Ask a Doctor

David A. Ruedrich MD
Scioto Ob Gyn, Inc. 
5150 Bradenton Ave
Suite A
Dublin , Ohio 43017
Phone: (614) 793-8544

Q:  What is gestational diabetes?  How does having gestational diabetes affect my pregnancy?  

A:  Gestational diabetes is diabetes diagnosed during the current pregnancy. All pregnant women have a screening test for diabetes between 24 and 28 weeks. A one-hour screening glucose tolerance test is used to determine which women need to go on to a more thorough 3 hour (4 blood draw) test.  If two of these four blood tests are above a certain level, gestational diabetes is diagnosed.

All women have increased resistance to insulin (glucose regulatory hormone made in the pancreas) during pregnancy. This means it takes more insulin to get sugar into the cells for metabolism. Most women have a pancreas that can rise to the task.  If the pancreas cannot make enough insulin to keep the blood sugar below a specific level, diabetes is diagnosed.

When diabetes is diagnosed, the first step is education: specifically concerning dietary modification and blood glucose monitoring. Caloric intake is calculated on body weight and oftentimes a nutrition consultation with a dietician occurs. Meals are comprised of more proteins and complex carbohydrates and fewer simple carbohydrates. Primary meals are comprised of lesser calories, with snacks between meals and at bedtime. In this manner, often the pancreas can keep up with the insulin needed.  If the pancreas cannot make enough insulin to keep the blood sugar under a certain level, insulin is needed.

Blood glucose monitoring is an important component in the management of gestational diabetes. Fasting (before breakfast) blood sugars are best below 100 and two hour post eating sugars are desired to be below 120.  If the sugars cannot be maintained below these levels, insulin may be needed.

The primary concern for women with diabetes is a big baby. If blood sugars are not well controlled, the baby receives extra calories and grows larger. Mothers with big babies may have more difficult deliveries and increased risk of caesarean section delivery.

Prevention of diabetes during pregnancy is unlikely. Most importantly, diagnosis and dietary modification is the cornerstone of management.