You’ve heard of diabetes. But have you ever heard of gestational diabetes? It’s a form of diabetes that develops during pregnancy.
Carolyn Christo is a Registered Dietitian and Certified Diabetes Educator within the Leadership Sinai Centre for Diabetes. To increase awareness around gestational diabetes, Christo answers some important questions about the disease – and how it affects pregnant women.
What is gestational diabetes?
Gestational diabetes develops when the pancreas can’t make enough insulin to keep up with the pregnancy hormones. During the second half of pregnancy (starting around 24 to 28 weeks) the placenta makes hormones that are necessary for the growth of the baby. These hormones interfere with how insulin in the body works. Due to the “insulin resistance” caused by pregnancy hormones, the pancreas must make more insulin to keep the blood sugar levels in a normal range.
Does gestational diabetes go away after pregnancy?
In most cases, yes. Once the baby’s born and the placenta is delivered, hormone levels adjust. This decreases insulin resistance and allows blood sugar levels to return to normal.
In rare cases, the blood sugar levels remain high and a woman may get pre-diabetes or type 2 diabetes. It’s very important that all women who have had gestational diabetes take a two-hour oral glucose tolerance test. This test can confirm blood sugar levels have returned to normal. A woman can take this test anytime between six weeks and six months after delivery.
Does gestational diabetes during one pregnancy affect future pregnancies?
Having gestational diabetes in one pregnancy increases your risk of having it in future pregnancies. The recurrence rate of gestational diabetes is 30% to 84%.
Does gestational diabetes affect a baby’s health or development?
It can. If blood sugar levels are untreated and remain high during pregnancy, the baby will get the extra sugar and will grow bigger. A big baby may mean a more difficult delivery and higher risk of shoulder dystocia. That’s a complication of delivery in which the baby’s shoulders become stuck in the pelvis. Other risks for the baby include jaundice and hypoglycemia (low blood sugar) following delivery.
Does gestational diabetes cause long-term problems for the mother and baby’s health?
Women who develop gestational diabetes in pregnancy are at greater risk of developing type 2 diabetes in the future. Research shows that large babies born to mothers who’ve had gestational diabetes are at greater risk of becoming overweight as children. They’re also at greater risk of developing impaired glucose tolerance or pre-diabetes as they grow older.
Breastfeeding immediately after delivery and for at least three to four months can help reduce these health risks.
What are the risk factors for gestational diabetes?
In Canada, pregnant women are routinely screened for gestational diabetes. Women may be at increased risk for gestational diabetes if they’re:
- age 35 or older;
- are from a high-risk ethnic group such as African, Arab, East Asian, Hispanic, Indigenous or South Asian background;
- have a family history of diabetes;
- are obese, with a pre-pregnancy body mass index of 30 or greater;
- have previously had gestational diabetes;
- have a pre-existing condition such as pre-diabetes, polycystic ovarian syndrome or the skin condition acanthosis nigricans;
- use corticosteroid medications such as prednisone or celestone; or
- have previously given birth to a baby weighing more than eight and a half pounds.
Does gestational diabetes increase the risk of other pregnancy complications?
Women who have gestational diabetes are at higher risk of having high blood pressure or preeclampsia. Also, with the risk of bigger babies comes a higher risk of Caesarean section delivery.
How can you manage gestational diabetes?
You can help manage gestational diabetes through:
- healthy eating,
- physical activity and
- regularly checking blood sugar levels (i.e., four times per day) with a blood glucose monitor.
Medication (i.e., insulin) may also be necessary if blood sugars don’t reach target levels with healthy eating and activity.
What diet should you follow for gestational diabetes?
Women with gestational diabetes must follow healthy eating recommendations for pregnancy. They must also pay special attention to carbohydrates, which are the nutrient in food that raise blood sugar. All women diagnosed with gestational diabetes must meet with a registered dietitian for specific carbohydrate recommendations.
Our expert recommends the following nutrition tips:
1. Eat three meals and a healthy snack per day.
2. Choose high-fibre, low-glycemic-index carbohydrate foods more often. (For example: berries, stone fruits and citrus fruits, whole grains, vegetables, milk and unsweetened yogurt.)
3. Limit foods and drinks that have a lot of added sugar. This includes foods like jams, candies, chocolates and other sweets, soft drinks and juices.
Sun Life has taken a leading role in the awareness, prevention, care and research of diabetes all around the world. Since 2012, we’ve committed more than $25 million to diabetes initiatives, globally. Learn more at “Taking steps to prevent diabetes.”