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Gestational Diabetes

What it is

Gestational diabetes (GDM) is diabetes that develops while you are pregnant. Gestational diabetes is still diabetes, which means your blood sugar levels are abnormally high. That excess sugar crosses the placenta and can make your baby grow too large and lead to problems with your pregnancy and delivery.

The following guidelines for diagnosing GDM were revised in 2011 by the American Diabetes Association:

  • Screen in the first trimester if a woman has risk factors for type 2 diabetes
  • In pregnant women not known to have diabetes, screen for GDM at 24 - 28 weeks of gestation, using a 75-gram 2-hour glucose (sugar) tolerance test. A diagnosis of GDM is made when any of the following glucose values are exceeded:
    • Fasting    > 92 mg/dl
    • 1 hour    > 180 mg/dl
    • 2 hour    > 153 mg/dl

What causes it

The causes of gestational diabetes have not been determined, but the many hormonal changes during pregnancy contribute to what is called insulin resistance - which is your body not using the insulin that your pancreas produces.

Here are the risk factors that contribute to insulin resistance and the development of gestational diabetes:

  • Family history of diabetes
  • Member of a high-risk ethnic group, such as:
    • African American
    • Asian American or Pacific Islander
    • Hispanic American
    • Native American
  • Older than age 25
  • Overweight or obese
  • Personal birth weight greater than 9 pounds
  • Polycystic ovarian syndrome
  • Previous delivery of baby greater than 9 pounds or a delivery with complications

How you know you have it

You may have signs, such as unusual tiredness or thirst, but you probably won't know until your doctor orders a glucose tolerance test.

What you can do

As soon as you are informed you have gestational diabetes, ask your doctor to immediately refer you to a diabetes educator at your hospital. The complications of GDM do not have to happen, especially if you learn all you need to know to have a safe, healthy pregnancy and delivery.

Here is what you will learn from a diabetes educator:

  • How and when to check your blood sugar, and what the numbers tell you
  • How to prevent developing type 2 diabetes in the future, including the benefits of breastfeeding for you and your baby
  • Planning your meals and snacks
  • Starting an exercise routine
  • If necessary, how to take medication or inject insulin

The American Diabetes Association recommends that, to ensure you had gestational diabetes, and not type 2 diabetes, ask your doctor to check your blood sugar 6 - 12 weeks after you have your baby, and every 3 years after that.

Insurance/financial questions

With your doctor's prescription, your insurance company should cover your meter and supplies to check your blood sugar. For the lowest co-pay, call the customer service number to ask if there is a particular brand you should use.

With your doctor's referral, diabetes education at your hospital's diabetes center should also be a covered benefit, but call your health plan's customer service number to make sure, and to see what your out-of-pocket costs will be.