Are you over the age of 25 and pregnant or planning a pregnancy? If so, you may be at risk for gestational diabetes mellitus (GDM). GDM is a type of diabetes that develops during pregnancy when a woman’s hormones change the way that insulin normally works in her body. This results in hyperglycemia, or elevated blood sugar, which can be harmful to both the mother and baby. Although GDM resolves after a woman gives birth, it is estimated that half of all women with GDM will develop type 2 diabetes later in life.
How do you know if you are at risk for developing GDM? Are you over the age of 25 and/or obese? Do you have a family history of diabetes, polycystic ovarian syndrome, pre-diabetes or GDM in another pregnancy? Have you given birth to a large baby? Are you a member of one of the high-risk ethnic groups: Native American, African American, Hispanic American, Asian American or Pacific Islanders?
If you answered yes to any of these questions, you are at risk of developing GDM. GDM occurs in approximately 7 percent of all pregnancies and is usually diagnosed in the second trimester when there is an increase in hormones that affect insulin action.
If you are considered to be at high risk between the 24th and 28th week of pregnancy or earlier, your doctor will do an oral glucose tolerance test. This test involves drinking a liquid that contains a load of glucose or sugar and having your blood drawn at various intervals to determine how well your body is able to use the sugar that you consumed. If you have GDM, your body will be unable to do this well as the sugar will not be able to get into your cells to be used for energy and will stay in your blood stream, causing your results to come back elevated.
What are the complications of GDM? One of the most common occurrences with GDM is that the baby can grow larger than normal increasing the risk of having a difficult labor and prompting the need for a Cesarian section. The mother’s blood pressure could rise to an unhealthy level and lead to a condition called preeclampsia, which if left untreated, can be fatal. The baby may be born prematurely, be at risk for birth defects, have hypoglycemia or low blood sugar after birth, or experience respiratory distress which could lead to stillbirth.
Although GDM can lead to serious problems, it doesn’t have to. Evidence has shown that education is key to achieving good blood sugar control and decreasing the risk of complications. Blount Memorial Hospital’s Diabetes Management Center has qualified staff that can provide this education for you. Our GDM education program includes instruction on testing blood sugar and urine ketones, nutrition therapy, exercise, insulin use, prevention of hyperglycemia, hypoglycemia and the development of type 2 diabetes. For more information, contact one of the certified diabetes educators at 865-977-5767.
Barbie Haas is a registered nurse and certified diabetes educator for the Blount Memorial Weight Management Center.