Gestational diabetes is high blood sugar in pregnant women who haven’t had diabetes before. For tips and information watch Rei’s story.

Around 16 in 100 pregnant women get gestational diabetes. Up to 50% of them will go on to develop type 2 diabetes within four years of giving birth.

To find out how to look after yourself if you have gestational diabetes – or how to reduce your risk of type 2 diabetes – go to https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes
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Gestational diabetes is a transient form of diabetes mellitus some women may acquire during pregnancy. Diabetes refers to high levels of blood glucose, commonly known as blood sugar. Glucose is the major energy source of the body. It comes from digestion of carbohydrates and is carried by the bloodstream to the body’s cells. But glucose cannot enter the cells on its own; to do so, it requires assistance from a hormone produced by the pancreas called insulin. Insulin induces the cells to take up glucose, thereby removing it from the blood. Diabetes happens when insulin is either deficient or not used effectively. Without insulin, glucose cannot enter the cells; it stays in the blood, causing high blood sugar levels.
During pregnancy, a temporary organ develops to connect the mother and the fetus, called the placenta. The placenta supplies the fetus with nutrients and oxygen, as well as produces a number of hormones that work to maintain pregnancy. Some of these hormones impair the action of insulin, making it less effective. This insulin-counteracting effect usually begins at about 20 to 24 weeks of pregnancy. The effect intensifies as the placenta grows larger, and becomes most prominent in the last couple of months. Usually, the pancreas is able to adjust by producing more insulin, but in some cases, the amount of placental hormones may become too overwhelming for the pancreas to compensate, and gestational diabetes results.
Any woman can develop gestational diabetes, but those who are overweight or have family or personal history of diabetes or prediabetes are at higher risks. Other risk factors include age, and having previously given birth to large babies.
While gestational diabetes usually resolves on its own after delivery, complications may arise if the condition is severe and/or poorly managed.
Because of the constant high glucose levels in the mother’s blood, the fetus may receive too much nutrients and grow too large, complicating the birth process, and a C-section may be needed for delivery.
High levels of glucose also stimulate the baby’s pancreas to produce more insulin than usual. Shortly after delivery, as the baby continues to have high insulin levels but no longer receives sugar from the mother, the baby’s blood sugar levels can drop suddenly and become exceedingly low, causing seizures. The newborn’s blood sugar level must therefore be monitored and corrected with prompt feeding, or if necessary, with intravenous glucose.
High blood sugar may also increase the mother’s blood pressure and risks of preterm birth. Future diabetes in both mother and child is also more likely to occur.
Gestational diabetes can be successfully managed, or even prevented, with healthy diets, physical exercise, and by keeping a healthy weight before and during pregnancy. In some cases, however, medication or insulin injection may be needed.
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Ellen Seely, MD, Director of Clinical Research in the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women’s Hospital discusses the health risks associated with gestational diabetes mellitus (GDM) during and after pregnancy. Dr. Seely also describes Balance After Baby, a web-based program designed to educate women on eating healthfully and increasing their physical activity, with the goal of helping them lose their pregnancy weight within a year of giving birth.

GDM is a type of diabetes that occurs only in pregnancy. It comes on in the second half of pregnancy and it goes away after delivery. In the US it’s estimated that five percent of all pregnancies are complicated by GDM. The rates of GDM are higher in Hispanic and non-white populations, ranging from ten to 20 percent of all pregnancies.

Obesity is one of the main risk factors for GDM. In the United States, most health centers screen all women for gestational diabetes because obesity is becoming so common in the overall population.

Gestational diabetes can impact the health of the mother and the fetus, as well as the newborn. Women with GDM have an increased risk of preeclampsia, which is a type of high blood pressure that develops during pregnancy. Preeclampsia is a serious condition that can lead to early delivery. Women who have gestational diabetes may also have larger babies, increasing their risk of cesarean section.

While GDM goes away after pregnancy, the health risks persist. Research has found that 50 to 70 percent of women who have gestational diabetes may develop Type 2 diabetes later in life. Research has also found that babies born to mothers with GDM, have a higher birth weight and may become obese during adolescence, increasing their risk of developing diabetes and other conditions such as high blood pressure.

The Pregnancy and Diabetes Program at Brigham and Women’s Hospital offers multidisciplinary care to women with GDM. The program includes a high risk obstetrician, two diabetes specialists, a nutritionist, and a nurse practitioner who is certified in diabetes education. The first approach to treatment is to control blood glucose levels with healthy eating and physical activity. Lifestyle changes, healthy eating and physical activity, are effective in controlling blood glucose levels about 75 percent of women with GDM. If the lifestyle changes don’t work, insulin therapy is started to control a mother’s blood sugar for the rest of her pregnancy.

Learn more about the Pregnancy and Diabetes Program at Brigham and Women’s Hospital:
https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/pregnancy-and-medical-conditions/diabetes

Read the Gestational Diabetes: Managing Risk During and After Pregnancy video transcript:
https://www.brighamandwomens.org/medicine/endocrinology-diabetes-and-hypertension/diabetes/gestational-diabetes-managing-risk-video-transcript

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This 3D medical animation shows how to check blood glucose (sugar) levels using a glucose meter.

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