Linnet Steinman, a Certified Diabetes Educator with the Carolinas HealthCare System, discusses the causes and symptoms of gestational diabetes.
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Gestational diabetes means people are having an inability to handle extra glucose, extra carbohydrates in the presence of Diabetes. This is the only kind of diabetes at this point in time that goes away. What happens is when the mother becomes pregnant, they’re hormones start to climb and in the presence of increase hormones, growth hormones from the baby, those hormones work against the mothers insulin. If we have a period where those hormones at such a high level and the mother may be coming in to the pregnancy with some amount of insulin resistance or glucose intolerance, pre-diabetes if you will. Then what can happen is the blood sugars end up going up higher. There is an increase and a lot of it has to do with—there are plenty of people with glucose intolerance or pre-diabetes when they become pregnant. Most women that have gestational diabetes have no symptoms. It is noticed when they do a routine screening. Typically, at about 28 weeks, women are routinely screened for insolvent where they are given a quantity about 50 grams of pure sugar and a glucose level is checked. If that is high, this is just a screening, if that level is high then they go in and have a three-hour glucose tolerance test where they have come in to the lab fasting. They are given 100 grams of sugar and we challenge the body, we challenge the pregnant woman to see how their blood sugar response. If their blood sugar levels are quite high at one hour or two hours or three hours, then we diagnose gestational diabetes but most women are totally asymptomatic. At the end of the pregnancy, what happens is the growth hormones that the baby is circulating back into the body, back into the mother’s system that its making the insulin not work well in the mother’s system. Those growth hormones are gone because the baby has delivered. So the insulin resistance from those growth hormones goes back to what it was before the mother became pregnant. We are seeing more and more gestational diabetes. Thin, pregnant women, young thin pregnant woman that are coming in with abnormal blood sugars, we are seeing a lot of that these days.
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