Gestational Diabetes: Pregnancy Services at UPMC in Central, Pa.

Gestational diabetes is a common pregnancy complication that causes high blood sugar. The glucose that is released into your bloodstream after digesting food is normally controlled by insulin. During pregnancy, however, your growing placenta produces high levels of hormones that can impair the function of insulin.

If left untreated, gestational diabetes can be harmful to you and can affect the growth and development of your baby. However, by making appropriate diet and lifestyle changes and, in some cases, taking medication, gestational diabetes can usually be successfully managed.

Risk factors for gestational diabetes include:

• Previous history of gestational diabetes
• Glucose in urine
• Strong family history of diabetes
• Obesity
• Previous history of large babies
• Previous pregnancy loss
• Ethnic background (Hispanic, African, Native American, South or East Asian, or Pacific Island ancestry)

Testing

Because gestational diabetes often does not cause any symptoms, your physician will give you a routine gestational diabetes test sometime between your 24th and 28th week of pregnancy. This screening can take place at your obstetrician’s office or at any UPMC Pinnacle laboratory.

You will be asked to drink a very sweet glucose beverage. An hour later, your blood will be drawn and tested to determine your blood sugar level. If your blood sugar is higher than it should be, your physician will order a follow-up test.

The follow-up screening requires that you fast overnight. In the morning, your blood will be drawn to establish your fasting blood sugar level. You will be asked to drink an even sweeter glucose beverage. Your blood will be tested every hour for three hours. If two of the three tests show a high blood sugar level, you will be diagnosed with gestational diabetes.

Treatment

Most women are able to control their gestational diabetes by following a careful diet, exercising regularly and making other lifestyle changes. You will need to monitor your blood sugar every day and, in some cases, you may need to receive insulin injections.

If you are diagnosed with gestational diabetes, you will also be referred to a UPMC Pinnacle diabetes educator and dietitian, who will help you learn how to manage your condition and have a healthy pregnancy.

Your physician may also conduct regular ultrasounds and non-stress tests to check the health of your baby. Some women with gestational diabetes can have very large babies or babies who are born with a low blood sugar level. Your physician will work with your pediatrician to ensure that your baby receives appropriate screening and care after birth.

In most cases, gestational diabetes goes away after your baby is born. However, you will have an increased risk of developing diabetes later in life. It is very important that you receive follow-up care from your primary care physician within the first year after delivering your baby.

Gestational Diabetes Diet

If you’ve been diagnosed with gestational diabetes, one of the easiest ways to manage your condition is to change your diet. A healthy diet and moderate exercise can help ensure that you have a healthy pregnancy.

Your physician may refer you to a UPMC Pinnacle nutritionist to help you learn how to regulate and stabilize your blood sugar.

Your nutritionist will provide a variety of tips that may include:

• Eating breakfast. Because your blood sugar will be lowest in the morning, it is important that you start your day with a balanced meal. A healthy breakfast may include eggs or peanut butter for protein, whole wheat toast for a complex carbohydrate, and a slice of melon.
• Limiting carbohydrates. Because refined carbohydrates and sugars are the chief contributors to spikes in blood sugar, you should choose whole grains instead of refined flour whenever possible. For breakfast, the suggested carbohydrate intake is 15 grams (about the size of a small bagel). Snacks should contain 15 to 30 grams of carbohydrates (about the size of three graham cracker squares). For lunch and dinner, you should eat between 45 and 60 grams of carbohydrates (about one cup of rice/pasta and two-thirds cup of lima beans).
• Avoiding sugars. You should avoid simple sugars, such as desserts, flavored tea and soda. Sugars can cause elevated blood sugar, which can lead to extreme fatigue, nausea, excessive thirst and blurred vision. You should check with your physician or nutritionist before using artificial sweeteners.
• Eating plenty of fiber. High-fiber foods, such as legumes, beans, fresh fruits, vegetables and whole grains, are digested slowly and help keep blood sugar levels stable.
• Eating several small meals and snacks. Eating several small meals and snacks throughout the day helps prevent drops and spikes in your blood sugar.

Locations

Maternal Fetal Medicine
Located at PinnacleHealth Alex Grass Medical Sciences Building
100 South 2nd Street
Suite 4B
Harrisburg, PA 17101
Phone: 717-231-8472
Fax: 717-231-8490

UPMC Pinnacle Obstetrics and Gynecology Specialists
Located at Commerce Park Professional Center
20 Expedition Trail
Suite 203
Gettysburg, PA 17325
Phone: 717-637-7755
Fax: 717-646-1991

UPMC Pinnacle Obstetrics and Gynecology Specialists
20 North Street
Hanover, PA 17331
Phone: 717-637-7755

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Talk to your doctor if you have questions about prenatal testing.