Birth defects usually originate sometime during the first trimester before the 13th week of pregnancy. The insulin resistance from the contra-insulin hormones produced by the placenta does not usually occur until approximately the 24th week.
Women with gestational diabetes mellitus generally have normal blood sugar levels during the critical first trimester.
The complications of GDM are usually manageable and preventable. The key to prevention is careful control of blood sugar levels just as soon as the diagnosis of diabetes is made. Infants of mothers with gestational diabetes are vulnerable to several chemical imbalances, such as low serum calcium and low serum magnesium levels, but, in general, there are two major problems of gestational diabetes: macrosomia and hypoglycemia:.
Macrosomia refers to a baby who is considerably larger than normal. All of the nutrients the fetus receives come directly from the mother's blood. If the maternal blood has too much glucose, the pancreas of the fetus senses the high glucose levels and produces more insulin in an attempt to use this glucose. The fetus converts the extra glucose to fat. Even when the mother has gestational diabetes, the fetus is able to produce all the insulin it needs.
The combination of high blood glucose levels from the mother and high insulin levels in the fetus results in large deposits of fat which causes the fetus to grow excessively large. 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. Your blood sugar levels will usually return to normal after your baby is born.
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. Talk to your doctor about how much weight you should gain for a healthy pregnancy.
You can do a lot to manage your gestational diabetes. If the 1-hour test is abnormal, you will have a second glucose tolerance test done to confirm the diagnosis. You will drink another special beverage, but with more sugar. Your healthcare provider will measure your blood sugar levels 1 hour, 2 hours, and 3 hours later. You have gestational diabetes if at least two of the glucose measurements are higher than normal. If you are diagnosed with gestational diabetes, you should get tested for diabetes 4 to 12 weeks after your baby is born.
You should also get this screening at least every 3 years for the rest of your life. Treatment for gestational diabetes focuses on keeping your blood sugar levels in the normal range.
Treatment may include:. Special diet. You should eat 5 servings of vegetables, fruits, low-fat or nonfat dairy products, and lean meats. Use liquid fats for cooking instead of solid fats. You should eat whole grains and avoid high-calorie snacks or sweet desserts. You should do moderate exercise unless your healthcare provider tells you not to.
Daily blood glucose monitoring. Insulin injections. You may need these to control your blood sugar levels. Or you may need other medicines taken by mouth.
Excess weight before pregnancy often plays a role. Normally, various hormones work to keep your blood sugar levels in check. But during pregnancy, hormone levels change, making it harder for your body to process blood sugar efficiently. This makes your blood sugar rise. Some women have a greater risk of gestational diabetes. Risk factors for gestational diabetes include the following:. Gestational diabetes that's not carefully managed can lead to high blood sugar levels.
High blood sugar can cause problems for you and your baby, including an increased likelihood of needing a C-section to deliver. There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better.
If you've had gestational diabetes, these healthy choices may also reduce your risk of having it again in future pregnancies or developing type 2 diabetes in the future. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.
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