the 24th and 28th week of pregnancy. And your doctor will probably talk to you about risk factors during your first checkups, too.

If you have several risk factors or if there is a lot of glucose in your urine during these first prenatal visits, you will probably get tested sooner.

“For people who have risk factors for gestational diabetes, we generally recommend getting tested earlier in pregnancy, usually in the first trimester,” says Jeff Chapa, MD, maternal-fetal medicine specialist.

You are more likely to have gestational diabetes if you:

  • Are over 35 years old.
  • Have a body mass index (BMI) greater than 30.
  • Have a family history of type 2 diabetes.
  • Had a previous baby who weighed over 9 lbs.
  • Had gestational diabetes in a previous pregnancy.

The Screening Process

Your doctor will ask you to take a test called an oral glucose tolerance test. Here is what happens:

  1. You will quickly drink a sweet liquid that contains 50 grams of glucose. Your body quickly absorbs this glucose, causing your blood sugar levels to rise.
  2. An hour after drinking the sweet liquid, you will have blood drawn from your arm. This blood test measures how well your body processes glucose solution.
  3. If your test results show high blood sugar, you will likely need to take a similar but longer test that requires you to fast (not eat anything) beforehand. For this test, you will drink a liquid with 100 grams of glucose; your blood sugar will be checked before you drink the glucose and every hour for three hours thereafter. If this test shows abnormal results, you will be diagnosed with gestational diabetes.

“When screened early, if that screening is normal, you should get screened again around 24 to 28 weeks when placental hormone insulin resistance approaches its peak,” says Dr. Chapa.

The placenta is the organ that connects you to your baby to nourish him as he grows. The placenta also makes certain hormones that work against the action of insulin produced by your body. So, as the placenta grows, so does this “insulin resistance.” In some people, this change is enough to cause an increase in blood sugar.

How you can reduce your risk of gestational diabetes

There are no guarantees – and about half of people with gestational diabetes have no risk factors.

“A lot of people think they can’t have gestational diabetes because they don’t have a family history and they’re a healthy weight,” says obstetrician and gynecologist Salena Zanotti, MD. “But the hormonal changes that happen during pregnancy can still cause you to develop gestational diabetes, so raising awareness about the lifestyle changes they can make before getting pregnant is key.

She suggests adopting the healthiest habits possible, not only during pregnancy, but also before and after.

  • Step up your exercise: Generally, walking, swimming, yoga, and other low-impact exercises are best. Talk to your doctor about what activities are right for you.
  • Pay attention to what you eat: Your doctor or a nutritionist can help you make healthier choices in your diet. In general, aim for less sugar and refined carbohydrates (like white bread, white rice, pasta, etc.) and add more fiber to your diet (like raw fruits and vegetables, whole grains, nuts, and unsweetened nut butters).

“These two things can make a huge difference,” notes Dr. Zanotti, “but healthy habits make the biggest difference if you adopt them. before you get pregnant.”

What are the risks of having gestational diabetes?

Gestational diabetes can cause problems for you and your baby.

“When your body’s insulin supply can’t keep up, excess glucose stays in your blood and your baby gets more sugar than he needs, which is then stored in his body as sugar. fat,” says Dr. Chapa.

Possible outcomes include:

  • Higher risk of cesarean delivery, also known as caesarean section.
  • Increased risk of preeclampsia, a serious blood pressure condition.
  • Probability of delivering a larger than average baby (macrosomy).
  • Slightly higher risk of fetal and neonatal death.

“Babies born to mothers with diabetes need to monitor their blood sugar levels after birth,” adds Dr. Chapa. “Hypoglycemia can result in newborn babies of mothers with any type of diabetes, which can lead to problems for your baby, including seizures.”

What if gestational diabetes develops?

If you are diagnosed with gestational diabetes, your doctor will monitor you closely throughout your pregnancy, but you can still have a healthy baby if you focus on good habits.

“Try not to be worried or alarmed,” reassures Dr. Zanotti. “Your provider will help you manage it so you and your baby are as healthy as possible.”

To ensure stable blood sugar:

  • Stay alert: Your healthcare professional will talk to you about your target blood sugar and teach you how to monitor it regularly.
  • Watch your diet: A diet for gestational diabetes can go a long way in preventing complications in pregnancy and childbirth. This includes focusing on lean proteins and limiting carbohydrates and simple sugars.
  • Regular exercise: There are many ways to exercise safely when you are pregnant. It has been shown to help reduce pregnancy-related illnesses, including gestational diabetes.

“Fortunately, if we diagnose gestational diabetes early enough, the majority of patients can control it with diet and exercise,” notes Dr. Zanotti. “For a small percentage of people, these things don’t work on their own, and medication can help.”

After giving birth

Most people’s blood sugar levels return to normal after giving birth, but your doctor will likely check them during the postpartum period. This is because gestational diabetes has long-term effects, increasing your overall risk of:

  • High blood pressure.
  • Heart disease.
  • Type 2 diabetes.

In fact, about 10% of people with gestational diabetes have type 2 diabetes and don’t know it, and about half of people with gestational diabetes will have type 2 diabetes in 10 years.

That means it’s especially important for your GP to monitor your blood sugar and do your best to take control of your health, says Dr. Zanotti. “Being as healthy as possible will go a long way to reducing your risk.”

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