Gestational Diabetes

Yesterday, I had to go back into the doctor for my 3 hour glucose testing. It was not fun at all. I had to start fasting around 10pm Tuesday night and then went in for my first blood draw at 8:15am. After that they made me drink that orange glucose drink again. My time started when I finished it at 8:20, so at 9:20, 10:20 & 11:20 I had to go back and get my blood drawn. The worst part was that they wouldn't let me leave the office in case I passed out. Overall, it was the longest three hours ever and I was starving! I don't remember doing that with Harleigh but I guess I did. They then called this morning and said that my test results were abnormal and I again have gestational diabetes. Bummer! I should get a phone call sometime this week from the dietitian to set up an appointment.

Other exciting things today.....EMISD and Harleigh's dental appointment were both cancelled due to the weather so we got to sleep in and we are still prancing around in our pajamas. What a lazy day!

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Gestational diabetes

Overview

Gestational diabetes is high blood sugar that starts or is first diagnosed during pregnancy.

Symptoms

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood glucose level returns to normal after delivery.

Symptoms may include:

• Blurred vision
• Fatigue
• Frequent infections, including those of the bladder, vagina, and skin
• Increased thirst
• Increased urination
• Nausea and vomiting
• Weight loss in spite of increased appetite

However, high blood sugar levels in the mother can cause problems in the baby. These problems can include:

• Birth injury (trauma) because of the baby's large size
• Increased chance of diabetes and obesity
• Large size at birth
• Jaundice
  
• Low blood sugar (hypoglycemia)
  

Rarely, the unborn baby dies in the womb late in the pregnancy. Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy and delivery by c-section.

Treatment

The goals of treatment are to keep blood glucose levels within normal limits during the pregnancy, and to make sure that the fetus is healthy.

Your health care provider should closely check both you and your fetus throughout the pregnancy. Fetal monitoring to check the size and health of the fetus often includes ultrasound and nonstress tests.

A nonstress test is a very simple, painless test for you and your baby. A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen. When the baby moves, its heart rate normally increases 15 - 20 beats above its regular rate.

Your health care provider can look at the pattern of your baby's heartbeat compared to its movements and find out whether the baby is doing well. The health care provider will look for increases in the baby's normal heart rate, occurring within certain period of time.

Managing your diet can give you the calories and nutrients you need for your pregnancy and to control blood glucose levels. You may have nutritional counseling with a registered dietitian.

If managing your diet does not control blood glucose levels, you may be prescribed diabetes medicine by mouth or insulin therapy. You will need to monitor your blood glucose levels during treatment.

Causes

Risk factors for gestational diabetes include:

• African or Hispanic ancestry
• Being older than 25 when pregnant
• Family history of diabetes
• Giving birth to a previous baby that weighed more than 9 pounds
• Obesity
• Recurrent infections
• Unexplained miscarriage or death of a newborn

Tests & diagnosis

Gestational diabetes may not cause symptoms. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to screen for the condition.

Prognosis

There is a slightly increased risk of the baby dying when the mother has untreated gestational diabetes. Controlling blood sugar levels reduces this risk.

High blood glucose levels often go back to normal after delivery. However, women with gestational diabetes should be watched closely after giving birth and at regular doctor's appointments to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within 5 - 10 years after delivery. The risk may be increased in obese women.

Prevention

Beginning prenatal care early and regular prenatal visits helps improve the health of you and your baby. Knowing the risk factors for gestational diabetes and having prenatal screening at 24 - 28 weeks into the pregnancy will help detect gestational diabetes early.

Complications

• Delivery-related complications due to the infant's large size
• Development of diabetes later in life
• Increased risk of newborn death
• Low blood glucose or illness in the newborn