gestational diabetes (onset and provocation)

Diabetes is a condition that causes high levels of sugar in the blood. Some women have diabetes before they become pregnant. Others develop it during pregnancy, a form called gestational diabetes.......click more


Hormones cause a normal rise in blood sugar in all pregnant women. You may develop diabetes in pregnancy if your body has trouble with this increase in blood sugar. You may need to start a special diet or even take insulin shots.

If you had diabetes before you became pregnant, it may be harder for you to control your sugar levels during pregnancy. You may need to change your insulin dosage. If you were not using insulin before the pregnancy, you may need to use it while you are pregnant.

If diabetes is not treated before and during pregnancy, these problems might occur:

- The high sugar levels in your blood might cause the baby to get too big before birth. Very large babies tend to have more problems before birth, during delivery, and after birth. Babies who are large or have other problems may need to be delivered by cesarean section (C section).

- The baby might have birth defects, such as problems with the heart, kidney, spine, or brain.

- You might have high blood pressure during the pregnancy (preeclampsia), which can cause problems for both you and the baby.

- You might go into preterm labor (before 37 weeks of pregnancy), or the baby might need to be delivered early.

- After delivery the baby may have low blood sugar problems (hypoglycemia).

- The baby might have high levels of bilirubin in the body (jaundice).

- After delivery the baby may have trouble breathing because the lungs are not fully developed.

- The baby could die in the uterus before delivery.

If you have proper treatment before and during your pregnancy, there is a good chance you will deliver a healthy baby.

How does it occur?

Insulin is a hormone produced by the pancreas. It helps your body change sugar to energy. Pregnancy hormones can change the way insulin works, so during pregnancy the pancreas needs to release more insulin than normal. Sometimes the pancreas cannot make enough insulin to control the sugar level and you become diabetic. After delivery the sugar level usually returns to normal and you are no longer diabetic (unless you were diabetic before you became pregnant).

No one knows why some people develop diabetes and others do not. It may be a problem you can inherit from your parents. Women with the following histories or conditions are particularly at risk for developing diabetes during pregnancy:

- a family history of diabetes;

- overweight, especially over 200 pounds;

- a previous baby that weighed more than 9 pounds (4000 grams) at birth;

- a previous baby born dead;

- a previous baby with birth defects;

- previous miscarriages;

- age over 35 years.

What are the symptoms?

Symptoms of diabetes include:

- excessive thirst;

- weight loss;

- eating too much;

- urinating a lot;

- unexplained fatigue.

Gestational diabetes can occur without noticeable symptoms. However, urine and blood tests during your pregnancy may show that you have diabetes.

A woman who already has diabetes and becomes pregnant will notice that her diabetes is harder to control.

How is it diagnosed?

Urine checks for diabetes are done during prenatal visits.

If you are at risk for developing diabetes, you will probably have a blood test to screen for diabetes at your first prenatal visit and again later in the pregnancy. If you are not known to be at risk, you may be screened around the 24th to 28th week of pregnancy. The screening is done by having you drink a sugar drink. A sample of your blood is then taken 1 hour later.

If the result of the first blood test is not normal, your health care provider may order a 3-hour glucose tolerance test. For this test, a sample of your blood is taken soon after you get up in the morning, when you have not eaten anything since the night before. Then you drink a sugar drink, and your blood and urine are tested every hour for three hours.