Pregnancy brings many changes and for women who are diagnosed with gestational diabetes more attention to diet and activity are needed. Some patients will even require pills or insulin to control the glucoses. Like other types of diabetes, gestational diabetes is on the rise – and it needs to be monitored by a physician.
How common is gestational diabetes? “Gestational diabetes is a common problem that we deal with,” says Naomi L. Wahl, MD, FACOG, perinatologist at Saint Francis Medical Center. “The incidence of gestational diabetes increases with obesity, family history of diabetes, and in women who delay childbearing until they are older. Therefore, because all of these issues are becoming more common, we are seeing more patients who are affected.”
Who and when do we test for gestational diabetes? “Women who have a strong family history of diabetes and those women who have had gestational diabetes with a previous pregnancy or those who have had a large baby in the past are screened early in the pregnancy. Women who are very overweight are also screened early in the pregnancy. All women are screened for gestational diabetes at 24-28 weeks.”
What are the risks for patients who have gestational diabetes? “Women who have gestational diabetes are at increased risk to have babies who are bigger than they were destined to be,” says Wahl. “These women are more likely to develop high blood pressure and also are more likely to have difficult deliveries or require a cesarean section for delivery. If the patient’s sugars are not well-controlled, the baby is more likely to have problems. These babies as newborns are more likely to have problems that require longer hospitalization and even care in the neonatal intensive care unit. Patients who have gestational diabetes are also at more risk to develop diabetes in later life.”
How is gestational diabetes treated? “The initial treatment is diet. Daily walking or other exercise can also improve the glucose control,” says Wahl. “If the glucoses (sugars) are not adequately controlled with diet, the patient will either need pills or insulin to control the sugars. This will improve the outcome for both the mother and the baby.”