An increasing number of women in the US have diabetes. Women with diabetes face some additional health risks during pregnancy such as having a very large baby, cesarean birth, or pregnancyinduced high blood pressure. Extra prenatal care is needed to ensure a healthy pregnancy and delivery. Glucose, a sugar, is derived from digested food and is important to the nourishment of the cells in the body. Diabetes occurs when insulin—a hormone that helps the cells use glucose—is in short supply or does not function properly, allowing glucose to build up in the blood stream. Diabetes is diagnosed when screening tests show blood glucose to be higher than normal. Type 1 and type 2 diabetes are the most common forms, affecting roughly one out of every 100 nonpregnant US women. Additionally, between 2% and 10% of women who do not have diabetes will develop gestational diabetes during pregnancy. Though it usually goes away after delivery, gestational diabetes raises a woman’s risk of related conditions, such as glucose intolerance or type 2 diabetes, in the future. ACOG recommends that all pregnant women be screened for gestational diabetes. Factors that can increase a woman’s By Gerald F. Joseph Jr, MD, President, The American College of Obstetricians and Gynecologists chances of developing type 2 or gestational diabetes include being overweight, physical inactivity, high blood pressure, low HDL (“good”) cholesterol levels, previous abnormal glucose screening results, a family history of diabetes, gestational diabetes in a previous pregnancy, or giving birth to a baby weighing more than nine pounds. Gestational diabetes risk is also increased in pregnant women who are older than 25. If you are diagnosed with gestational diabetes during pregnancy, your doctor will set up a treatment plan to ensure a healthy pregnancy. You will need to visit the doctor more frequently. Diabetes can be controlled with careful monitoring of blood glucose levels, changes in diet, regular exercise, and medications. A registered dietician can help devise a diet that will keep blood sugar in check, reduce the risk of having a large baby, and ensure proper nutrition and calorie intake. If diet and exercise don’t work, some pregnant women will need to take insulin to control their blood glucose levels. ACOG recommends that women with gestational diabetes be rescreened for diabetes 6–12 weeks after delivery. Women with normal results should be rescreened at least every three years, and those who are found to have diabetes can be put on a management plan.
