Q: Gestational Diabetes – what is it and can it be prevented?

A: Gestational diabetes is a condition of impaired glucose tolerance that is discovered during pregnancy. Traditionally, certain patient groups were felt to be at high risk for gestational diabetes, such as those with a family history of diabetes, past pregnancy with gestational diabetes, past pregnancy with unexplained stillbirth, or a history of a large infant. Obesity, hypertension, glucose in the urine and maternal age over 25 were other indications for screening.

The American Diabetes Association has recommended that all pregnant women be screened for gestational diabetes with a 1-hour post glucola test. Normal values fall between 135-140 mg per dl.

If the 1-hour is abnormal, a 3-hour GTT is done. If two abnormal values are noted on the 3-hr GTT, a diagnosis of gestational diabetes is made.

Most patients can be treated with diet and exercise. However, about 15% require insulin or an oral diabetic medication. If normal blood sugars can be maintained during pregnancy, the risks to the fetus can be minimized and/or eliminated.

Gestational diabetes usually resolves after delivery, but 50% of these patients will develop diabetes later in life, and close follow-up is important.