Are you at risk?

The National Institutes of Health has published the following set of questions to help pregnant women learn about their risk of gestational diabetes:

• Are you overweight?
• Are you related to anyone who has diabetes or has had diabetes in the past?
• Are you Hispanic, Latino/a, African American, American Indian, Alaska Native, Asian American, or Pacific Islander?
• Are you older than 25?
• Have you had any of the following in a previous pregnancy:
  • Gestational diabetes?
  • Stillbirth or miscarriage?
  • A baby weighing more than 9 pounds at birth?
• Do you have polycystic ovary syndrome or another condition related to problems with insulin?
• Have you ever had problems with insulin or blood sugar, such as insulin resistance, glucose intolerance, or pre-diabetes?
• Do you have high blood pressure, high cholesterol levels, or heart disease?

If you answered yes to two or more of these questions, your risk for gestational diabetes is considered high and your healthcare provider will likely test you for gestational diabetes at your first prenatal visit. If you answered yes to fewer than two questions, you will most likely be tested between weeks 24 and 28 of your pregnancy.

Treating gestational diabetes

If you’re diagnosed with gestational diabetes, it’s important to keep up with a healthy lifestyle. You’ll also need to work closely with your healthcare provider to develop an effective monitoring and treatment plan, with the goal of keeping your blood sugar well managed throughout pregnancy.

Studies suggest 70–85% of women with gestational diabetes can control the condition with healthy lifestyle modifications alone; when that’s not enough to keep blood sugar levels in a healthy range, you may need drug treatment. Insulin appears to be the safest choice for pregnant women, as it only crosses the placenta minimally. Other drugs like glyburide and metformin may also be prescribed, but they can come with side effects, and long-term safety studies on these medications during pregnancy are lacking.

To help manage this condition, consult with your doctor and make sure you eat a healthy diet, get regular exercise, monitor your blood sugar regularly, and take insulin or other medications if prescribed.

Lower your risk

You could reduce your risk of developing gestational diabetes by sticking to a healthy diet, getting regular exercise, and maintaining a healthy weight. Specifically,

• Eat a nutritious diet, emphasizing fruits, vegetables, whole grains, lean protein, low-fat dairy, nuts/seeds, and legumes.
• Aim for 30 minutes of moderate-intensity exercise on most days of the week.
• If you’re overweight, lose weight before you plan to become pregnant.

(Diabetes Care 2017;40 Suppl 1)