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Gayotri Goswami, MD, FACE, Endocrinology
Gestational diabetes – a type of diabetes that can develop during pregnancy in women who don’t already have the disease – can sometimes be overlooked when discussing the diabetes pandemic. But with November being Diabetes Awareness Month, this is a good time to shine a light on the subject.
Although researchers have yet to pinpoint why some women develop gestational diabetes and others do not, they have identified some risk factors for developing the disease, which include:
- Having had gestational diabetes during a previous pregnancy
- Having given birth to a baby who weighed over 9 pounds
- Are overweight
- Are over 25 years old
- Having a family history of type 2 diabetes
- Having a hormone disorder called polycystic ovarian syndrome (PCOS)
- Are an African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander
In addition, while various hormones are usually working consistently to maintain blood sugar levels, hormone levels are affected during pregnancy – making it more difficult for the body to process blood sugar efficiently. Gestational diabetes is like type 2 diabetes, and in many instances goes away once the baby is delivered.
The Centers for Disease Control & Prevention estimates that every year, 2% to 10% of pregnancies in the U.S. are affected by gestational diabetes. And just like non-gestational diabetes, cases are on the rise: the CDC reports that among women giving birth in 2020, the overall rate of gestational diabetes was 7.8%, a 30% increase from 2016’s 6%.
As noted, an unhealthy and/or sedentary lifestyle can be a major contributing factor – as it is with the rise in non-gestational diabetes around the world, which research firm BMC calls “the greatest epidemic in human history.” Lifestyle changes can play a positive role. Consuming a more healthy diet is a great idea for everyone; I recommend following the MyPlate model (https://www.myplate.gov/), where half of your meal consists of fruits and vegetables. I also recommend 30 minutes a day of exercise, even if it’s just walking, Before you get pregnant, you may be able to prevent gestational diabetes by losing weight if you’re overweight.
Fortunately, being unaware of whether they have gestational diabetes is highly unlikely, as most pregnant women have a glucose screening test between 24 and 28 weeks of pregnancy (or even earlier if they have been found to have a high glucose level in routine checkups) or are otherwise at risk of developing gestational diabetes.
Having gestational diabetes can increase your risk of high blood pressure during pregnancy. It can also increase your risk of having a large baby that needs to be delivered by cesarean section (C-section). If you have gestational diabetes, your baby is at higher risk of:
- Being very large (9 pounds or more), which can make delivery more difficult
- Being born early, which can cause breathing and other problems
- Having low blood sugar
- Developing type 2 diabetes later in life
Your blood sugar levels will usually return to normal after your baby is born. However, about 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery. Visit your doctor to have your blood sugar tested 6 to 12 weeks after your baby is born and then every 1 to 3 years to make sure your levels are on target.
Patient education is also highly recommended; while a primary care physician, obstetrician or endocrinologist can provide some general insights, a certified diabetes care and education specialist (CDCES) can help develop a strategy that meets each woman’s specific needs.
With proper precautions and education, gestational diabetes does not have to be a frightening prospect. Discuss your background and risk factors with your provider during one of your regular prenatal visits; they will refer you to an endocrinologist if necessary.
Dr. Gayotri Goswami is an endocrinologist with White Plains Hospital Physician Associates. To make an appointment, call 914-849-7400.
The original version of this article was published in Health Matters, a White Plains Hospital publication.
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