Gestational Diabetes: A Common-Sense Approach

If you are tested for gestational diabetes (GD), the odds range somewhere between three and fifteen percent that you will be diagnosed as a gestational diabetic, meaning “elevated blood-sugar values in pregnancy.” Your chances depend on such factors as your race and your age, but most especially, on the testing threshold used and your weight before pregnancy (14,35-36,43,48).

Most doctors and some midwives believe GD to be a condition that can cause serious complications if not closely monitored and aggressively treated, chief among them being a high-weight baby. Women identified as gestational diabetics will be prescribed restrictive diets, including reduced calorie diets, have frequent testing for blood-sugar levels, and possibly insulin injections. They will probably have repeated tests to evaluate the baby’s wellbeing and an ultrasound scan to estimate weight. Women may have labor induced or even have a planned cesarean. After birth, the baby may have heel pricks to measure blood sugar. Based on results, the baby may be given bottles of sugar water or formula or removed to the nursery for observation.

Despite these practices, the research has not established the degree, if any, to which high blood-glucose levels short of true diabetes cause harm. This is because mildly elevated blood-sugar tends to be found in company with known risk factors. For example, most gestational diabetics are high-weight women. High-weight women are far more likely to have high-weight babies and to have high blood pressure. We also have little evidence that GD treatment has benefits, but studies do show that it has hazards. In particular, identification as a gestational diabetic increases the probability of c-section apart from any consideration of birth weight.

All of this presents you with a series of decisions, the first of which is whether to agree to be screened for GD. If you decide to go ahead with GD testing, you will want to try to ensure that any abnormal results are real and not due to the vagaries of the testing process. Finally, if you are diagnosed as a gestational diabetic, you will want to minimize your chances of experiencing the drawbacks of GD treatment. The rest of this article will help you make those choices and achieve those goals.

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