NEWS | March 22, 2019

How does gestational diabetes affect pregnant women and their babies?

UC Davis Health OB/Gyn physician answers questions for expecting mothers

(SACRAMENTO)

Gestational diabetes is a concern of many pregnant women. Obstetrics and gynecology physicians field questions from expecting mothers like, “How will gestational diabetes affect my pregnancy?” and “Will my baby have diabetes going forward?”

Gestational diabetes is developed during pregnancy and accounts for 80 to 90 percent of diabetes diagnoses in expecting mothers. Gestational diabetes is developed during pregnancy and accounts for 80 to 90 percent of diabetes diagnoses in expecting mothers.

UC Davis Health OB/Gyn physician and certified diabetes educator Nancy Field hosted a Facebook Live to answer some frequently asked questions about diabetes during pregnancy.

How does diabetes affect pregnant women?

Field: There are three types of diabetes in pregnancy. Gestational diabetes is discovered during pregnancy and normally goes away after the baby is delivered. This is the most common form of the disease in pregnancies. There are two kinds of pregestational diabetes: Type 1 and 2. Type 1 is diagnosed earlier. These women are insulin-dependent and have to be on medication their whole life. Patients with Type 2 pregestational diabetes are diagnosed later in life. They don’t need to be on insulin but may be overweight and may have a family history of diabetes. These patients often have their blood sugar levels managed by oral medication.

Can women pass gestational diabetes on to their baby?

Field: No, expecting mothers don’t pass it on to their children. However, there is a higher risk if the mother has a family history of diabetes and develops gestational diabetes that she could pass it on to her baby. In addition, women who develop gestation diabetes in a pregnancy have a 20 to 60 percent risk of developing Type 2 diabetes themselves later on in life.

If a woman had gestational diabetes with her first child, is she more likely to get it in her second pregnancy?

Field: There’s about a 50 percent risk of gestational diabetes coming back for a second pregnancy. In women who had it in a prior pregnancy, we want to screen them earlier than usual because of the higher risk. However, there are women who have the disease in their first pregnancy but not in their second. Those are typically women who have lost a lot of weight. Women who had twins or triplets in their first pregnancy and a single child in their second pregnancy also may not develop the disease.

Are there any tricks for pregnant women who are testing for diabetes?

Field: It’s a misconception that you can trick the system. If you take two women who are both thin, and one fasts for 12 hours before the test while the other goes to IHOP and eats the whole left side of the menu, the second woman is going to have a lower value. That’s because there’s more circulating insulin. When the glucose comes down, it’s going to be sucked up in the cells, leaving less to be measured in the blood stream. People should not try to alter the test; they are more likely to have an abnormal value.

For pregnant women who take insulin, does it affect their baby?

Field: The insulin does not go across the placenta to get to the baby. In fact, the fetal pancreas while you’re still pregnant makes insulin starting at about 14 weeks. If too much glucose is coming across the placenta, the fetal pancreas puts out more insulin to try and lower the blood sugars.

Is it ok for pregnant women with diabetes to exercise?

Field: Pregnancy is not a time to get in shape or take up a new sport. However, exercise does lower blood sugar. If you walk for 10-15 minutes after a meal, that could lower your blood sugar by about 10-15 points. We encourage people to do that. There are studies that suggest if people start exercising for 15-20 minutes a day, it may improve their glycemic control. It’s rarely enough to eliminate the need for medication, if patients are heading in that direction.

What are some good foods for pregnant women with gestational diabetes?

Field: There are certain foods that we know are typically bad, like those that spike blood sugar. These are things like refined carbohydrates; pretty much all breakfast cereals are bad. Certain fruits -- pineapple, kiwi -- that don’t have a lot of fiber can really spike your blood sugar. Pure fruit juices are really bad. A good meal would be something that has some complex carbs with a low glycemic index, so they don’t go into your blood stream all at once. Add in a combination of fat, which delays glucose absorption, and a protein that stabilizes blood sugar.

Are babies born earlier if the mother has gestational diabetes?

Field: Typically, that’s not the case. There are not standard recommendations when people with gestational diabetes should be delivered. If the patient is well-controlled, she doesn’t have other complications and the baby isn’t too big, my goal is to have her go into labor on her own and hopefully have a vaginal delivery. The data doesn’t really support inducing labor early. I have criteria for who I’m worried enough about that I might consider an early delivery.

Additional resources:

Centers for Disease Control and Prevention: Gestation diabetes and pregnancy
American Diabetes Association: Gestational diabetes | How to treat gestational diabetes
Birth Center and Maternity Services at UC Davis Health
UC Davis Health Management and Education: Start learning about diabetes
UC Davis Health's Department of Obstetrics and Gynecology