Gestational Diabetes and Lifelong Diabetes Risk
November 14, 2018
By Karen Wilkinson, RN, NHA, CLNC – CareerSmart® Learning Contributor
November is National Diabetes Awareness Month, and the goal of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is to focus attention on gestational diabetes, the type of diabetes that develops during pregnancy. Although gestational diabetes generally goes away after the baby is born, NIDDK wants us to know that these mothers and babies have an increased, lifelong risk for development of type 2 diabetes. The surprising statistic is the magnitude of that risk. Fifty percent of women diagnosed with gestational diabetes will go on to develop type 2 diabetes later in life. And the babies born to mothers with gestational diabetes are also at risk for the development of type 2 diabetes later in life, as well obesity during their child or teen years.
Some women will already have some level of insulin resistance before they get pregnant, making gestational diabetes more likely. And, all pregnant women develop some insulin resistance toward the end of their pregnancy because of hormonal and weight changes that occur. Statistics from Centers for Disease Control and Prevention (CDC) reveal that two to ten percent of pregnant women in the U.S. will go on to develop gestational diabetes. Women at risk for gestational diabetes include those who have had gestational diabetes previously, delivered a baby who weighed more than nine pounds, are currently overweight, age 25 or older, have a family history of type 2 diabetes, a diagnosis of polycystic ovary syndrome, or are African American, Hispanic/Latino American, American Indian, Native Hawaiian, or Pacific Islander. Although some risk factors cannot be altered, lowering the risk for gestational diabetes is possible through lifestyle changes made before becoming pregnant, such as losing excess weight and increasing physical activity. The diagnosis of gestational diabetes is concerning because it represents an increased risk for complications during pregnancy, such as hypertension, preeclampsia, miscarriage, stillbirth, or the need for a cesarean section because of the baby’s large size. And gestational diabetes puts the baby at higher risk of high birth weight (greater than 9 pounds), prematurity, hypoglycemia, breathing problems after birth, and the later development of type 2 diabetes.
Diagnosis of gestational diabetes is made through a glucose screening test or glucose tolerance test, usually completed between 24-28 weeks of pregnancy, or earlier if the mother has identified risk factors. Treatment of gestational diabetes is aimed at maintaining healthy blood glucose levels. Some of the same lifestyle changes that are helpful to anyone, such as being active and eating healthy foods in the right amounts, will be part of the treatment regimen. More specific diabetic treatments include routine monitoring of blood glucose and/or urine ketones, and insulin or oral diabetes medication, if necessary. Lastly, the baby’s growth and development will also be carefully monitored.
After the baby is born, NIDDK recommends that a woman who has had gestational diabetes be tested for type 2 diabetes within 12 weeks following delivery. If the blood glucose level is normal, testing should reoccur every three years. Other NIDDK recommendations include a discussion with the woman’s physician if another pregnancy is planned, informing the baby’s physician that the mother had gestational diabetes, and implementation of good lifestyle habits to help prevent or delay the onset of type 2 diabetes for both the mother and child.
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,9 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2017). National Diabetes Month 2018. Retrieved from https://www.niddk.nih.gov/health-information/communication-programs/ndep/partner-community-organization-information/national-diabetes-month
3,8 CDC. (2017). Gestational Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/gestational.html
2, CDC. (2017). Who’s at Risk? Retrieved from https://www.cdc.gov/diabetes/basics/risk-factors.html
 NIDDK. (2017). Preventing Gestational Diabetes. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational/prevention
 NIDDK. (2017). Definition & Facts of Gestational Diabetes. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational/definition-facts
7 CDC. (2017). Getting Tested. Retrieved from https://www.cdc.gov/diabetes/basics/getting-tested.html