6 Things You Need to Know About Gestational Diabetes

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By Muniyra Douglas
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November 14 is World Diabetes Day. Over 200 million women around the world are living with diabetes. Gestational diabetes is a type of diabetes that occurs during pregnancy.  The body cannot produce enough insulin to handle the development of a growing baby and fluctuating hormone levels.  Insulin helps regulate the body’s glucose (sugar) in the blood.  If the body cannot produce enough insulin, your blood sugar level will increase.

According to Diabetes Canada, all pregnant women should be screened for gestational diabetes between 24 to 28 weeks of pregnancy.
 
Dr. Howard Berger – Head, Maternal Fetal Medicine and Deputy Chief, Obstetrics at St. Michael’s Hospital, discusses with VIBE 105, research into diabetes during pregnancy.

Here are six facts you need to know about gestational diabetes.

1. The risk factors for gestational diabetes are the same for Type 2 diabetes

​Obesity is a major factor, as well as family history, mainly first degree relatives.  Those are two big ones.  Having gestational diabetes in a previous pregnancy is a very strong predictor of getting it again.  The risk does increase with age, but that can be because of increased pregnancies.

2. Pre-existing and gestational diabetes are two different things

One of the major things we distinguish is between pre-existing Type 1 or Type 2 diabetes.  There are few differences between them. Type 2 diabetes and gestational diabetes are caused by the same type of abnormalities, however the impacts on pregnancy is very different.

3. Effects on the fetus depend on whether or not you had pre-existing diabetes

Pre-existing diabetes refers to women who get pregnant with some degree of sugar ‘mishandling’.  Their sugar is generally higher of course, and for some reason persistently high sugars around the time of conception are a significant risk factor for fetal birth, heart and spinal defects.

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4. Insulin treatment does not affect the fetus

​There are different ways of managing diabetes depending on the type of diabetes.  Insulin itself does not cross the placenta so it is definitely not associated with any birth defects.  You would want to avoid the misconception that all medications should be stopped if you’re pregnant. Almost all diabetic medication should be continued until a doctor is consulted, and then there can be adjustments made.  If you have Type 2 diabetes and you’re on pills, you should still continue the pills with some adjustments, or the introduction of insulin for many different reasons.

5. Diabetes can affect breastfeeding

In general, a lot of the research says there are more difficulties in breastfeeding for moms with diabetes in pregnancy.  It’s not exactly clear why, and usually it can be overcome with good guidance by a professional lactation consultant.  There are some studies conducted - but show it’s probably, not necessarily a direct relationship. One thing we do know is that breastfeeding is good for diabetes control.  It helps lower the blood sugar in moms and can help achieve sugar control. In moms with gestational diabetes, breastfeeding helps bring them down to normal glucose, and maintain the levels in many cases afterwards.

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6. ​Discontinuing diabetes medication during pregnancy should not be done without consultation

One thing we encounter a lot is that medications are a bad thing. We want to discourage the blind discontinuation of medication.  There are some medications that are not good to take during pregnancy, and it’s better for every woman to consult their family physician if they’re planning to get pregnant. The most important thing those with pre-existing diabetes need to know is that they’re not always aware that a planned pregnancy is the key to success - as opposed to an unplanned pregnancy.  When you have a planned pregnancy, especially if you have more severe diabetes, then you can really help achieve a very normal outcome by entering the pregnancy in an optimally controlled state.  The second thing is that gestational diabetes doesn’t mean you are going to continue to have diabetes or your kids are going to have diabetes.  There are familial risk factors if the mom develops Type 2 diabetes in the future, the child will also have the same risks for Type 2 diabetes.  

You can read more about Gestational Diabetes here.