Pregnant women can acquire a form of diabetes called gestational diabetes—even if they have not been diagnosed with diabetes before.

Between weeks 24 and 28 of a pregnancy, a health care provider will run tests to determine if your blood glucose levels are running higher than normal. During this time the fetus and the placenta produce hormones that help the baby grow but can also have anti-insulin properties. These properties might cause a response in the mother that is called “insulin resistance,” which is essentially a characteristic of Type 2 diabetes.

The proper action of insulin is needed to move blood glucose into the cells for energy. However, if the mother is resisting her own insulin, her blood glucose remains in her blood stream longer than it should. The baby gets more glucose than it needs and starts to grow too large.

The treatment goal is to keep the mother’s blood glucose level as close to normal as possible. A good understanding of food choices and their effects on blood glucose is critical. Appointments with a registered dietitian throughout the final months of pregnancy are very beneficial. Daily exercise also helps to control glucose levels. Many mothers find walking after each meal helps keep blood glucose levels in range. Frequent blood glucose monitoring can be necessary, in order to watch for fluctuations throughout the day.

Often a change in diet and exercise is all that’s needed. However, if the insulin resistance is too strong, injections of insulin may be required for the best control and safety of the growing baby. Injected insulin is considered to be safe for both the mother and her baby.

Large babies (marcosomia) are the result of gestational diabetes if the mother’s blood glucose is not kept in tight control. A caesarean section delivery might be the only option for such a large baby.

Macrosomic babies face problems, including damage to their shoulders during birth, breathing problems, and low blood sugars after birth. Newborns of mothers with gestational diabetes are watched carefully for hours after birth to ensure the baby does not become hypoglycemic. Hypoglycemia (low blood glucose) is serious in newborns and can result in seizures.

Once the baby is born and the placenta is removed, the anti-insulin hormones are gone. Usually, blood glucose levels return to normal. However, gestational diabetes is a red flag that the mother is at risk for developing Type 2 diabetes later on. Lifestyle changes to improve weight, eating habits and exercise routines can help prevent the development of Type 2 diabetes

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