Is Gestational Diabetes the Same as Diabetes Mellitus?

Most women with gestational diabetes do not have noticeable symptoms. However, some women may experience symptoms such as:

• Increased thirst
• Frequent urination
• Weight loss despite increased appetite
• Fatigue
• Nausea or vomiting
• Yeast infections
• Blurred vision

However, since gestational diabetes often does not cause symptoms, prenatal screening tests are recommended for all pregnant women irrespective of risk factors.

Risk factors for gestational diabetes include the following:

• Maternal age over 35
• Obesity
• Family history of type II diabetes
• History of gestational diabetes
• Previous birth a baby weighing over 9 lbs
• History of antipsychotic or steroid medication use
• Polycystic ovary syndrome
• African American, Asian, Hispanic, or Native American descent

During weeks 8-12 of pregnancy, your doctor will ask you questions to see if you are at an elevated risk of gestational diabetes and may recommend early screening tests.

In most cases, gestational diabetes is detected in the second trimester of pregnancy during standard screening tests. To diagnose gestational diabetes, one or both of the following blood tests may be ordered:

• Glucose challenge test
  • Fasting is required for this test.
  • Your blood is tested 1 hour after you drink a sweet liquid.
  • If your blood sugar is 140 mg/dL or above, you may need to return for an oral glucose tolerance test.
  • If your blood sugar level is over 200 mg/dL, you may have type II diabetes.
• Oral glucose tolerance test
  • Fasting for at least 8 hours is required for this test.
  • Your blood is tested 2 hours after you drink a glucose-containing beverage
  • High blood sugar levels (200 mg/dL) suggest that you have gestational diabetes.

The oral glucose tolerance test should be performed between weeks 24-28 of pregnancy. If you have a history of gestational diabetes, you will be offered an oral glucose tolerance test earlier in your pregnancy, followed by another oral glucose tolerance test at about 24-28 weeks. Once gestational diabetes is diagnosed, proper treatment is essential to ensure a healthy pregnancy.

Gestational diabetes can be managed with dietary changes, regular physical activity, and blood sugar monitoring:

• Diet: Eat a healthy diet high in fiber and protein and low in fat and calories, making sure to include plenty of fruits, vegetables, whole grains, and lean protein.
• Exercise: Engage in 30 minutes of light exercise every day to reduce blood sugar and help relieve other discomforts of pregnancy.
• Check your blood sugar: Check your blood sugar 4-5 times each day: before bed, after waking up, before meals, and after meals.
• Medications: If lifestyle changes do not work, your doctor may recommend insulin injections or oral medications to keep your blood sugar under control.
• Get regular prenatal tests: Follow up with your doctor to monitor the growth and development of your baby via ultrasounds and other prenatal tests.

Untreated or uncontrolled gestational diabetes can lead to complications during and after pregnancy.

During pregnancy

• Premature birth (delivery before 37 weeks)
• Miscarriage (before 23 weeks)
• Stillbirth (birth of a dead baby)
• Macrosomia or a big baby

During delivery

• Difficult delivery, often requiring surgical (cesarean section) or assisted delivery
• Shoulder dystocia, which occurs when the baby’s shoulders get trapped behind the mother's pelvic bone

After birth

• Low blood sugar in the baby
• Breathing difficulties

Later in life

• Babies are more likely to acquire diabetes or obesity (having a body mass index of more than 30 kg/m2) later in adulthood
• Women who have had gestational diabetes are considerably more likely to acquire diabetes later in life