Risk Factors For Gestational Diabetes

Pregnant woman sitting at desk
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According to a 2014 analysis by the Centers for Disease Control and Prevention, the prevalence of gestational diabetes is as high as 9.2%. Pregnant women who have never had diabetes before, but have high blood sugar levels during pregnancy are said to have gestational diabetes. It usually appears midway through the second trimester, after the baby is formed, but while it is busy growing. Gestational diabetes disappears after the birth of the baby.

Once you've had gestational diabetes, you are at risk for having it again during another pregnancy. In fact, once you've had gestational diabetes, your chances are 2 in 3 that it will return in future pregnancies.

In addition, you are also at increased risk of developing type 2 diabetes. Mothers who have gestational diabetes have a nearly 10-fold long-term risk of type 2 diabetes. They also have a substantially increased risk of developing prediabetes and premature cardiovascular disease. Gestational diabetes should be a wake up call for any expecting mother to make lifestyle changes not only for the health of the baby, but also so that they can prevent developing these diseases after the baby is born. 

Who is at Risk for Gestational Diabetes?

Most of the risk factors for gestational diabetes are controllable. If you are planning to have a baby, modifying some of your lifestyle factors can help to reduce your risk.

The good news is that even if you get diagnosed with gestational diabetes, you can still have a healthy baby. Here are some of the risk factors: 

  • Obesity - with a BMI of 30 or over - losing about 20% of your body weight can reduce your risk 
  • Family history of Type 2 diabetes
  • If you are an older mom - age 35 or over
  • If you previously delivered larger babies (between 8 lbs. 5 oz and 9 lbs. 14 oz.)
  • If you have high blood pressure
  • You are Hispanic, African American, Native American, South or East Asian, or of Pacific Island descent.
  • If you have unhealthy cholesterol 
  • If you smoke
  • If you do not get enough physical activity 
  • If you are an unhealthy eater 

What Causes Gestational Diabetes?

Although there is no clear cause of gestational diabetes, there are some ideas as to why certain women develop it. During pregnancy, your body needs insulin so that it can use glucose for fuel. When a baby develops, it is supported by the placenta. The placenta produces many different types of hormones, which help the baby develop, but these exact hormones can also block the action of insulin in a mother's body. As a result, the cells become resistant to the insulin the mother is making and the blood sugars rise. 

Excess sugar can cross the placenta, causing the baby's pancreas to make insulin to get rid of the sugar. Because the baby is getting more energy than it needs to develop, the extra sugar is stored as fat.

This can lead to "macrosomia", aka, "a fat baby". Macrosomia can cause shoulder issues at birth and increase a babies risk of becoming obese and developing diabetes later on in life. In addition, babies who are born to mothers who have uncontrolled blood sugars, can have dangerously low blood sugars at birth (due to the extra insulin they are making), which can lead to breathing problems. This is why it is extremely important for all mothers to get tested for gestational diabetes and that those with gestational diabetes keep their blood sugars tightly controlled. 

How Do You Treat Gestational Diabetes?

Good prenatal care is important for all pregnant mothers, but especially important for women who carry the risk factors for gestational diabetes. Once a woman has become pregnant, continuance with doctor's appointments is important. Gestational diabetes is usually tested for between 24 and 28 weeks of gestation. If you test positive for gestational diabetes, you'll need to learn how to properly control blood sugars to ensure the well being of both yourself and your baby.

Usually, under your healthcare provider's guidance, a healthy, balanced diet that is consistent in carbohydrates, and more exercise can go a long way towards controlling gestational diabetes. Carbohydrates are the nutrients that impact blood sugars the most, therefore you'll want to understand where carbohydrates come from and how to choose the right kinds of carbohydrates for good blood sugar control. 

Exercise helps to burn sugar and improves insulin resistance so getting into a good routine will also help to normalize your blood sugars. If you've never exercised before, simply walking can really benefit your health. 

In some instances, when diet and exercise are not enough to control blood sugars on there own, insulin will also be used to keep blood glucose levels as close to normal as possible. 

Your medical team will give you your blood sugar targets and teach you how to use your glucometer. Good control will ensure a happy, healthy outcome for all. 

Updated: Barbie Cervoni MS, RD, CDE 

Resources: 

American Diabetes Association. What is Gestational Diabetes. http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html 

Feig DS, Zinman B, Wang X, Hux JE. Risk of development of diabetes mellitus after diagnosis of gestational diabetes. CMAJ 2008; 179:229

American Diabetes Association. Gestational Diabetes. http://www.diabetes.org/are-you-at-risk/lower-your-risk/gdm.html?referrer=https://www.google.com/

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