What is it?
Gestational Diabetes (GD) is a form of diabetes that occurs in 3-5% of all pregnant women in the US and that is directly related to the hormones of pregnancy. These hormones make a mother's insulin less effective at transporting glucose out of the blood stream and into the cells. So there is more glucose available in the circulatory system for the baby. Gestational diabetes is not caused by a lack of insulin like Type I diabetes or a limited supply of insulin like Type II but by something called "insulin resistance". As pregnancy progresses insulin resistance increases. Normally, the pancreas makes enough insulin to overcome the resistance but when it does not it is called Gestational Diabetes.

Risk Factors
There are certain risk factors that make it more likely that a woman will develop GD.Those are obesity, a family history of diabetes, previous large infant, still birth or birth defect, polyhydramnios, and/or age greater than 25 years old.

Diagnosis
This condition is diagnosed by Glucose Tolerance Test (GTT) which is usually done sometime around the 24th to 28th week of pregnancy. This test involves drinking a sugary glucose drink and waiting one hour, then blood is drawn and the level of glucose in the blood is measured. In general if the result is greater than 140 a second test will be done after a few days on a special diet. This test involves drawing blood at three hour intervals. If this second test is abnormal GD will be diagnosed.

Treatment.
GD is usually easily managed. The key is careful control of blood sugar levels. This control may be arrived at through the use of diet and exercise, daily blood sugar monitoring and, if necessary, insulin.

How does GD affect the baby?
The baby's body senses the high glucose levels in the maternal blood and responds by producing extra insulin in order to use the glucose. The fetus converts the extra glucose to fat. As a result of these deposits of fat the infant may be larger than normal, a condition called "macrosomia". Macrosomia is usually defined as an infant larger than 8 pounds 13 ounces.
The other problem that occurs as a result of the baby being used to high levels of glucose is that they continue to produce high levels of insulin for a little while after they are born and the extra glucose is no longer present. This can cause the baby's blood sugar to drop to dangerously low levels. As a result most infants born to a mother know to have gestational diabetes or over 8 pounds 13 ounces are routinely tested for blood sugar levels. These tests involve painful heel sticks to obtain the needed drop of blood. To help your infant to have as few of these tests as possible you should feed him early and often so that he can maintain his blood sugar levels on his own without intervention from the nursery staff.

The good news is that soon after the baby is born mom's Gestational Diabetes disappears. However, having had GD is considered an indicator that you MIGHT develop diabetes again later in life.