How To Prevent Gestational Diabetes – Cleveland Clinic

If you’re pregnant, get in the habit of peeing in cups — as you would with every single health check-up. One thing your doctor will look for is glucose (sugar). It can be normal for some to appear in your urine, but if it occurs repeatedly or in large quantities, you may have high blood sugar, known as gestational diabetes, during pregnancy.

It’s a common condition that’s on the rise in the US. A study showed that rates of gestational diabetes increased in pregnant women of all races and ethnicities from 2011 to 2019. And because it carries a variety of health risks, it’s important to know what causes this condition and what you can do about it.

Here’s what you need to know about gestational diabetes, including risk factors, screening, treatment, and prevention.

What are the risk factors for gestational diabetes?

The American College of Obstetricians and Gynecologists recommends that pregnant women be screened for gestational diabetes between 24 and 28 weeks of gestation. And your doctor will likely talk to you about risk factors during your early checkups, too.

If you have multiple risk factors, or if there’s a lot of glucose in your urine at those early prenatal visits, you’ll likely want to do the screening sooner.

“For people with risk factors for gestational diabetes, we typically recommend that they get screened earlier in the pregnancy — typically in the first trimester,” says maternal-fetal medicine specialist Jeff Chapa, MD.

You are more likely to have gestational diabetes if you:

• Are older than 35 years.
• have a body mass index (BMI) over 30.
• Have a family history of type 2 diabetes.
• Had a previous baby that weighed over 9 pounds.
• Had gestational diabetes in a previous pregnancy.

The screening process

Your doctor will ask you to take a test called an oral glucose tolerance test. Here’s what happens:

1. You will quickly drink a sweetened liquid that contains 50 grams of glucose. Your body absorbs this glucose quickly, causing your blood sugar levels to rise.
2. Blood will be taken from your arm an hour after you drink the sugary liquid. This blood test measures how well your body is processing the glucose solution.
3. If your test results show high blood sugar, you’ll likely need to take a similar but longer test that requires you to fast (not eat) beforehand. For this test, drink a liquid containing 100 grams of glucose; Your blood sugar is checked before drinking the glucose and every hour for three hours after that. If this test shows abnormal results, you will be diagnosed with gestational diabetes.

“If you’re screened early and that screening is normal, you should be screened again at about 24 to 28 weeks, when placental hormone insulin resistance is nearing its peak,” says Dr. Chapa.

The placenta is the organ that connects you to your baby to nourish him as he grows. The placenta also produces some hormones that counteract the effects of the insulin your body produces. So as the placenta grows, so does this “insulin resistance”. In some people, this change is enough to cause blood sugar levels to spike.

How to reduce your risk of gestational diabetes

There are no guarantees — and about half of the people who get gestational diabetes have no risk factors.

“Many people think they can’t get gestational diabetes because they don’t have a family history and are a healthy weight,” says Ob/Gyn Salena Zanotti, MD. “But the hormonal changes that occur during pregnancy can still cause you to develop gestational diabetes, so make people aware of the lifestyle changes they can make.” before getting pregnant is key.”

She suggests adopting the healthiest habits — not just during pregnancy, but before and after.

• Increase your practice: Typically, walking, swimming, yoga, and other gentle exercises are best. Talk to your doctor about what activities are right for you.
• Watch what you eat: Your doctor or nutritionist can help you make healthier choices in your diet. In general, aim for fewer sugars and refined carbohydrates (like white bread, white rice, pasta, etc.) and add more fiber to your diet (like raw fruits and vegetables, whole grains, nuts, and unsweetened nut butters).

“Both things can make a big difference,” notes Dr. Zanotti, “but healthy habits make the biggest difference when you adopt them before You’re going to get pregnant.”

What are the risks of gestational diabetes?

Gestational diabetes can cause problems for you and your baby.

“When your body’s supply of insulin can’t keep up, excess glucose remains in your blood and your baby gets more sugar than he needs, which is then stored in his body as fat,” explains Dr. Chapa.

Possible results are:

• Higher chance of a caesarean section, also called a cesarean section.
• Increased risk of preeclampsia, a serious blood pressure condition.
• Likelihood of giving birth to a baby larger than average (macrosomia).
• Slightly higher risk of fetal and neonatal death.

“Babies born to mothers with diabetes need monitoring of blood sugar levels after birth,” adds Dr. Added chapa. “Low blood sugar can result in newborns to mothers with any type of diabetes, and this can cause problems for your baby, including seizures.”

What if gestational diabetes develops?

If you’re diagnosed with gestational diabetes, your doctor will monitor you closely throughout your pregnancy, but you can still have a healthy baby if you focus on good habits.

“Don’t be worried or alarmed,” assures Dr. Zanotti. “Your provider will help you with this so that you and your baby are as healthy as possible.”

To ensure stable blood sugar levels:

• Stay alert: Your doctor will talk to you about your target blood sugar level and teach you how to monitor it regularly.
• Be aware of your food: A gestational diabetes diet plan can go a long way in preventing pregnancy and childbirth complications. This includes focusing on lean protein and limiting carbohydrates and simple sugars.
• Do sports regularly: There are many ways to exercise safely when pregnant. This has been shown to help reduce pregnancy-related illnesses, including gestational diabetes.

“Fortunately, if we diagnose gestational diabetes early enough, the majority of patients can control it through diet and exercise,” notes Dr. Zanotti. “For a small percentage of people, these things don’t work on their own, and medication can help.”

After birth

Most people’s blood sugar levels normalize after birth, but your doctor will likely check them in the postpartum period. That’s because gestational diabetes has some long-term effects, increasing your overall risk of:

• High blood pressure.
• cardiovascular disease.
• Type 2 diabetes.

In fact, about 10% of people with gestational diabetes have type 2 diabetes without knowing it, and about half of people with gestational diabetes will have type 2 diabetes in 10 years.

That means it’s extra important for your GP to monitor your blood sugar and for you to do your best to take control of your health, says Dr. Zanotti. “By being as healthy as possible, you’re going to go a long way in reducing your risk.”