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Gestational diabetes is a form of the metabolic disease that impacts pregnant women who do not have a previous history of diabetes, but who have high blood glucose levels during their pregnancy. The Centers for Disease Control and Prevention (CDC) estimate that in 2014 as many as 9.2 percent of pregnant women suffered from this condition. If you are pregnant or trying to become pregnant, understand the risks and treatment options available to help ensure a safe and healthy pregnancy.

Causes
The causes of gestational diabetes are not completely known, however it is believed that hormones from the placenta that help the infant during development begin to block the action of the mother’s insulin into her own body. When proper insulin levels decline, glucose cannot leave the blood to be converted into energy, instead building up in the blood in unsafe levels, a condition known as hyperglycemia.

Risk Factors
All pregnant women are at risk of developing gestational diabetes, however some women are at a higher risk. Risk factors for gestational diabetes include:

• Age. Women age 25 or older during their pregnancy are more likely to develop gestational diabetes.
• Weight. Women with a body mass index (BMI) of 30 or higher are more likely to develop gestational diabetes.
• Family history. Women who have a close relation, such as a parent or sibling, that has previously been diagnosed with type 2 diabetes are at a greater risk for gestational diabetes.
• Personal health history. Those who have suffered from prediabetes are at a greater risk of gestational diabetes. Prediabetes is a condition defined by slightly elevated blood sugar that may be a precursor to type 2 diabetes. Women are also at a greater risk if they were diagnosed with the condition during a previous pregnancy, if they delivered a stillbirth, or if they delivered a baby who weighed more than nine pounds.
• Race. While experts are uncertain of the reason, women who are African American, Hispanic, American Indian, or Asian are more likely to develop gestational diabetes.

Potential Impact to Mother and Baby
Gestational diabetes impacts the mother in late pregnancy after the baby’s body has been formed. Untreated or poorly controlled gestational diabetes can have serious consequences on infants. Women with gestational diabetes experience an overuse of the pancreas as it works to produce insulin that is ultimately ineffective in lowering blood glucose levels. The high levels of blood glucose are eventually transferred to the baby through the placenta, causing the baby’s pancreas to overproduce insulin as well. Eventually, the extra, unneeded energy is stored by the baby as excess fat, a condition known as macrosomia.

Babies with macrosomia face several potential health risks, including damage to their shoulders during birth, low blood glucose levels at birth due to extra insulin levels, and breathing problems. Later in life, the babies are at a higher risk of suffering from obesity and type 2 diabetes.

Testing
Your OBGYN will likely evaluate your risk factors for gestational diabetes early in your pregnancy. Based on those factors, he or she will help determine a screening frequency to identify any risk factors early. For example, women at high risk may be tested at their very first prenatal visit, while women at average risk will likely be screened during the second trimester.

Women diagnosed with gestational diabetes will require frequent checkups, especially during the final trimester. During these exams, and possibly even in between visits through self-testing, their blood sugar will be monitored. Your OBGYN may also prescribe insulin to help control your blood sugar.

Directly after the birth, your OBGYN will likely check your blood sugar and will want to test it again in six to 12 weeks to determine if levels have returned to normal. Even with an eventual normal reading, women who have been diagnosed with gestational diabetes should receive a diabetes screening at least every three years.

Treatment
In addition to constant monitoring of blood sugar levels, there are treatment options available for women to manage gestational diabetes, including:

• Following a healthy diet high in fruits, vegetables, and whole grains.
• Receiving regular exercise, which helps lower blood sugar by stimulating the body to move glucose into cells and use it as energy.
• The use of insulin, which is prescribed for 10 – 20 percent of women suffering from gestational diabetes.

Every woman strives for a healthy pregnancy. Talk to the doctors at Chouchani, Sayegh and Bagnarello about the factors that may impact your risk for developing gestational diabetes. Our doctors will work with you to help identify any threats early to keep you and your new loved one safe and healthy.