During pregnancy glucose (sugar) is released at higher levels into the blood stream. This makes sense, because the developing baby uses this sugar as an energy source for development. One of the more common diagnoses during pregnancy is gestational diabetes. About 7% of all pregnant women will be told they have it. It's when you have more glucose circulating in your blood than we think you should. (The exact “right amount” is currently unknown). This is different from diabetes that existed before you were pregnant and has different outcomes.
How is it diagnosed?
Some women are at such low risk they won’t be tested at all. For most women, though, around 26 weeks you’ll be asked to drink a glucose-containing drink and your blood tested before and after. If your level is high another, longer test is done and if two values are high the diagnosis is made.
How will it affect my pregnancy?
Often, a pregnant mother with gestational diabetes is counseled about her diet in order to bring her blood sugar numbers under control. You likely will be asked to keep a food diary and learn to take your own blood sugar numbers at home with a finger stick. If you can be strict about limiting carbohydrates you often won’t need any further medication. If diet doesn’t work, insulin or other medications can be used. These have side effects on the baby once born, but the benefits may outweigh the risks depending on how high your glucose is and your other risk factors.
How will it affect my labor?
Likely, it won’t. The most common intervention faced by women with gestational diabetes is pressure to induce labor early. Since babies born to mothers that have gestational diabetes are on average heavier, the idea is to limit complications by delivering a lighter baby. However, induced labors more often end in a cesarean and the risks of a premature or baby that is “not quite ready” should be weighed against the supposed benefit of avoiding a “big baby”. Stillbirth may be increased in certain mothers with gestational diabetes (although this association is uncertain), and you can read more about that in another article.
As someone who has personally attended births of mothers with gestational diabetes who had a normal or even low-weight baby at term, I would make sure mothers understand the diagnosis does not guarantee a big baby and a big baby doesn’t even necessarily pose a problem. The thing your doctor or midwife will be on the lookout for is shoulder dystocia, or where the shoulders get stuck once the head is born. This is unpredictable, and most often is remedied by quick action of a trained attendant.
What about after pregnancy?
Women who were diagnosed with gestational diabetes are more likely to develop type-II diabetes later in life. After pregnancy you’ll be checked to see if your glucose levels have returned to normal or are still high. The bad news is that there’s about a 50% chance you’ll later have diabetes, but the good news is that there’s a lot you can do to prevent or delay it. Diet and exercise are the first step in reducing your chances of developing diabetes, and in this way, your pregnancy may have given you a “heads-up” on ways to improve your future health!