Advanced Institute for Diabetes & Endocrinology

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  • 1900 Matlock Rd, Ste 304 Mansfield, TX 76063
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Gestational Diabetes

What is gestational diabetes (GDM)?

This is a form of diabetes that is caused by pregnancy. The placenta makes a protein called Human Placental Lactogen, and this causes insulin resistance and high blood sugars in the mother. We expect GDM to resolve in the weeks following delivery of the placenta.

How do we diagnosis GDM?

In the second trimester (24-28 weeks), your OB/GYN will have you drink Glucola and check your blood 2 hours later for glucose. Blood sugar cutoffs for diagnosis are:

  • Fasting: > 92
  • 1 hour post-Glucola: > 180
  • 2 hours post-Glucola: > 153

I had high blood sugars early in pregnancy, is that the same thing?

No. If you have any of the following lab results, it counts as a diagnosis of regular garden-variety diabetes:

  • Fasting glucose greater than 125
  • Random glucose greater than 200
  • Hemoglobin a1c greater than 6.5

So I have GDM, how does that matter for my pregnancy?

The presence of diabetes, whether it’s the usual kind or GDM, has significant impact on a pregnancy. It raises the risks to mother and baby and needs to be followed closely and carefully to have the healthiest, safest pregnancy possible. Risks include:

  • Large birth weight, especially large head which makes delivery difficult
  • Early labor and delivery, before baby’s lungs are mature
  • Low blood sugar in the baby after birth
  • Baby at higher risk for diabetes later in life

How do we manage GDM?

  • #1 is lifestyle! Exercise, weight management, and nutritional/portion changes.
  • Carbohydrate restriction is key to needing less insulin in the body.
    • Sweet Success, a California program, provides guidelines for eating and exercise, listed under Resources.
    • We will ensure you have access to nutritional counseling.
  • Goal blood sugars during treatment:
    • Fasting < 95
    • 2 hours after a meal < 120
    • Hemoglobin a1c 6-6.5%
    • These goals will be adjusted if low blood sugars are a problem.
  • After the 1st trimester, sometimes Metformin can be used to help reduce blood sugar.
  • Drugs like glyburide are NO LONGER recommended for use in pregnancy, as of May 2018.
  • Insulin is the official recommended medical treatment for GDM.
  • Once you make it to the 3rd trimester, it is recommended to use Aspirin to help reduce the risk of pre-eclampsia.

Will GDM come back with the next pregnancy?

Usually yes. It also significantly raises the risk of developing regular diabetes over the next 2-3 years. It’s very important that blood sugars are optimal before attempting to conceive again, to minimize or eliminate the risks to mother and baby.

Resources

Having trouble paying for medications? Try GoodRx.com for discounts, or we can help you enroll at universaldrugstore.com to obtain certain medications from Canada. Livongo.com can help you get a glucometer. Also check with the drug manufacturer and http://prescriptionhelp.aace.com for assistance programs/coupons.