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

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What is Type 2 Diabetes?
Type 2 diabetes is a condition in which your body has high blood sugar.

How does your blood sugar rise?
If you have insulin resistance, your insulin cannot unlock the cells to let glucose in, because the locks called the receptors are abnormal or missing. As a result, glucose is locked out up of your cells. Consequently, the amount of glucose builds up in the blood stream in a condition called hyperglycaemia.

How do we lose the ability to create insulin?
To compensate for hyperglycaemia, your pancreas produces more and more insulin. Your over worked beta cells try to keep up with the demand but gradually lose their capability to produce enough insulin. If you don’t receive treatment for hyperglycaemia, it can result in diabetic ketoacidosis as there will be a shortage of insulin in the body. Over time, chronic poorly controlled Type 2 diabetes can cause degenerative tissue damage resulting in long-term complications such as atherosclerosis, blindness, neuropathy, heart attack and renal failure. Diabetes and heart disease have a high rate of correlation. Watch the video to know more about the causes, symptoms, diabetes attack and high blood sugar treatment.

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