What is Gestational Diabetes? Simply put, gestational diabetes is diabetes that develops during pregnancy. It is a result of high blood sugar, due to your body not producing enough insulin to counteract the glucose we get from our food.
What is Gestational Diabetes? Understanding the Basics
If I ever write a book about pregnancy, it will be called, “Who the hell knows why?”
What we do know is that while you’re pregnant, your body sometimes works against itself in the pursuit of growing a baby.
Usually, your pancreas does an adequate job of balancing glucose by producing insulin. When you’re pregnant, your placenta is a cruel taskmaster, creating more and more hormones that cause your body to resist insulin. Undeterred, the pancreas works overtime to produce more insulin. When it can’t keep up, you end up with gestational diabetes.
Your pancreas tried, it really did. But pregnancy is a bitch sometimes.
The Glucose Challenge: What to Expect During Testing
Because gestational diabetes has a prevalence of around 9%, all pregnant women are tested for it in routine prenatal care.
If you have significant risk factors, you may be tested at the beginning of your pregnancy to get a baseline reading.
For everyone else, the first test is called the glucose challenge test and takes place between 24-28 weeks. You will be given a syrupy drink glucose drink (frequently referred to by the name “Glucola”) that you have to choke down in a specific amount of time.
You know how some people love pregnancy and never have the slightest hint of nausea? And how before you got pregnant you fantasize that maybe you would be one of those women? I have heard of people who think this Halloween syrup doesn’t taste so bad. Go ahead and imagine yourself being one of them, but don’t be surprised when you realize it tastes like flat, concentrated orange soda mixed with melted candy corn.
After one long hour of orange-flavored burps, you will have your blood drawn to see how your body dealt with that influx of glucose.
In a day or two, you should find out if you passed or failed. Failure just means you have a higher than average risk of gestational diabetes. The one-hour test is not diagnostic. In fact, different clinics and offices have different cutoffs for what is considered “failing.”
Beyond the First Test: Navigating the Three-Hour Glucose Test
What does it mean to fail the one-hour glucose test?
It means more orange-flavored sadness syrup! It’s called the Glucose Tolerance Test, and this time, you get the pleasure of fasting beforehand and drinking twice as much.
You have your blood drawn before you drink, and again every hour for three hours. You can’t have anything to eat or drink during that time. I wish I could say that it wasn’t so bad, and in the grand scheme of things it wasn’t exactly traumatic, but it definitely wasn’t fun. Hangry pregnant women are rarely fun.
Some people hate the idea of the three-hour test enough that they would prefer to move along as though they have gestational diabetes. This means routinely checking blood sugars and eating a healthy diet. That is another option you could discuss with your provider.
If you fail the three-hour test, you will be diagnosed with gestational diabetes.
Are You at Risk? Key Factors That Increase Your Chances
Age: Women over 25 are more likely to develop gestational diabetes. That really narrows it down for a lot of us, I know.
Health history: If you have prediabetes, or have a close family member with type 2 diabetes, you are more likely to develop gestational diabetes. Your risk also increases if you have had gestational diabetes in a previous pregnancy, if you had a baby who weighed more than 9 pounds (4.1 kg) at birth, or if you have had an unexplained stillbirth.
Weight: Women with a BMI over 30 are at increased risk.
Race: Women who are black, Hispanic, American Indian, or Asian are also at increased risk.
Silent Signs: Recognizing Gestational Diabetes Symptoms
For many women, there are no noticeable symptoms, which is partially why we are all tested. The ones that do show up can sometimes be written off as a normal part of pregnancy.
- Unusual thirst
- Frequent urination
- Fatigue
- Nausea
- Frequent vaginal, bladder, and skin infections
- Blurred vision
- Sugar in urine (don’t drink your pee, your doctor would be the one to catch this symptom)
Protecting Your Baby: Understanding the Potential Risks
- Macrosomia – aka “a really freaking big baby.” This can lead to shoulder dystocia, which is when the baby’s shoulders have trouble getting through the pelvis. You could also be at an increased risk of needing a c-section.
- Preterm birth
- Respiratory distress syndrome
- Low blood sugar, which comes with a risk of seizures
- Later risk of type 2 diabetes
How Gestational Diabetes Affects Mom
- High blood pressure
- Preeclampsia
- Future diabetes risk
Managing Gestational Diabetes: Treatment Options That Work
- Frequent monitoring of blood sugar
- Diet and exercise. (This gives you an idea of what type of diet you’d follow)
- Between 10 and 20 percent of women with gestational diabetes will need supplemental insulin
- You will likely have your blood sugar tested after delivery and again at the six-week postpartum visit
Can You Prevent It? Diet, Exercise and Proactive Steps
Diet and exercise is the answer to pretty much everything. Need to lose a few pounds? Diet and exercise. Need to lower your blood pressure? Diet and exercise. Depressed? Anxious? Got a wicked hangnail? Diet and exercise.
Life After Diagnosis: Your Next Steps
Being diagnosed with gestational diabetes isn't the end of your pregnancy journey – it's just a detour that requires a bit more attention. Remember that you're not alone and that around 9% of pregnant women face this challenge every year (hard to say if that's comforting or not).
With proper monitoring, thoughtful food choices, regular movement, and collaboration with your healthcare team, you can successfully manage your blood sugar levels and reduce risks to both you and your baby.
While the orange drink memories may linger (unfortunately), the condition itself typically resolves after delivery. Keep in mind that this experience does increase your future risk of type 2 diabetes, so maintaining healthy habits postpartum isn't just good practice – it's preventative medicine.
Further reading:
Also check out: The Perks of Gestational Diabetes (and There Aren't Many)
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