Gestational Diabetes Information

Gestational diabetes is when high blood sugar levels arise during pregnancy, then typically disappear after pregnancy. Gestational diabetes, which affects about 7 percent of all pregnant women, usually appears around the 24th week of pregnancy, when the placenta begins producing large quantities of hormones that cause insulin resistance.

Diabetes Management Program, Newton-Wellesley Hospital
2014 Washington Street – 3 South
Newton, MA 02462
Phone: 617-243-6144 

Who is at Risk?

You may be at greater risk for gestational diabetes if you:

• Are obese
• Are over the age of 30
• Have a family history of diabetes

Potential Concerns for the Mother and Baby

If you have gestational diabetes, your baby can have an increased risk of:

• Large birth weight
• Hypoglycemia, or low blood sugar
• Jaundice

In addition, you can have an increased risk of:

• Preeclampsia, or high blood pressure during pregnancy
• Urinary tract infections

The development of ketones, substances that the body produces when it breaks down fat for energy, also can affect your baby. Ketones cross the placenta and enter the baby’s bloodstream, which may happen when your diet is low in carbohydrates or if your body cannot use glucose properly. You will need to check your urine every morning during pregnancy for the presence of ketones.

Treatment

Do not skip meals or decrease calories. East three meals and three snacks a day, as outlined by your dietitian. If you have moderate or large amounts of ketones for two mornings in a row, call your diabetes nurse educator or dietician — you probably need more calories.

Blood Glucose Testing

Below are guidelines to follow when testing your blood sugar levels:

• Fasting: A blood sugar between 95 and 100 mg/dl
• If you are on insulin: The fasting blood sugar should be between 85 and 92 mg/dl
• One hour after finishing a meal: A blood sugar of less than 130 mg/dl 

Check your blood sugar when fasting and one hour after every meal. Call your doctor or diabetes nurse educator if your blood sugar is above 100 in the morning or above 130 one hour after meals for two days in a row. An endocrinologist may need to evaluate you  to see if you need insulin.

Follow-Up

• In 98 percent of women with gestational diabetes, the diabetes goes away after delivery.
• Checkups are important. Fifty percent of women with gestational diabetes risk developing diabetes in later years. This risk increases to 70 percent if you are obese.
• You should get your blood sugar checked once a year when you see your primary care physician.
• You must be monitored closely if you plan on becoming pregnant again.
• Staying active and at a healthy weight are the most important tools to prevent diabetes.

Your Regular Schedule

To continuously ensure you are successfully managing your gestational diabetes:

• Check urine ketones every morning before breakfast: If ketones are moderate or high for two mornings in a row, call your diabetes nurse educator or dietitian.
• Test your blood sugar four times a day: Before breakfast and one hour after breakfast, lunch, and dinner.