What is Gestational Diabetes: Managing Your Blood Sugar in PregnancyPregnancy
Everyone tells you the horror stories about that nauseating, sugary, orange drink when you get pregnant! We all end up dreading this test. Your doctor or midwife will usually screen you for gestational diabetes (GD) between your 24th to 28th week of pregnancy since this disease has no obvious signs or symptoms in most expectant women. You’re required to drink a glucose solution, wait an hour, and then have your blood drawn to see how your insulin levels react to the implosion of sugar on your system. A blood glucose level below 7.8 mmol/L is considered normal. If the result is higher than expected, a second 3-hour fasting test is usually recommended. Gestational diabetes is diagnosed when at least two blood glucose level tests are higher than normal.
No one really knows what causes gestation diabetes; however, we do know that pregnancy does affect how the body breaks down glucose. Normally glucose is absorbed into the bloodstream when you eat a snack or a meal. Your body then releases insulin in response to convert the glucose cells—they’re broken down and turned in energy. Sometimes during pregnancy, excess hormones block the effects of insulin and blood sugar accumulates in your bloodstream. While your pancreas usually will compensate by increasing insulin production sometimes during pregnancy it cannot increase insulin production enough. GD is the result.
Once you’ve been diagnosed with gestational diabetes, self-monitoring glucose testing is recommended several times a day, every day, for the remainder of your pregnancy. You also may be referred to a dietician to go over your nutrition and dietary choices as part of an overall management plan. Many cases of GD can be managed with diet alone, but you may require insulin injections and oral diabetes medication such as metformin to maintain normal glucose levels.
Uncontrolled blood sugars can cause several serious complications for you and your baby. Babies born to mothers with gestational diabetes may have macrosomia (excessive birth weight), or may be at higher risk for premature birth, respiratory distress, and hypoglycemia (low blood sugar) soon after birth. Complications that can affect pregnant women with gestational diabetes include preeclampsia, developing type 2 diabetes later in life, needing a caesarean section due to a large-sized baby, induction of labour if the baby is growing too big, and polyhydramnios (too much amniotic fluid) which can lead to premature delivery. Keeping blood sugars controlled reduces your risk and increases your chances of an uncomplicated pregnancy, labour, and birth.
Your blood sugar will likely be monitored after delivery and for several weeks after to ensure your glucose level returns to normal. Most women who have gestational diabetes will have their blood sugars return to normal, but some will not and are diagnosed with Type 2 Diabetes going forward. It’s important that if you’ve had gestational diabetes you continue to exercise and eat a healthy diet after pregnancy to prevent, or delay, getting Type 2 diabetes. Your family physician will also monitor your blood sugars every 1 to 3 years.
We encourage you to learn more about our "What in the World" series. Please see our A to Z index for a whole host of pregnancy, postpartum, and parenting information and terminology.
Loree Siermachesky works as a multi-certified labour and postpartum doula, certified Lamaze childbirth educator, certified breastfeeding counselor, certified placenta encapsulation specialist and a certified car seat technician in Medicine Hat and Lethbridge. She has had the honour of attending over 1400 births in the last 20 years. She is well-known and greatly respected by the medical providers in Medicine Hat, Lethbridge, Brooks, Taber, and Calgary. She cares deeply for this profession and even more for her clientele, honoring them in whatever method of birth they choose, or helping them transition to new parenthood as they wish.