You are 28 weeks pregnant. Your
health care provider has just told you that you have
gestational diabetes. Should you be concerned about
The short answer: yes. Good care
means a lot for your health and your baby's health.
What is gestational diabetes?
Pregnant women who have never had
diabetes before but who have high blood sugar (glucose)
levels during pregnancy are said to have gestational
diabetes. Gestational diabetes affects about 4% of all
pregnant women - about 135,000 cases of gestational diabetes
in the United States each year.
We don't know what causes gestational
diabetes, but we have some clues. The placenta supports the
baby as it grows. Hormones from the placenta help the baby
develop. But these hormones also block the action of the
mother's insulin in her body. This problem is called insulin
resistance. Insulin resistance makes it hard for the
mother's body to use insulin. She may need up to three times
as much insulin.
Gestational diabetes starts when your
body is not able to make and use all the insulin it needs
for pregnancy. Without enough insulin, glucose cannot leave
the blood and be changed to energy. Glucose builds up in the
blood to high levels. This is called hyperglycemia.
How gestational diabetes can affect your baby
Gestational diabetes affects the
mother in late pregnancy, after the baby's body has been
formed, but while the baby is busy growing. Because of this,
gestational diabetes does not cause the kinds of birth
defects sometimes seen in babies whose mothers had diabetes
However, untreated or poorly
controlled gestational diabetes can hurt your baby. When you
have gestational diabetes, your pancreas works overtime to
produce insulin, but the insulin does not lower your blood
glucose levels. Although insulin does not cross the
placenta, glucose and other nutrients do. So extra blood
glucose goes through the placenta, giving the baby high
blood glucose levels. This causes the baby's pancreas to
make extra insulin to get rid of the blood glucose. Since
the baby is getting more energy than it needs to grow and
develop, the extra energy is stored as fat.
This can lead to macrosomia, or a
"fat" baby. Babies with macrosomia face health problems of
their own, including damage to their shoulders during birth.
Because of the extra insulin made by the baby's pancreas,
newborns may have very low blood glucose levels at birth and
are also at higher risk for breathing problems. Babies with
excess insulin become children who are at risk for obesity
and adults who are at risk for type 2 diabetes.
Continued.... for "Treating Gestational Diabetes"