While uncontrolled gestational diabetes can have harmful effects on your baby, they are usually preventable. The key to avoiding problems in the fetus is to control blood glucose levels as soon as a woman knows she has gestational diabetes.
If blood glucose levels continue to remain elevated, the fetus develops a condition called "macrosomia." Macrosomia means "large body" and refers to a baby that is much larger than normal. Macrosomia occurs when maternal blood glucose levels remain elevated, allowing more glucose to cross the placenta and enter the bloodstream of the fetus. When this occurs, the fetus responds by producing more insulin to try to lower its own blood glucose levels. The fetus then converts the extra sugar it has received into fat stores. Additional fat stores result in extra weight gain in the fetus.
If the fetus grows too large, it cannot be delivered vaginally and the woman may be forced to undergo a cesarean delivery. At times, when vaginal delivery is attempted, the baby will experience shoulder trauma as it passes through the birth canal. If you have gestational diabetes, your doctor may order an ultrasound examination to monitor the size of your fetus more closely.
Infants born to mothers with gestational diabetes are at higher risk for developing low blood glucose levels after birth. This occurs when high glucose levels in the mother cause the fetus to produce excess insulin, which may still be present at birth. After delivery, the infant no longer has excess blood glucose from the mother, but may still have high levels of circulating insulin. Blood glucose levels are closely monitored in the infant following birth, and extra glucose can be given to the infant when needed. Infants born to mothers with gestational diabetes can develop other chemical imbalances in the blood, but careful monitoring can detect them and allow for early intervention when needed.
Because infants born to mothers with gestational diabetes run a greater risk of developing newborn jaundice and respiratory problems, they will be monitored closely for evidence of these disorders. Maintaining normal blood glucose levels makes the fetus less likely to develop any of the complications of gestational diabetes.
Self care
The good news is that the condition is manageable and you can have a healthy baby. To help ensure this, treatment must start immediately. Your doctor will want you to keep your blood glucose the same as pregnant women who do not have diabetes. Special meal plans and regular exercise should be part of your treatment. You may need to do daily glucose testing and insulin injections. Effectively managing the condition involves working with your health care team.
Home monitoring: You will need to monitor your blood sugar levels several times a day. Your doctor or a diabetes educator can help you learn how.
Diet: Generally, your diet should be rich in fruits, vegetables and whole grains. Most women with gestational diabetes should avoid single, large meals with an excess of simple carbohydrates, which are contained in sweets and processed food. Rather, a diet of three small meals and two or three snacks helps relieve stress on your pancreas, while also assuring your baby gets enough glucose. The specific content of your meals, such as the amount of carbohydrate, fat and protein, is based on your food preferences, activity level, blood glucose readings and insulin requirements. About 40 percent of your calories should come from carbohydrates, 30 percent from protein and the remaining 30 percent from fat (and less than 7 percent saturated fat). Your diet should also include plenty of fiber. A registered dietitian with training in diabetes care should be able to guide you.
Medication: You may need daily insulin injections.
Exercise: Blood sugar control can often be improved through exercise. Physical activity causes sugar to be transported into your cells for use as energy. This lowers levels in the blood. Be as active as possible. All pregnant women should talk with their doctor before starting or continuing an exercise program.
If diet and exercise don't work, insulin may be needed. Your doctor will tell you if this is necessary.
After pregnancy
Also, because gestational diabetes increases the risk of developing type 2 diabetes later on, women who have had gestational diabetes should:
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Lose weight. Even losing a few pounds helps reduce your risk.
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Change your diet. Eat plenty of fruits, vegetables and whole grains while limiting your fat intake to 30 percent or less.
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Exercise. Regular exercise helps your body use glucose. Check with your doctor before starting any exercise program.
- Follow your doctor's recommendations for screenings to detect diabetes.
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External Sources
 | National Institute of Child Health and Human Development
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| American Diabetes Association
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This article was reviewed and updated June 2007.
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