Gestational diabetes: 1 in 10 pregnant women

Special to The Dallas Examiner | 9/8/2014, 9:38 a.m.
Every woman worries about weight gain during pregnancy. But for women who are obese before pregnancy or gain an excessive ...
Pregnant woman Stock Photo

Special to The Dallas Examiner

Every woman worries about weight gain during pregnancy. But for women who are obese before pregnancy or gain an excessive amount of weight while expecting, serious health risks can result for both mother and baby. According to Parkland Health & Hospital System experts, gestational diabetes is becoming more common.

“Appropriate weight gain during pregnancy is normal and healthy,” said Melissa Amie, RN, Director of Nursing, Women & Infants Specialty Health at Parkland. “But research shows a link between the rise of obesity in the U.S. and steadily increasing rates of gestational diabetes. This is concerning.”

Gestational diabetes occurs in pregnant women who have never had diabetes before but develop high levels of blood glucose – sugar in the blood stream – during pregnancy. The mother’s body does not make and use all the insulin needed. Without enough insulin, glucose builds up in the blood to high levels.

A study released by the Centers for Disease Control and Prevention in June 2014 reported that at least 9.2 percent of pregnant women in the U.S. might have gestational diabetes, putting them at risk for obstetric complications including preterm delivery and cesarean delivery. In addition, these women are more than seven times as likely to develop type 2 diabetes five to 10 years after the pregnancy. Parkland’s OB Complications Clinic provides prenatal care for high-risk pregnant patients. Women with gestational diabetes represented 15 percent of the clinic’s total visits during the first six months of 2014.

Untreated, gestational diabetes can be harmful to the developing baby because the mother’s high blood glucose levels travel through the placenta to the fetus. The baby’s pancreas is forced to make extra insulin to deal with the blood glucose. The extra energy in the baby’s body is stored as fat, sometimes leading to a condition called infant macrosomia, or a “fat” baby.

“Gestational diabetes can result in several potentially serious health complications for the infant of a mother with this condition,” said Myra Wyckoff, MD, a neonatologist at The University of Texas Southwestern Medical Center and Parkland’s Neonatal Intensive Care Unit. “They may have respiratory distress syndrome or experience hypoglycemia, which can lead to seizures. Because these babies can be very large, they are at increased risk for getting stuck in the birth canal during labor, which can lead to poor gas exchange and trauma. Neonatal hypoglycemia – very low blood glucose levels – due to the extra insulin produced by the pancreas can occur and they are also at greater risk for childhood obesity. These children are more likely to develop type 2 diabetes as adults.”

“Women who don’t eat a healthy diet and don’t exercise are the ones at greatest risk of developing gestational diabetes,” said Amie. “We encourage women to maintain a healthy weight throughout their life, but especially when they are considering becoming pregnant. Preventing gestational diabetes is a priority for us.”

Treatment of gestational diabetes includes frequent monitoring of the mother’s blood sugar throughout the day, careful attention to a healthy diet and regular exercise to help lower blood sugar levels. As many as 20 percent of women with gestational diabetes require insulin injections to reach their blood sugar goals.

To improve health outcomes for mothers and infants, Parkland offers classes to all new gestational diabetic patients. Classes are held in the clinic following the patient’s prenatal visit and are taught in Spanish and English. The class consists of an overview of gestational diabetes, followed by a registered dietitian providing information on nutrition and meal planning, and ending with instructions on how to use a glucometer for checking glucose levels at home. Meters are provided and patients perform a return demonstration on the proper technique for testing. Patients requiring treatment with insulin are provided an additional two-session insulin class.

“Parkland is committed to helping pregnant women improve their diet and nutrition and learn to make healthy lifestyle choices,” Amie said. “The OB Complications clinic combines patient management and comprehensive patient education to improve pregnancy outcomes for gestational diabetic patients.”