Gestational Diabetes
Overview Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health. Any pregnancy complication is concerning, but there's good news. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy. In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes. You'll continue working with your health care team to monitor and manage your blood sugar. Symptoms For most women, gestational diabetes doesn't cause noticeable signs or symptoms. When to see a doctor If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you're pregnant, your doctor will check you for gestational diabetes as part of your prenatal care. If you develop gestational diabetes, you may need more-frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health. Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy. To make sure your blood sugar level has returned to normal after your baby is born, your health care team wil Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Gestational Diabetes: The Overlooked Form of Diabetes
Why Big Is Not Always Beautiful When It Comes To Babies
On Thursday, the largest ever baby born naturally in Spain was delivered of a British mother, Maxine Marin who – in a footnote that I will never stop finding annoying – was said not even to need an epidural. Baby Maria, at a massive 6.1kg (13lb 7oz), is said to be in perfect health. She is a beautiful thing, with one of those wise-baby faces and a full head of hair; she looks about six months old. This comes exactly a week after the appearance of the heaviest baby – Jasleen – ever to be born in Germany. Her mother had untreated gestational diabetes, which leads to large babies, so the baby's condition isn't so good, though nor is it life-threatening. While two swallows don't make a summer, and two giant babies do not confirm a giant baby trend, obstetricians nevertheless detect an upward curve. Daghni Rajasingam, consultant obstetrician and Royal College of Obstetricians and Gynaecologists spokeswoman, says: "We are having, on average, larger babies being born. There are several reasons for it, the biggest of which is the global epidemic of obesity and diabetes. If you're obese you have a higher risk of having a large baby anyway, even if you don't have diabetes. "This idea of having a bonnie baby, and that being a good thing, is an old wives' tale. Babies who are born bigger have a higher risk themselves of being obese, developing diabetes and heart problems. You want an appropriate-sized baby, is the thing." What's appropriate? What's normal? What's macrosomic (or, if you prefer, "large")? The numbers have come down a bit – you're now screened for gestational diabetes if you've had a previous birth of 4kg, or 8lb 13oz (it used to be 4.5kg). But the key issue for people with near-hand experience of a large baby is probably not the threshold of what constitute Continue reading >>
I Am 31 Weeks, And Have Gestational Diabetes...
I delivered my son at 39 weeks by emergency c-section. I had gestational diabetes. My doctor told me that my baby was going to be at least a 9lb. or 10lb. baby. When he was born, he weighed 7lbs. 7.6 oz. Talk about a prediction? Doctors do not know everything, they can only speculate, just like us. My advice during pregnancy, THE BEST ADVICE I RECEIVED WAS... forget that you are eating for two, make healthy choices, splurge in moderation, exercise when possible. It did help me control my diabetes. I had gestational diabetes with my son and it also runs in my family to have huge babies. My doctor made me go full term plus a week. She etimated my son to weigh about 8lbs. He weighed 9lbs 12oz and I had him vaginally. I can't help but think maybe if she had induced me a little early it would've save me a few stitches and him a broken collar bone. Trust your instincts. My son felt huge and my doctor wouldn't listen to me. Also did your mother or grandmother have large babies? (my sister weighed 11 lbs 3 oz) Really the best thing you can do for yourself is to control your diet. Which will be extremely hard because diabetes gives you an insatiable hunger. Watch starch nd sugar the last month especially because sugar promotes cellular growth and thats all the baby does the last month. Your doc may want you to have another ultrasound closer to the end to estimate how big the baby is. Hang in there. I'm right there with you at 31 wks with #2 hoping he ends up smaller than his big bro. Please keep in mind that the weight of your baby right now is only an estimate and babies can weigh less or more than what they are estimated to weigh even with the help of an ultrasound. My third child was estimated to be 8 lbs just days before he was born. He was 10lbs and 6 oz, born at 41 weeks a Continue reading >>
Baby Large For Gestational Age
Large for gestational age (LGA) means a baby is bigger than other babies of the same age. It can refer to newborns (also known as macrosomia) or babies that are still in the wombs. If you are an expectant mom or new mom, you must really want to know how to determine if your baby is large for its gestational age or not. Now let's get a closer look. Gestational age is an indicator for the growth and development of a fetus or infant. A fetus or newborn that is more developed or bigger in size than expected for the baby's gestational age is referred to as large for gestational age. If an unborn baby is called LGA, it means its size is larger than 90% babies of the same gestational age. A newborn with a birth weight above the 90th percentile also falls into this category. If you want to know whether your baby is developing in the right track, you should estimate his/her gestation age and take measurements, like head size, weight and height; then you need to compare these measurements with that of an average kid of the same age and gender. LGA babies may be more vulnerable to birth injuries and at higher risks of complications like low blood sugar levels after delivery. What Causes Baby Large for Gestational Age? There are various factors that can make your baby large for its gestational age, which include: 1. Poorly Controlled Diabetes Poorly controlled diabetes, particularly gestational diabetes and preexisting diabetes, is the main cause of LGA. And preexisting type 2 diabetes is more likely to be linked with macrosomia. High maternal blood sugar levels along with insulin stimulate fetal growth. Usually an increase in weight is the only symptom that LGA newborns with a history of maternal diabetes have, but if the newborn has complications, its measurements will be bigger Continue reading >>
Macrosomia – 5 Myths About Big Babies And Birth
When thinking about giving birth, we often jump to thinking about the size of baby. There is so much joking and fear about huge babies in the movies, on commercials and even amongst friends. We think having a big baby means pain, complications and birth interventions, such as a c-section. But is baby's size something we really need to worry about? Firstly, it helps to understand some basics about the definition of big baby, and what it really means. Macrosomia Definition Macrosomia literally means ‘large body,' and is the medical term for a big baby. A baby is considered macrosomic by some if they are 4kg (8lb 13oz) or larger. Other professionals define macrosomia as a baby weighing 4.5kg (9lb 15oz) or larger. The average size of a full term baby is 3.4kg (7lb 8oz). Keeping in mind that an average is just that, an average. Some babies will be smaller than that, others much larger. That's how we calculate an average, by working out the mid figure. So there is a wide range of normal. How Common Are Big Babies? If we define a large baby as ≥4.5kg, around 1.8% of Australian babies are considered macrosomic, or big. Similar statistics are seen in the US with 1.8% of babies being born ≥4.5kg. If we define large babies as ≥4kg around 8.7% of US babies are macrosomic. While having a large baby can increase the risk of certain birth complications, a large baby does not automatically equal a high risk birth. We hear of growth scans, percentages and weights before baby is even born, which leads to the idea that baby's size is extremely important. While baby's size can impact labour, there are many myths surrounding just how much it impacts it. Here are 5 myths about fetal macrosomia babies and birth: #1: A Baby Can Be Accurately Diagnosed As Macrosomic Before Birth While w Continue reading >>
Gestational Diabetes: How Will It Affect Me And My Baby?
Find out what this type of diabetes could mean for you and your baby, and how you can manage the condition Gestational diabetes (GD) is a type of diabetes that can affect some women during pregnancy. It tends to appear in later pregnancy and usually disappears after your baby is born. You can generally just treat it with changes in the way you eat and exercise but some women with GD may need medication. Most women with GD have healthy babies and have no further complications after the birth. But it is worth knowing that having GD can raise your risk of developing type 2 diabetes later in life. What is gestational diabetes exactly? Gestational diabetes is caused by having too much glucose (sugar) in your blood (see more about this in So, what causes gestational diabetes?, below). It affects about 1 in 6 of us and a warning sign can be sugar in your wee – but you'd then need a blood test to confirm GD for sure. Finding out that you have gestational diabetes can be a shock but, "the good news is that, with expert care from medical staff, your pregnancy and birth should both go smoothly," says midwife Anne Richley, And that certainly the experience shared by many of the mums on our forum: "I had gestational diabetes and my LO is fine!" says wannababy. "She arrived by herself and I had a normal birth and it went away after she arrived." One of the reasons we all have to pee in those pots before an antenatal appointment is so that our midwife can do dip test to see if there’s sugar in our wee. If there is, that may be a sign that you have GD. To find out if it is GD, you’ll have to have a Glucose Tolerance Test. This is usually done when you're between 24 and 28 weeks pregnant – unless you’ve had gestational diabetes before, when you’ll be offered it at around 16 Continue reading >>
Gestational Diabetes - Diabetes That Begins During Pregnancy
Gestational diabetes affects up to 5% of pregnant women and usually appears around the middle of the pregnancy. It is usually temporary and goes away after their baby is born. What causes gestational diabetes? In pregnancy, the placenta produces hormones that help the baby to grow and develop. These hormones also block the action of the mother’s insulin. This is called insulin resistance. Because of this insulin resistance, the need for insulin in pregnancy is 2 or 3 times higher than normal. If the body is unable to produce this much insulin, gestational diabetes develops. When the pregnancy is over and the insulin needs return to normal, the diabetes usually disappears. As gestational diabetes usually develops around the 24th to 28th week of pregnancy, the baby’s development is not affected. But as glucose crosses the placenta, the baby is exposed to the mother’s high glucose level. This high level of glucose in the baby’s blood stimulates the baby’s pancreas to produce extra insulin. The extra insulin causes the baby to grow bigger and fatter. The result of this may be a large baby that may need to be delivered early when it is not fully mature. When gestational diabetes is well controlled, these risks are greatly reduced. Your baby will not be born with diabetes, but there is an increased risk that your child will develop diabetes later in life (as an adult). Will I be able to breastfeed my baby? Yes, breastfeeding is still the normal way to feed a baby. More information Women's and Children's Hospital (South Australia), Department of Nutrition ' Healthy eating for gestational diabetes' Diabetes Australia Pregnancy, birth and baby Pregnancy, Birth and Baby is a national Australian Government service providing support and information for expecting parents a Continue reading >>
Gestational Diabetes: What You Need To Know
This pregnancy complication is more common than you might think. Learn who's at risk for it, how it's detected, and what can be done to treat it. For years, doctors believed that gestational diabetes affected three to five percent of all pregnancies, but new, more rigorous diagnostic criteria puts the number closer to 18 percent. The condition, which can strike any pregnant woman, usually develops in the second trimester, between weeks 24 and 28, and typically resolves after baby is born. If gestational diabetes is treated and well-managed throughout your pregnancy, "There's no reason you can't deliver a very healthy baby," says Patricia Devine, M.D., perinatologist at New York-Presbyterian Hospital in New York City. But gestational diabetes that goes untreated, or isn't carefully monitored, can be harmful for both mother and baby. Consult our guide for risk factors, signs of gestational diabetes, and treatment options. What is gestational diabetes? Gestational diabetes, or diabetes that is diagnosed during pregnancy in a woman who previously did not have diabetes, occurs when the pancreas fails to produce enough insulin to regulate blood sugar efficiently. "A hormone produced by the placenta makes a woman essentially resistant to her own insulin," Dr. Devine explains. How does gestational diabetes differ from type 1 or 2 diabetes? Gestational diabetes affects only pregnant women. People who have type 1 diabetes, sometimes referred to as juvenile diabetes, are generally born with it. Type 2 diabetes accounts for 95 percent of all cases of diabetes in the U.S.; it occurs in adulthood, and is triggered by lifestyle factors such as obesity and lack of physical activity. What causes it? It's unclear why some women develop gestational diabetes while others do not. Doctors th Continue reading >>
Gestational Diabetes Can Lead To What?!
In Germany, a woman gave birth to a baby weighing in at a whopping 13.47 pounds—wait for it—naturally! That's right, even though the 22.6 inch baby was nearly twice the weight of the average newborn, she was not born via cesarean section, according to the Daily Mail. That is one brave and very strong mama, if you ask me! I just hope for her sake her delivery wasn't as painful as it seems. All I can say is, "Ouch!" And if you're saying, "Wait, I thought this story was about Gestational Diabetes," well, then hold your horses, ladies. I'm getting there! The shocking thing is that throughout all of this new mama's sonograms, no one raised a red flag that her baby seemed big. That's wild to me because my son ended up weighing in at seven pounds, seven ounces, and I was told along the way that we needed to watch his growth to make sure he wasn't getting too large. It turns out like me, and about 18 percent of pregnant women in the United States, the mom had developed Gestational Diabetes. But while mine was monitored and I cut down on white flour, carbs and sugars and made sure to get at least 30 minutes of exercise three times a week, this mom's gestational diabetes went undiagnosed—which can be a dangerous thing. Normally, the amount of glucose in the blood is controlled by insulin. But during pregnancy, hormone levels can get out of whack, and some women have higher than normal levels of glucose in their blood and their pancreases fail to produce enough insulin to have the cells absorb it all. So the baby can end up being larger and heavier, which translates to often a longer, harder delivery, and many times ends in a cesarean section. It can also lead to the baby having shoulder dystocia, which is when the baby's shoulder gets stuck in the mother's pelvis during bir Continue reading >>
Scans Reveal Babies Of Mothers With Gestational Diabetes Have More Body Fat
Babies born to mothers with gestational diabetes have more body fat at two months of age compared to babies born to healthy mothers, says new study. Scientists from Imperial College London used MRI scanning to measure body fat in 86 babies - they took these readings shortly after birth, and again when the babies were 8-12 weeks old. The research, published in the journal Diabetes Care, revealed that although babies born to mothers with gestational diabetes had no differences in body fat content at birth, by two months old they had 16 per cent more body fat compared to those born to healthy mothers. Most of the babies in the study were breast-fed. The reasons behind the differences are unknown, but possible explanations include changes in the baby's metabolism while in the womb - or even differences in the composition of breast milk in mothers with gestational diabetes. Gestational diabetes affects around one in 20 pregnant women in the UK (and nearly one in ten in the US) and results in a woman's blood sugar levels becoming too high. The condition, which can be controlled with diet, exercise and medication, usually starts when the woman is around seven months pregnant. Typically, it resolves soon after giving birth - though the woman may be at elevated risk of type 2 diabetes later in life. This is the first study to show the condition causes such early changes in the baby, despite no differences at birth, explains Dr Karen Logan, lead author of the study from the Department of Medicine at Imperial: "Gestational diabetes is becoming more and more common, and babies born to these mothers are at increased risk of developing diabetes when they grow up. Therefore we need to understand what effects maternal diabetes has on the baby. "This new study suggests diabetes in the m Continue reading >>
Your Baby Was How Big?! Why Your Supersized Baby Is Perfectly Normal (and Beautiful)
When my son was born, he weighed in at a very solid 8 pounds,13 ounces. In 2012, that raised a few eyebrows and elicited some empathetic grimaces from fellow moms. But just a few years later, my “big guy” now seems kind of average. Especially compared to these bouncing babes… In 2014, a 14.5-pound baby was born in Massachusetts. In 2015, there were a number of babies born who weighed between 12.9 and 14.7 pounds. And in 2016, not to be outdone by the Western mothers, a 19-year-old mother in India gave birth to a 15-pound baby girl. To say the least, those were some big babies! To put those numbers into perspective, consider this: An average baby weighs around 7.5 pounds at birth. Are babies really getting bigger? It’s not our imaginations that babies have been getting bigger in recent years, and it’s not just that the internet is whipping everyone into a frenzy. According to research, there has been a 15 to 25 percent increase in babies weighing 8 pounds, 13 ounces or more in the past 20 to 30 years in the developed world. This was, as a reminder, my son’s weight at birth — apparently the weight at which babies are considered “oversized” nowadays. The medical term for that is “macrosomia,” but “very big baby” will do in casual conversation. This is a source of endless fascination for people, though men and women tend to have very different reactions to this phenomenon. Men hear about it and think, Oh, wow, that’s crazy. And then they move on. Women, on the other hand, involuntarily shrink inward, break into a cold sweat and think, Dear God, how does that happen? Could that happen to me? Even women who aren’t planning to have more children — or who don’t plan to have any children at all — can’t help but feel extremely empathetic in t Continue reading >>
What Are The Risks Of Gestational Diabetes?
A risk means there is a chance that something might happen. With every pregnancy there are some risks, but if you have gestational diabetes your risks of some things will be increased. Managing your blood sugar level brings these risks right down again though and most women with gestational diabetes have healthy pregnancies and healthy babies. These things are very unlikely to happen to you, but understanding the risks may help you see why it is important that you follow your healthcare team’s advice. The risks linked to gestational diabetes are caused by blood glucose levels being too high. If you can keep your blood glucose as close as possible to the ideal level, your risks will be reduced. Risk of having a large baby (macrosomia) If your blood glucose level is high, it can cause high blood glucose levels in your baby. Your baby will produce more insulin in response, just like you do. This can make your baby grow larger than normal. This is called macrosomia. Babies weighing more than 4kg (8lb 8oz) at birth are called macrosomic. Macrosomia increases the risk of: Birth trauma - either the mother or baby can be affected when it is difficult for the baby to be born. Trauma may include physical symptoms, such as bone fractures or nerve damage for the baby, or tearing and severe bleeding for the mother as well as psychological distress. Shoulder dystocia - where the baby’s shoulder is stuck in your pelvis once the head has been born. This can squash the umbilical cord, so the team need to use additional interventions to deliver the baby quickly and safely. It means you may have labour induced early or to have a caesarean section so that your baby is born safely. Your baby's weight will be monitored carefully in pregnancy to see whether these interventions are needed. Continue reading >>
What Is So Bad About A Big Baby?
The most common and significant neonatal complication clearly associated with gestational diabetes is macrosomia: an oversized baby with a birth weight greater than the 90th percentile for gestational age and sex, or a birth weight >2 SD above the normal mean birth weight. If fetal macrosomia associated with maternal diabetes is directly related to maternal glucose levels (1,2,3), then strategies to prevent hyperglycemia must be devised to treat the diabetic pregnant woman (4). However, not only is the concept that macrosomia is directly related to maternal hyperglycemia is considered controversial, but also the notion that normalizing the maternal glucose could prevent macrosomia is hotly debated. In addition, the definition of normoglycemia during pregnancy has not been adequately reported because of difficulty with measuring glucose excursions in the home setting. The initial attempts to normalize the 24-h glucose profile were all made with hospitalized patients (5). When self-monitoring of blood glucose became available for outpatient surveillance of glucose control (6), normalization programs could be continued at home. However, the number and timing of the blood glucose determinations have not been adequately studied. In addition, reports that macrosomia occurred despite normoglycemia (7) perpetuated the philosophy that it is urgent to deliver the infant early to avoid fetal overgrowth, which was perceived to be unaffected by glycemic control. Perhaps the debate continues because many of the reports claiming that neonatal complications occur despite excellent metabolic control failed to measure postprandial glucose levels (1,2,3). The Diabetes in Early Pregnancy (DIEP) study was a multicenter trial of type 1 diabetic pregnant women who were compared with normal co Continue reading >>
I'm Having A Giant Baby: No More Fruit Salad?
Aware of the risks of gestational diabetes, Roma Kojima talks to her OB/GYN about food choices...but when did fruit become the enemy? Roma Kojima is a soon-to-be mom of a tiny, wriggly girl. Aside from growing a human, she works in business development at Rogers Media, loves to travel and cook, and obsesses about leather purses she can’t afford. Follow along as she shares her pregnancy journey. At 35 weeks now and in the throes of what everyone helpfully calls The Home Stretch. I feel neither at home in my body, nor stretchy. Mostly I feel overcrowded, grumpy and in pain whenever this kid kicks me in the junk from the inside. But whatever, one month (ish) to go. Read more: Is birth weight related to ethnicity? I had my 32-week ultrasound recently. Much fun was had by all, especially when this little diva decided she wasn’t going to entertain any pictures and insisted on covering her face with her hands the entire time. They took all her measurements anyway and off I waddled to see a doctor. The doctor, not my regular OB/GYN, informed me quite enthusiastically that I was having a “Giant Baby.” “What’s a Giant Baby?” I asked nervously. “Oh, your baby is within the 94th percentile in size—we measure the size of the head (ouch says future-me), abdomen and femur. By our estimates, the average weight at this point should be around 3.75 lbs. Yours is around 5.4 lbs.” I looked at my five-foot, four-inch-tall husband and I looked at myself—a towering five-foot-three. “Maybe she’s adopted?” Jokes aside, I would much rather she be bigger than too small. “But wait,” the paranoid side of my brain said. “Doesn’t a bigger fetus often mean gestational diabetes?” I have a family history of diabetes and my mother suffered from GD during more than one Continue reading >>
Does Gestational Diabetes Always Mean A Big Baby And Induction?
July 3, 2012 by Rebecca Dekker, PhD, RN, APRN © Copyright Evidence Based Birth®. Please see disclaimer and terms of use. This question was submitted to me by one of my readers, Sarah. “I have a question about gestational diabetes. It seems like everyone I know who has had it has ended up being induced. Does gestational diabetes automatically mean induction? Does it automatically mean big babies? It seems like people get diagnosed and then give up on a natural childbirth and are treated as a sick person.” I talked to Dr. Shannon (a family medicine physician), and she echoed Sarah’s perceptions about gestational diabetes: “I would say that ‘routine care’ in the U.S. is to induce at 38 to 39 weeks for gestational diabetes (leaning towards 39 weeks nowadays) if the mom’s glucose is uncontrolled or if she is controlled on medication. However, women can technically be treated as ‘normal’ if their gestational diabetes is well controlled and baby’s growth looks normal on a 32 week scan. So people just might want to know they will get major push back from their provider if they refuse induction. It’s tough. Many OB’s cite the risk of stillbirth as a reason for induction, because the risk of stillbirth in women with regular diabetes is higher. However, there is no evidence that the risk of stillbirth goes up in gestational diabetes.” Evidence Based Birth® offers an online course on Big Babies and Gestational Diabetes (3 contact hours)! To learn more, click here! Dr. Shannon brings up several good points. First, she is talking about “routine care,” which is very different from “evidence-based care.” Routine care means that this is what everyone is doing—it’s routine, it’s standard. Evidence-based maternity care means offering care that is Continue reading >>
