Gestational diabetes | |
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Other names | Gestational diabetes mellitus (GDM) |
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Universal blue circle symbol for diabetes[1] | |
Specialty | Obstetrics and endocrinology |
Symptoms | Typically few symptoms[2] |
Complications | Pre-eclampsia, stillbirth, depression, increased risk of requiring a Caesarean section[2] |
Usual onset | Most common last three months of pregnancy[2] |
Causes | Not enough insulin in the setting of insulin resistance[2] |
Risk factors | Overweight, previously having gestational diabetes, family history of type 2 diabetes, polycystic ovarian syndrome[2] |
Diagnostic method | Screening blood tests[2] |
Prevention | Maintaining a healthy weight and exercising before pregnancy[2] |
Treatment | Diabetic diet, exercise, insulin injections[2] |
Frequency | ~6% of pregnancies[3] |
Gestational diabetes is a condition in which a person without diabetes develops high blood sugar levels during pregnancy.[2] Gestational diabetes generally results in few symptoms;[2] however, it increases the risk of pre-eclampsia, depression, and of needing a Caesarean section.[2] Babies born to individuals with poorly treated gestational diabetes are at increased risk of macrosomia, of having hypoglycemia after birth, and of jaundice.[2] If untreated, diabetes can also result in stillbirth.[2] Long term, children are at higher risk of being overweight and of developing type 2 diabetes.[2]
Gestational diabetes can occur during pregnancy because of insulin resistance or reduced production of insulin.[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.[2] Diagnosis is by blood tests.[2] For those at normal risk, screening is recommended between 24 and 28 weeks' gestation.[2][3] For those at high risk, testing may occur at the first prenatal visit.[2]
Maintenance of healthy weight and exercising before pregnancy assist in prevention.[2] Gestational diabetes is treated with a diabetic diet, exercise, medication (such as metformin), and sometimes insulin injections.[2] Most people manage blood sugar with diet and exercise.[3] Blood sugar testing among those who are affected is often recommended four times a day.[3] Breastfeeding is recommended as soon as possible after birth.[2]
Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.[3] It is especially common during the third trimester.[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.[3] A number of ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Islanders are at higher risk.[3][2] However, the variations in prevalence are also due to different screening strategies and diagnostic criteria being used. In 90% of cases, gestational diabetes resolves after the baby is born.[2] Affected people, however, are at an increased risk of developing type 2 diabetes.[3]