Gestational Diabetes

Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy — doctors most often test for it between 24 and 28 weeks of pregnancy.

Often, gestational diabetes can be controlled through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin.

Problems of Gestational Diabetes in Pregnancy

Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby:

• An Extra Large Baby. Diabetes that is not well controlled causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-section to deliver the baby, and the baby can be born with nerve damage due to pressure on the shoulder during delivery.
• C-Section (Cesarean Section). A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth.
• High Blood Pressure (Preeclampsia). When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesn’t go away, she might have preeclampsia — a serious problem that needs to be watched closely and managed by her doctor. Women with diabetes have high blood pressure more often than women without diabetes.
• Low Blood Sugar (Hypoglycemia). People with diabetes who take insulin or other diabetes medications can develop blood sugar that is too low, which can be serious if not treated quickly. If a woman’s diabetes was not well controlled during pregnancy, her baby can very quickly develop low blood sugar after birth, so the baby’s blood sugar must be watched for several hours after delivery.

Screening and Diagnosis During Pregnancy

Most pregnant women are screened for gestational diabetes between 24 and 28 weeks of pregnancy using a glucose tolerance test, which measures how the body processes sugar. Women with risk factors such as a higher body weight, a family history of diabetes, or a previous pregnancy affected by gestational diabetes may be screened earlier, at the discretion of their doctor.

Managing Gestational Diabetes

Gestational diabetes is usually managed with a combination of blood sugar monitoring, regular physical activity as advised by your doctor, and dietary guidance suited to pregnancy. Our nutrition counselling team works with expectant mothers to plan meals that support both blood sugar control and the nutritional needs of pregnancy. When these measures are not enough on their own, insulin therapy may be recommended to keep blood sugar within a safe range.

After Delivery

Blood sugar levels usually return to normal soon after delivery, but women who have had gestational diabetes have a higher lifetime risk of developing Type 2 diabetes and are usually advised to have periodic blood sugar screening in the years that follow.

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