Diabetes in pregnancy puts the fetus at risk in several ways. nurses should be aware that:

Gestational diabetes (pronounced jess-TAY-shun-ul die-uh-BEET-eez) is one of the most common health problems for pregnant women. It affects about 5 percent of all pregnancies, which means there are about 200,000 cases each year. If not treated, gestational diabetes can cause health problems for mother and fetus.

The good news is that gestational diabetes can be treated, especially if it is found early in the pregnancy. There are some things that women with gestational diabetes can do to keep themselves well and their pregnancies healthy. Controlling gestational diabetes is the key to a healthy pregnancy. and can be achieved by following the Gestational Diabetes Treatment Plan.

Gestational Diabetes is a kind of diabetes that only pregnant women get. In fact, the word gestational means “during pregnancy.” If a woman gets diabetes or high blood sugar when she is pregnant, it is gestational diabetes.

Diabetes

Diabetes means your blood sugar is too high. Diabetes is a disease of metabolism, which is the way your body uses food for energy and growth. Your stomach and intestines break down (or digest) much of the food you eat into a simple sugar called glucose (pronounced GLOO-kos). Glucose is your body’s main source of energy. 

After digestion, the glucose passes into your bloodstream, which is why glucose is also called blood sugar. Once in the blood, the glucose is ready for your body cells to use. However, your cells need insulin (pronounced IN-suh-lin), a hormone made by your body, to get the glucose. Insulin “opens” your cells so that glucose can get in. When your metabolism is normal, your body makes enough insulin to move all the glucose smoothly from your bloodstream into your cells.

If you have diabetes, your body does not make enough insulin and your cells can’t use insulin properly. This causes the glucose to builds up in your bloodstream.

The Difference Between Diabetes and Gestational Diabetes

Only pregnant women get gestational diabetes. When you are pregnant, your body goes through many changes that can make it difficult for your insulin to work properly. Your body cannot get the sugar out of your blood and into your cells to use for energy as well as it did before.

The placenta, a system of vessels that passes nutrients, blood, and water from mother to fetus, makes certain hormones that prevent insulin from working correctly. This is insulin resistance. Your body has to make three times its normal amount of insulin or more to overcome the hormones made by the placenta.

For most women, the body’s extra insulin is enough to keep their blood sugar levels in the healthy range. For about 5 percent of pregnant women, even the extra insulin is not enough to keep their blood sugar level normal. Testing for gestational diabetes is done between the 24th and 28th week of pregnancy.

Will gestational diabetes hurt my baby?

If not treated, gestational diabetes can lead to health problems.  The best way to promote a healthy pregnancy if you have gestational diabetes is to follow the treatment plan outlined by your health care provider.

Most women who have gestational diabetes give birth to healthy babies, especially when they keep their blood sugar under control, eat a healthy diet, get regular, moderate physical activity, and gain the right amount of weight. In some cases, though, the condition can affect the pregnancy.

Keeping glucose levels under control may prevent certain problems related to gestational diabetes.

Below are some conditions that can result from your having gestational diabetes. Keep in mind that just because you have gestational diabetes does not mean that these problems will occur.

Macrosomia (pronounced mak-row-SOHM-ee-uh)—Baby’s body is larger than normal. Large-bodied babies can have difficulty by natural delivery through the vagina; the baby may need to be delivered through cesarean section. The most common complication for these babies is shoulder dystocia (pronounced dis-TOE-shee-uh).

Hypoglycemia (pronounced high-po-gl-eye-SEEM-ee-uh)—Baby’s blood sugar is too low. You may need to start breastfeeding right away to get more glucose into the baby’s system. If it is not possible for you to start feedings, the baby may need to get glucose through a thin, plastic tube in his or her arm that puts glucose directly into the blood.

Jaundice (pronounced JAWN-diss)—Baby’s skin turns yellowish; white parts of the eyes may also change color slightly. If treated, jaundice is not a serious problem for the baby.

Respiratory Distress Syndrome (RDS)—Baby has trouble breathing. The baby might need oxygen or other help breathing if he or she has RDS.

Low Calcium and Magnesium Levels in the Baby’s Blood—Baby could develop a condition that causes spasms in the hands and feet, or twitching or cramping muscles. This condition can be treated with calcium and magnesium supplements.

Will gestational diabetes affect my labor and delivery?

Most women with gestational diabetes can make it to their due dates safely and begin labor naturally. In some cases, though, gestational diabetes could change the way you feel or how your baby is delivered. Having gestational diabetes does not mean that you will have any change in delivery. 

If you have gestational diabetes, there are things you should know about delivery:

• Blood Sugar and Insulin Balance—keeping your blood sugar level under control during labor and delivery is vital to your own health and to your baby’s health. If you do not take insulin during your pregnancy, you probably will not need it during labor or delivery. If you do take insulin during your pregnancy, you may receive an insulin shot when labor begins, or you may get insulin through a thin, plastic tube in your arm that goes into your bloodstream during labor.
• Early Delivery—Gestational diabetes puts women at higher risk than women without the condition for developing preeclampsia (pronounced pree-ee-KLAMP-see-uh), late in their pregnancies. Preeclampsia is a condition related to a sudden blood pressure increase; it can be a serious. The only way to cure preeclampsia is to deliver the baby; but delivery may not be the best option for your health or for the health of the baby. Your health care provider will keep you under close watch, possibly at the hospital, and will run multiple tests to determine whether early delivery is safe and needed. Your health care provider will give you more information about early delivery, should it be necessary.
• Cesarean Delivery—This is a type of surgery used to deliver the baby, instead of natural delivery through the vagina. Cesarean delivery is also called a cesarean section, or “C” section. Simply having gestational diabetes is not a reason to have a C section, but your health care provider may have other reasons for choosing a cesarean delivery, such as changes in your health or your baby’s health during labor.

Will I have diabetes after I have my baby?

Once you have the baby, your body should be able to use its insulin more effectively. Shortly after the baby is born, the placenta is “delivered.” (This is sometimes called the afterbirth.) Because the placenta causes insulin resistance, when it’s gone, gestational diabetes usually goes away, too.

If you have gestational diabetes, you are at higher-than-normal risk for developing type 2 diabetes later in your life. Type 2 diabetes, like gestational diabetes, occurs when the body doesn’t use its insulin properly.

Eating a healthy diet, keeping your weight within a healthy range and getting regular physical activity after your baby is born can help lower your risk for type 2 diabetes.

Who can I go to for help with gestational diabetes?

Women who have gestational diabetes benefit most from a team approach, which may include management and treatment of the condition. Your team may include obstetricians, advanced practice nurses, registered nurses, a registered dietitian and certified diabetes educator.

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