Q: Why do some women get gestational diabetes and others don’t? Is it something I did?
A: Gestational diabetes is a condition that can happen to women who have never had diabetes before. It shows up sometime around the 24th week of pregnancy or during the third trimester and affects about 18% of all pregnancies. Gestational diabetes did not develop when you got pregnant and for many women it will disappear after you have had your baby. It can occur in any woman but there are some risk factors that make it more likely. If you have ever had gestational diabetes before or if you have delivered a baby that weighed more than 9 lbs, you are very likely to develop it with future pregnancies. Other risk factors that will increase the likelihood you will develop gestational diabetes include being overweight, being over age 30, strong family history of Type 2 diabetes, having been diagnosed with polycystic ovary syndrome or pre-diabetes, or if you are African American, Hispanic, Asian, American Indian or Pacific Islander.
Experts aren’t sure exactly what causes gestational diabetes but we have some ideas. As the placenta grows and supports your baby, it has hormones that can block the action of your insulin. This causes what is called ‘insulin resistance’ making it hard for your body to use its own insulin. Without enough insulin, the glucose in your bloodstream will not be able to get into the muscles where it is needed for energy and the blood glucose levels will build up. This can be harmful to your baby. But, the good news is there are steps you can take to protect yourself and your baby. We know that women who have diabetes in their family may be more likely to develop gestational diabetes and so taking preventive action before you get pregnant is your best defense. Watching your weight and being physically active are two very important ways to give yourself and your baby the best chance for a healthy pregnancy.
Teresa L. Pearson, MS, RN, CDE, FAADE is the Director of Clinical Services at Halleland Habicht Consulting, LLC and CEO of Innovative Health Care Designs. Until recently, Teresa served as the Director of Diabetes Care for Fairview Health Services where she provided direction and oversight for diabetes care services in 30 primary care sites.