Gestational Diabetes Mellitus

Diabetes Acquired During Pregnancy

Jan 5, 2009

A definition of gestational diabetes, how it is diagnosed, the treatments and the complications that can occur if the disease is left uncontrolled.

Gestational diabetes mellitus (GDM) is a common disorder affecting 7% or 200,000 pregnant women in the United States each year (1). Research has shown that while untreated GDM can cause complications during pregnancy, treatment of the condition with dietary modifications, self blood glucose monitoring and medical therapy if necessary, can help achieve glycemic control and prevent complications (2).

What is Gestational Diabetes Mellitus (GDM)?

GDM is defined as “glucose intolerance, the onset or first recognition of which occurs during pregnancy (3).” GDM is usually diagnosed during the second or third trimester of pregnancy. While 81%-94% of women with GDM return to normal glucose tolerance after delivery, they are at higher risk of developing GDM earlier in subsequent pregnancies and are at increased risk for type 2 diabetes (1).

How is Gestational Diabetes Mellitus Diagnosed?

Women who are at high risk (those with a history of obesity, previous history of GDM or a strong family history of diabetes) should be tested during the first prenatal visit. The pregnant women are given an oral glucose tolerance test. To prepare for the test the woman does not eat or drink anything after midnight the night before the test. At the time of the test the woman is asked to drink a liquid containing glucose. Blood is taken every 30 to 60 minutes after drinking the solution. If 2 hours after the solution is drunk the woman’s blood glucose is equal to or greater than 155ml/dl, she is diagnosed with GDM (3).

How is Gestational Diabetes Mellitus Treated?

It is important that the women who are diagnosed with GDM use a carbohydrate counting diet to help control blood glucose levels. The American Diabetes Association has found that patients benefit significantly by receiving dietary counseling from a registered dietitian to learn to count carbohydrates and plan meals (4). Women should also follow any medical intervention recommend by their doctor. While not required in all cases, some women may need insulin to control blood sugar levels. Insulin will be prescribed and monitored carefully by a physician. Maintaining a healthy weight is also an important part of controlling the disease. Research has shown that “women with GDM who gain weight above the recommended guidelines have a higher risk of undesirable outcomes, including preterm delivery, macrosomic neonates and cesarean deliveries.(2)” The Institute of Medicine recommends that women of normal weight should gain 25-35 pounds during pregnancy. Women who are overweight should gain 15-25 pounds and obese women should gain about 15 pounds (2).

What are the Complications Caused by Uncontrolled Gestational Diabetes Mellitus?

Women with uncontrolled GDM are at higher risk for development of hypertensive disorders and preeclampsia, a condition of high blood pressure. Women with uncontrolled GDM are also at increased risk for cardiovascular disease and type 2 diabetes. Babies born to mothers with uncontrolled GDM have a higher risk of developing macrosomia, hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, polycythemia, hypertrophic cardiomyopathy and hypocalcemia.

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The copyright of the article Gestational Diabetes Mellitus in Prenatal Health is owned by Melissa Black. Permission to republish Gestational Diabetes Mellitus in print or online must be granted by the author in writing.