Ellen Seely, MD, Director of Clinical Research in the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women’s Hospital discusses the health risks associated with gestational diabetes mellitus (GDM) during and after pregnancy. Dr. Seely also describes Balance After Baby, a web-based program designed to educate women on eating healthfully and increasing their physical activity, with the goal of helping them lose their pregnancy weight within a year of giving birth.

GDM is a type of diabetes that occurs only in pregnancy. It comes on in the second half of pregnancy and it goes away after delivery. In the US it’s estimated that five percent of all pregnancies are complicated by GDM. The rates of GDM are higher in Hispanic and non-white populations, ranging from ten to 20 percent of all pregnancies.

Obesity is one of the main risk factors for GDM. In the United States, most health centers screen all women for gestational diabetes because obesity is becoming so common in the overall population.

Gestational diabetes can impact the health of the mother and the fetus, as well as the newborn. Women with GDM have an increased risk of preeclampsia, which is a type of high blood pressure that develops during pregnancy. Preeclampsia is a serious condition that can lead to early delivery. Women who have gestational diabetes may also have larger babies, increasing their risk of cesarean section.

While GDM goes away after pregnancy, the health risks persist. Research has found that 50 to 70 percent of women who have gestational diabetes may develop Type 2 diabetes later in life. Research has also found that babies born to mothers with GDM, have a higher birth weight and may become obese during adolescence, increasing their risk of developing diabetes and other conditions such as high blood pressure.

The Pregnancy and Diabetes Program at Brigham and Women’s Hospital offers multidisciplinary care to women with GDM. The program includes a high risk obstetrician, two diabetes specialists, a nutritionist, and a nurse practitioner who is certified in diabetes education. The first approach to treatment is to control blood glucose levels with healthy eating and physical activity. Lifestyle changes, healthy eating and physical activity, are effective in controlling blood glucose levels about 75 percent of women with GDM. If the lifestyle changes don’t work, insulin therapy is started to control a mother’s blood sugar for the rest of her pregnancy.

Learn more about the Pregnancy and Diabetes Program at Brigham and Women’s Hospital:
https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/pregnancy-and-medical-conditions/diabetes

Read the Gestational Diabetes: Managing Risk During and After Pregnancy video transcript:
https://www.brighamandwomens.org/medicine/endocrinology-diabetes-and-hypertension/diabetes/gestational-diabetes-managing-risk-video-transcript

Share this page:

From doctor’s appointments to blood tests, during pregnancy doctors make sure mothers are screened for anything that could cause health concerns to the mother and baby. “There is undiagnosed diabetes in the general population that gets picked up in pregnancy,” said Dr. Ravi Chokshi, an OB/GYN for Lee Health.

But the problem can be treated with diet changes and medication, if necessary. “There’s a misconception that I’m pregnant; I’m allowed to eat as much as I want. I‘m eating for two, and that’s not really true. The American of Congress of OBGYN actually recommends you go up by 300 calories by your second and third trimester. Most of us already overeat by 200 and 300 calories a day,” he explained.

Pregnant mothers are screened early to make sure their blood sugars are normal. “The recommendations are we screen at least everybody with a blood sugar very early in pregnancy. After that, we screen everybody after 24 weeks. The reason for that is the further pregnancy gets, the placenta gets bigger, and the hormones cause increased blood sugars,” said Dr. Chokshi.

If a mother is diabetic during pregnancy, her blood sugars are uncontrolled—that blood sugar goes to the baby, causing the baby to create more insulin. “Babies are not only bigger; they grow differently. Their bellies are bigger than their heads. Their shoulders are bigger than their heads,” he said.

Mothers who are diabetic during pregnancy are also at a higher risk of needing a C-section and developing diabetes later on in life. “If we can get your blood sugars in good control, studies show that you are going to have the same kind of pregnancy that non-diabetic moms have,” said Dr. Chokshi.

Eating a healthy diet, avoiding processed foods, and eliminating sugar can help pregnant mothers keep their blood sugar under control. All to ensure a healthy pregnancy and delivery for both mom and baby.

View More Health Matters video segments at LeeHealth.org/Healthmatters/

Lee Health in Fort Myers, FL is the largest network of health care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For more than 100 years, we’ve been providing our community with personalized preventative health services and primary care to highly specialized care services and robotic assisted surgeries. Lee Health – Caring People. Inspiring Care.

Visit LeeHealth.org
Video Rating: / 5

Share this page: