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Gestational Diabetes

Women develop gestational diabetes during pregnancy. Approximately 2-5% of all pregnant women in the United States are diagnosed with gestational diabetes. After delivery, this condition usually disappears in the mother. However, women who have had it are at high risk for type 2 diabetes in later years.

Gestational diabetes can complicate pregnancy for both mother and baby. Unlike women with type 1 diabetes, pregnant women diagnosed with gestational diabetes have adequate amounts of insulin in their blood. However, the insulin efficacy, or its ability to moderate blood sugar levels, is partially blocked by other hormones created by the growing placenta. The added effects of hormonal changes and weight gain during pregnancy increase demands on the pancreas and can lead to a condition often called insulin resistance.

As the placenta grows, more of these blocking hormones are produced and the greater the insulin resistance becomes. This contra-insulin effect usually begins about midway (20-24 weeks) through pregnancy.

For most women, the pancreas is able to make enough additional insulin to overcome the insulin resistance, but when this is not enough, gestational diabetes results. Ironically, if all the placenta’s hormones were removed from the mother’s blood, the condition would be alleviated.  This usually happens following delivery of the baby.

You are at risk for developing gestational diabetes if you:

  • are obese or overweight
  • have a family history of gestational or type 2 diabetes
  • have given birth previously to a very large infant weighing more than 9 lb (4 kg), a still birth, or a child with birth defects
  • have too much amniotic fluid (polyhydramnios)
  • are older than 25 years of age

The Council on Diabetes in Pregnancy of the American Diabetes Association strongly recommends that all pregnant women be screened for gestational diabetes between the 24th and 28th weeks of pregnancy. Women who are African American, Hispanic, or Native American are also at a greater risk for developing this condition. If gestational diabetes is diagnosed, the mother will need to modify her diet and monitor weight gain carefully; she may require daily insulin injections for the rest of the pregnancy.