“Gestational diabetes is defined as carbohydrate intolerance that either begins or is first recognized during pregnancy,” says Mary Jo Johnson, M.D., a perinatologist with WellSpan Health.

“It includes women who become diabetic during pregnancy due to hormonal changes of pregnancy that lead to glucose intolerance. It also includes women who were previously not diagnosed with diabetes and are first discovered when they are tested while pregnant.”

What causes gestational diabetes?
The body makes a hormone called insulin, which helps it to use and store the sugar from food eaten.  This keeps the blood sugar level at a safe range.  But when a woman is pregnant, the placenta produces hormones that make it harder for insulin to work.  When the pancreas cannot make enough insulin to keep the blood sugar level within a safe range, diabetes develops.

Screening Process
Because there are no symptoms of gestational diabetes, women should be screened between weeks 24 and 28 of pregnancy.  If a woman had gestational diabetes in the past or has a strong family history, a screening test will be ordered earlier than the usual 28 weeks.

Gestational diabetes is diagnosed with two blood tests. In the first test, the woman’s blood sugar level is tested one hour after drinking a small cup of a sweet liquid.  If the blood sugar is too high, the woman will need to do a longer, three-hour glucose test. If the blood sugar is still above a certain level, the woman has gestational diabetes.

Treatment
“Treatment for gestational diabetes is a three-pronged approach,” says Johnson.  “It includes a carbohydrate-controlled diet (not a weight loss diet), glucose monitoring with a glucometer, and medication if the diet alone is not adequate.  Glyburide, an oral hypoglycemic, is the preferred medication, but insulin is still used when necessary.”

Complications of Gestational Diabetes
Complications of gestational diabetes are usually manageable and preventable. The key to prevention is careful control of blood sugar levels immediately upon diagnosis.

If a woman has gestational diabetes, the baby may be at increased risk of:

• Excess growth
• Low blood sugar (hypoglycemia)
• Birth trauma
• Type 2 diabetes later in life

Gestational diabetes may also increase your personal risk of:

• Developing hypertensive disorders
• Higher need for cesarean section
• Future diabetes

“Finding out that you have a problem during pregnancy can naturally increase anxiety.  But it is important to remember that most women can successfully control the disease and have healthy pregnancies if they follow the treatment plan outlined by their physician, says Johnson.”

How WellSpan Can Help
WellSpan offers expertise for high-risk pregnancies and the area’s only Level III Neonatal Intensive Care Unit.  So for those times when things don’t go quite as planned, rest assured that WellSpan will be there every step of the way.  Visit www.wellspan.org/wellwomen to learn more about maternity services at WellSpan. Or call WellSpan HealthSource at (800) 840-5905.