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Am Fam Physician. 1999;60(3):1004-1005

What is gestational diabetes?

Gestational diabetes is a kind of diabetes that starts during pregnancy. (The word gestational means “during pregnancy.”) If you have gestational diabetes, your body isn't able to use the sugar (glucose) in your blood as well as it should, so the level of sugar in your blood gets too high.

Gestational diabetes affects about 3% of all pregnant women. It usually starts in the fifth or sixth month of pregnancy (between the 24th and 28th weeks). This kind of diabetes goes away after the baby is born.

How can gestational diabetes affect me and my baby?

Your baby may grow somewhat larger than a typical baby. This can happen because the extra sugar in your blood “feeds” your baby more. If your baby is very large, you may have a more difficult delivery or need a cesarean section.

Gestational diabetes can also cause some problems for your baby at birth, such as a low blood sugar level or jaundice (yellowish skin color). Neither of these problems is very serious. If your baby's blood sugar level is low, he or she will be given extra glucose (sugar water) to bring it back to normal. Jaundice is treated by putting the baby under special lights. Jaundice is common in many newborns and not just those born to mothers with gestational diabetes.

What can I do if I have gestational diabetes?

Your doctor will probably suggest a special diet for you and may want you to have your blood tested to monitor (check) the sugar level. He or she may also want you to get regular exercise. Some women also need to take insulin to control their blood sugar levels.

What changes should I make in my diet?

Your doctor or a dietitian can help you plan what to eat. It's important to eat well-balanced meals with plenty of fruits, vegetables and grains. Your doctor will probably suggest that you cut back on foods that have a lot of sugar, such as cakes, cookies and soft drinks. You may need to eat less at each meal, depending on the weight you gain during your pregnancy. Your doctor or a dietitian will talk to you about weight gain during pregnancy, too.

Why is exercise important?

Moderate exercise helps keep your blood sugar level under control and helps with your weight gain. Your doctor will help you decide which exercise is right for you. Walking is usually the easiest type of exercise, but swimming or other exercises you enjoy can work just as well.

Is it safe for me to exercise while I'm pregnant?

Your doctor will help you choose an exercise that is safe for you and your baby. To be cautious, you should follow some simple guidelines when you exercise. For example, don't exercise too hard or get too hot while you're exercising. Depending on your age, your pulse shouldn't go higher than 140 to 160 beats per minute during exercise. If you get dizzy or have back pain or other pain while exercising, stop right away and call your doctor. If you have contractions (labor pains, like stomach cramps), vaginal bleeding or if your water breaks, call your doctor right away.

When will gestational diabetes go away?

It may be several weeks after your baby's birth before your gestational diabetes goes away. To make sure it's gone, your doctor will probably want you to have a blood test one or two months after you have had your baby.

Although gestational diabetes goes away after pregnancy, you may get it back if you get pregnant again. Gestational diabetes also increases your risk of getting type 2 diabetes later in life.

Will my baby have diabetes?

Research shows that most babies won't have diabetes after birth, but they may be somewhat more likely to get type 2 diabetes as adults.

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