Gestational Diabetes Mellitus (GDM) 1

1- What is Gestational Diabetes Mellitus (GDM)?

Gestational diabetes (pronounced jess-
TAY-shun-ul die-uh-BEET-eez) is a type
of high blood sugar that only pregnant
women get. In fact, the word
“gestational” means pregnant. If a
woman gets high blood sugar when she’s
pregnant, but she never had high blood
sugar before, she has gestational
diabetes.

Between 2 percent and 10 percent of U.S. pregnancies are affected by the condition
every year,1 making it one of the top health concerns related to pregnancy. If not
treated, gestational diabetes can cause problems for mothers and babies, some of
them serious.

But there is good news,

• Most of the time, gestational diabetes goes away after the baby is born. The
changes in your body that cause gestational diabetes normally occur only when
you are pregnant. After the baby is born, your body goes back to normal and the
condition goes away.

• Gestational diabetes is treatable, and the best outcomes result from careful
management and control of blood sugar levels. The best way to control
gestational diabetes is to find out you have it early and start treatment quickly.

• Treating gestational diabetes-even if you don’t have any symptoms or your

symptoms are mild-greatly reduces health problems for mother and baby.

2- Why do some women get gestational diabetes?

Usually, the body breaks down much of the food you eat into a type of sugar, called
glucose (pronounced GLOO-kos). Because glucose moves from the stomach into the
blood, some people use the term “blood sugar” instead of “glucose.” Your body
makes a hormone called insulin (pronounced IN-suh-lin) that moves glucose out of
the blood and into the cells of the body. In women with gestational diabetes, the
glucose can’t get into the cells, so the amount of glucose in the blood gets higher and
higher. This is called high blood sugar or diabetes.
 Gestational Diabetes Mellitus (GDM) 2
3- How will I be checked for gestational diabetes?
If you have any of the risk factors (see page 6), you should be offered a glucose test
during your pregnancy. This may be a blood test in early pregnancy and/or a glucose
tolerance test (GTT) when you are between 24 and 28 weeks pregnant.
A GTT involves fasting overnight (not eating or drinking anything apart from water):

▪ In the morning, before breakfast, you will have a blood test. You are then given
a glucose drink.

▪ The blood test is repeated 1-2 hours later to see how your body reacts to the
glucose drink.

If you have had gestational diabetes in a previous pregnancy, you will be offered
either a kit to check your own blood glucose levels or a GTT in early pregnancy. If
these are normal, you will be offered a GTT again at 24-28 weeks.
During your routine pregnancy care, your urine is tested for glucose. If glucose is
present in your urine, then your healthcare team may recommend that you have a
GTT.

4- What does gestational diabetes mean for me?

During Pregnancy:
Most women with gestational diabetes have healthy pregnancies and healthy babies
because they control their blood sugar levels. Women with gestational diabetes are
at higher risk for possible problems, including high blood pressure; preeclampsia (a
sudden, dangerous increase in blood pressure); pregnancy loss during the last 4
 Gestational Diabetes Mellitus (GDM) 3
weeks to 8 weeks; early/preterm labor and delivery; and surgery to deliver the baby
(cesarean section, or C-section) and its related risks (such as infection).
Keeping blood sugar levels under control and following the treatment plan outlined
by your health care provider are the best ways to improve pregnancy outcomes for
women with gestational diabetes.

After Pregnancy:
Women who have had gestational diabetes are at greater risk for developing type 2
diabetes during their lifetime. If you had gestational diabetes, your health care
provider will test you for diabetes 6 weeks after you give birth to measure your blood
sugar level.2 If the first test is negative, your doctor provider will test you every year
for diabetes.
Eating a healthy diet, getting regular physical activity, maintaining a healthy weight,
and taking certain medications can help prevent and control type 2 diabetes.

5- What does gestational diabetes mean for my baby?

During and Right After Birth:
Most women with gestational diabetes have healthy pregnancies and healthy babies
because they control their blood sugar levels. Babies whose mothers had gestational
diabetes are at higher risk for certain health problems, including being large bodied,
which can cause problems and injuries during delivery; low blood sugar at birth;
early/preterm birth; jaundice (yellowish color of the skin and white parts of the eye);
breathing problems; and low levels of certain minerals in the blood.

Keeping blood sugar levels under control is the best way to improve outcomes for
babies whose mothers have gestational diabetes.

Later in Life:
Babies whose mothers had gestational diabetes are at higher risk for certain health
problems as they get older. Some of these problems include overweight and obesity;
problems with glucose and/or insulin, such as glucose intolerance and insulin
resistance; and type 2 diabetes.
Eating a healthy diet, getting regular physical activity, maintaining a healthy weight,
and taking certain medications can help prevent and control type 2 diabetes.
 Gestational Diabetes Mellitus (GDM) 4
6- What are my options for feeding my baby?
▪ Breastfeeding is safe if you have
gestational diabetes and your
healthcare team will support you in
feeding your baby.

▪ Whichever way you choose to feed

your baby, you should start feeding as
soon as possible after birth, and then
every 2–3 hours to help your baby’s
blood glucose stay at a safe level.
Babies born to mothers with
gestational diabetes
gestational diabetes have
haveaahigh
highrisk
riskof low sugar levels after birth, so you may
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be low sugarto levels after birth,
hand express and so you
give your baby this early breast milk (also called
may be advised
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▪ Itbreastfeeding
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to do this. if you experience difficulties in breastfeeding after giving birth. Your
healthcare team will be able to advise you about how to store breastmilk safely.

▪ You should inform a member of your healthcare team if you have any concerns
about your baby’s wellbeing.

7- Monitoring Your Blood Sugar:

The American College of Obstetricians and Gynecologists (ACOG) says you should
try to keep your blood sugar below these levels:

Your doctor might recommend different blood sugar levels. Ask your doctor to write
in the chart above the levels you should have.
Gestational Diabetes Mellitus (GDM) 5
High blood sugar:
Your blood sugar is high when the numbers are 130 mg/dL or higher. High blood
sugar can:
• Make you thirsty
• Cause headaches
• Make you go to the bathroom often to urinate (pee)
• Make it hard to pay attention
• Blur your vision
• Make you feel weak or bathroom
• Cause yeast infections

Talk with your doctor if you notice any of these signs or symptoms.

Call your doctor if your blood sugar is greater than ________.

(Ask your doctor to write the levels).

Low blood sugar:

Your blood sugar is low when the numbers are 70 milligrams/deciliter or less. Low
blood sugar is also called hypoglycemia (hi-poh-gli-see-me-ah). Low blood sugar
can:
• Make you feel hungry
• Make you sweat
• Cause headaches
• Cause weakness
• Make you feel dizzy or shaky
• Make you feel anxious or cranky
• Make you look pale
• Make your heart feel like it’s beating too fast

If you notice any of these signs or symptoms, check your blood sugar. If it is low,
eat or drink a source of quick sugar—like a piece of hard candy or 4 ounces of a fruit
juice, skim milk, or a soft drink (not diet). Check your blood sugar again in 15
minutes. If it’s not better, eat or drink a source of quick sugar again. When you feel
better, have a protein snack like cheese and crackers or half a peanut butter sandwich.

Talk with your doctor if you have two or more low blood sugars during 1 week.
 Gestational Diabetes Mellitus (GDM) 6
8- For a healthy tomorrow, take good care of your GDM today by:
Choosing a healthy diet:
Ask your doctor to refer you to a registered dietitian to learn about healthy eating
during pregnancy. Try eating low-glycemic index foods (e.g. whole grains,
legumes), spread over 3 meals and 2 snacks to help manage your blood sugar.

Achieving a normal pregnancy weight gain:

The amount of weight you gain will vary depending on your weight before your
pregnancy. Weight loss is not recommended. Talk to your health-care provider
about appropriate weight gain for you.

Being physically active:

Regular physical activity can help control your blood sugar levels. It can also help
you:
• Boost your energy
• Sleep better
• Reduce stress
• Reduce pregnancy discomfort
• Prepare for childbirth
• Get your body back faster after childbirth

Talk to your health-care provider about the right type and amount of activity for you.

Checking your blood sugar at home:

Checking and tracking your blood sugar with a blood glucose meter will help
you and your health-care team manage your GDM.

Taking medication, if needed:

Sometimes healthy eating and physical activity are not enough to manage blood
sugar levels and your health-care provider may recommend insulin injections or pills
for the duration of your pregnancy. Medication will help keep your blood sugar level
within your target range. This will help to keep you and your baby in good health.
Your health-care team can answer your questions and support you through this
important time in your life. Your team may include your doctor, nurse and dietitian,
but remember: The most important member of your health-care team is you!
 Gestational Diabetes Mellitus (GDM) 7
Reference:
• Centers for Disease Control and Prevention. (2011). National Diabetes Fact Sheet:
National estimates and general information on diabetes and prediabetes in the United
States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention.

• American College of Obstetricians and Gynecologists Committee on Obstetric

Practice. (2009). Committee Opinion No. 435: Postpartum screening for abnormal
glucose tolerance in women who had gestational diabetes mellitus. Obstetrics &
Gynecology, 113, 1419-1421.

• American College of Obstetricians and Gynecologists Committee on Obstetric

Practice. (2011). ACOG Committee Opinion No. 504: Screening and diagnosis of
gestational diabetes mellitus. Obstetrics & Gynecology, 118, 751-753.

• American Diabetes Association. (2011). Diagnosis and classification of diabetes

mellitus. Diabetes Care, 34 (Supplement 1), S62-S69.

• American Diabetes Association. (2011). Standards of medical care in diabetes.

Diabetes Care, 34 (Supplement 1), S11-S61.