Gestational diabetes: Expert advice from the front lines

Crossroads OB/GYN
Dr. Stephanie Chin

For our piece on gestational diabetes, Crossroads OB/GYN Dr. Stephanie Chin provided some perspective, as she has been taking care of women and their unborn babies in Tucson for the past 13 years.  She shed some light about what causes gestational diabetes, why the screening process is so important, and why the condition can be so dangerous to both Mom and baby.

Why are women who have never had diabetes before at risk of developing it during pregnancy?

Non-diabetic women are at risk of developing it during pregnancy due to the effect of hormones created by the placenta on the body.  At Crossroads OB/GYN, we check the blood sugar of every expectant mother at twenty-eight weeks.  Pregnant women who have a high BMI, or are considered obese, and women with a family history of diabetes are already considered at high risk for developing gestational diabetes.  If diabetes runs in your family or if you’ve had gestational diabetes in a previous pregnancy, it’s very important to make your doctor aware of that early in your prenatal care.  You may need to get screened even earlier.

What’s involved in the screening process?

During the test, we’ll give you a whole sugar load, usually a sugary drink, and then draw your blood an hour later to see how your body is reacting to it.  If your number is 130 or higher, then we’ll have you repeat the test a few days later, getting your blood drawn hourly over three hours.  With gestational diabetes, there really aren’t any telltale symptoms that indicate the mother may have developed it, so that’s why the screening is so important.

What are the health risks to mom and baby associated with gestational diabetes?

We worry about the baby having especially broad shoulders, which can make it very difficult for mom to deliver vaginally.  We also worry about the possibility of something called shoulder dystocia in which the head comes out, but the shoulders don’t.  If that happens, it becomes an obstetrical emergency.  Another risk to the baby is a condition called polyhydramnios in which there is too much fluid in the amniotic sac.  This can cause pre-term labor.  The baby may be born with blood sugar that is too low, and need to be fed right away,  but these children are not necessarily at higher risk for developing diabetes later in life.

Once a woman is diagnosed with gestational diabetes, what’s next?

If an expectant mother is diagnosed, she’ll have to check her sugars four to five times a day for the rest of her pregnancy.  She’ll also attend diabetes education class to learn how to eat a truly diabetic diet.  If the gestational diabetes is not controlled with diet, we’ll start her on oral medications.  If that’s not working, she may end up on insulin.

What is your advice for women who worry about developing gestational diabetes?

If you had a healthy lifestyle before getting pregnant that included a balanced diet and daily activity, and you’re able to maintain that lifestyle throughout your pregnancy, you will certainly lower your risk of developing gestational diabetes.  For most women, gaining between 25-35 pounds during pregnancy is considered a healthy range.

If a woman is diagnosed with gestational diabetes, will she likely have diabetes for life, or does it typically go away?

It will usually go away after delivery.  If she gets pregnant again, she’ll be screened early in that pregnancy, and again at twenty-eight weeks.  There is a chance that she’ll develop Type 2 diabetes later in life, but maintaining a healthy weight, eating a balanced diet, and getting plenty of activity will help prevent it.

A special thanks to Dr. Stephanie Chin for her time and expertise on this topic.
For more information on gestational diabetes, click here.