According to the American Diabetes Association, gestational diabetes affects nearly 10 percent of pregnancies in the U.S. every year. Gestational diabetes is a health concern for women planning for pregnancy, or women who are already pregnant, and their families. Gestational diabetes develops during pregnancy when the body does not make enough insulin, or the body becomes resistant to insulin the body makes. During November, Diabetes Awareness Month, St. Vincent Healthcare has partnered with its Women's Health team in order to provide education about gestational diabetes.
Complications for mom and baby
Gestational diabetes may create complications for both the mom and baby. When blood glucose levels are elevated, as they are with gestational diabetes, blood glucose crosses the placenta and directly into fetal circulation.
"When there is an increase in glucose to the baby, there is a stimulation of the baby's insulin production, often resulting in the baby growing larger for gestational age, we call this macrosomia,” explained Melissa Lopez, nurse practitioner at St. Vincent Healthcare. “This leads to an increased risk of having a difficult vaginal delivery and increased risk for cesarean section or birth injuries."
Lopez notes that there are a few complications that can arise after the baby is born. “Babies may have a hard time maintaining their blood glucose levels after delivery,” she said. “This happens because the baby is used to secreting insulin for higher blood glucose levels from mom. When the newborn is unable to maintain blood glucose levels on their own, they often have to spend some time in the hospital for supportive care until they are able to moderate blood glucose levels independently.”
For women affected by gestational diabetes during pregnancy, most will return to normal blood glucose levels after delivery. However, it is estimated that about 50% of these women will develop type 2 diabetes in the future.
Lowering the risk
Understanding the risk factors for gestational diabetes can be helpful to an early diagnosis and positive outcome. Women who have a BMI that is 25 or greater, advanced maternal age, or family history of gestational diabetes may be more at risk for developing it.
The best way to prevent gestational diabetes is to practice a healthy lifestyle before even becoming pregnant. Recommendations to help lower the risk include exercising 150 minutes a week and maintaining a balanced diet before pregnancy. It is important to self-assess or ask a provider about risk factors in order to be aware of them and consider preconception testing.
What to do if diagnosed
At St. Vincent Healthcare, women are monitored and screened for gestational diabetes when they are between 24-28 weeks pregnant. While being diagnosed with gestational diabetes can be frightening, with proper care, patients can have positive, healthy outcomes for both mom and baby.
If diagnosed with gestational diabetes, St. Vincent Healthcare Women’s Health care team works with patients to increase the likelihood of a positive outcome for both mom and baby. Early in pregnancy, the primary goal is to control blood glucose levels with diet and exercise.
“During pregnancy, the goal is to foster a healthy pregnancy and provide support through education about healthy lifestyle changes and growth of a healthy baby,” explained Lopez. “The patient will be connected with the St. Vincent Diabetes and Pregnancy Team who provide education on nutrition, exercise and blood glucose monitoring. If altered activity and diet are ineffective in keeping maternal blood glucose levels at the target zone, the care team may suggest implementing insulin or an oral hypoglycemic.”
Working together for a healthy mother and child
Lopez shared one of many recent successful, healthy outcomes for a patient.
“We had a mom who was diagnosed with gestational diabetes at 28 weeks during a routine screening. We immediately referred her to the maternal-fetal medicine department for diabetes education and for a growth ultrasound.” said Lopez. “The patient began testing blood glucose levels 4 times a day and when we noted that blood glucose levels were starting to elevate, she was started on an oral hypoglycemic. The mom continued to work closely with her care team and on blood glucose management throughout her pregnancy and delivered a healthy 8 pound baby at term!”
Not only was her baby healthy, but the mother recovered as well. She was tested 6 weeks after delivery of her baby and she no longer had gestational diabetes.
“The key for women that develop gestational diabetes is to continue with healthy lifestyle changes of exercise and healthy diet to mitigate future risk of developing type 2 diabetes,” said Lopez. “Having the information about their risk factors and education on how to maintain a healthy lifestyle can help empower them to continue to improve their health.”
For questions or to book an appointment with Melissa Lopez, NP click here