Gestational Diabetes: Managing Risk During and After Pregnancy

Contributor: Ellen Seely, MD
Ellen Seely, MD, is Director of Clinical Research in the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women’s Hospital.

Women who develop diabetes during pregnancy, known as gestational diabetes mellitus (GDM), may need high-risk pregnancy care due to complications that can arise during pregnancy and childbirth. Women with GDM have an increased risk of preeclampsia, a condition that leads to pregnancy-induced high blood pressure. Preeclampsia is a serious condition that can result in early delivery. Women who have gestational diabetes also have an increased risk of cesarean section.

What Causes Gestational Diabetes?

GDM is a type of diabetes that occurs only in pregnancy. It develops in the second half of pregnancy, and it goes away after delivery. Obesity is one of the main risk factors for GDM. In the United States, most health centers screen all women for gestational diabetes, because obesity is becoming so common in the overall population. It’s estimated that five percent of all pregnancies are complicated by GDM. The rates of GDM are even higher in Hispanic and non-white populations, ranging from 10 to 20 percent of pregnancies.

The primary treatment for GDM is to control a mother’s blood glucose levels with lifestyle changes such as healthy eating and physical activity. Lifestyle changes are effective in controlling blood glucose levels in about 60-75 percent of women with GDM. If the lifestyle changes don’t work, insulin therapy will be started to control a mother’s blood sugar for the rest of her pregnancy.

Gestational Diabetes and Your Future Health

While GDM goes away after pregnancy, the health risks to a mother and her child continue. Research has found that 50 to 70 percent of women who have gestational diabetes develop type 2 diabetes later in life. Research also has found that babies born to mothers with GDM have a higher birth weight and may become obese during adolescence, increasing their risk of developing diabetes and other conditions, such as high blood pressure. Dr. Seely emphasizes that although women who have had gestational diabetes face an increased future risk for type 2 diabetes, they can take steps to decrease that risk.

 

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