Gestational Diabetes

Characteristics of Gestational Diabetes:

  • Most often diagnosed between 24-28 weeks of pregnancy in 4% of pregnant women.
  • If left untreated can result in very large baby (over 9 lbs.), infant low blood sugar at birth, and still births. Chronic maternal high blood pressure (hypertension) and an increased rate of cesarean deliveries may also occur.
  • Blood glucose/sugar levels return to normal after delivery in 90% of cases.

Cause of Gestational Diabetes:

  • Hormones produced by the placenta induce an environment of stress producing an insulin resistant state in the mother (see insulin resistance under Type 2 Diabetes).

Gestational Diabetes Screening Test:

  • drinking a 50-gram oral glucose solution followed by a 1-hour blood glucose test.
  • If result is equal to or greater than 140 mg/dl, further testing required.

Diagnostic Test for Gestational Diabetes:

  • drinking 100-gram oral glucose solution after an 8 hour fast
  • blood sugar test at 1, 2, and 3 hours after
  • positive diagnosis requires that any two of the four glucose values obtained during the test meet or exceed the following values:
    - Fasting - 105 mg/dl
    - 1-hour - 190 mg/dl
    - 2-hour - 165 mg/dl
    - 3-hour - 145 mg/dl

Treatment of Gestational Diabetes:

  • Diet
  • Exercise
  • Self Monitoring
    - blood sugar
    - ketones
    - baby's movements in utero
  • Education
  • Insulin may be needed

Goals of Gestational Diabetes Treatment:

  • Maintain normal blood glucose/sugar levels
    - Fasting ≤ 90 mg/dl
    - 1-hour after meals ≤ 120 mg/dl
  • Provide a nutritionally adequate diet for pregnancy
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