Will They Likely Induce Labor in a Borderline Gestational Diabetic?

Gestational diabetes is characterized by a blood sugar reading above 140, or hyperglycemia, while pregnant. It sometimes is controllable with diet and exercise but often requires medication. The prognosis is good, depending on certain factors, and delivery procedures depend upon how well the mother's blood sugar is controlled and what effects are likely for the infant.

Screening for Gestational Diabetes

• Gestational diabetes usually is diagnosed through prenatal screening, most often by blood work performed at 28 weeks gestation. It also may be caught at regular prenatal appointments where urine is tested for glucose and measurements are taken to assure normal growth.

Babies of Gestationally Diabetic Mothers

• Hyperglycemia in the mother causes her baby and placenta to grow larger than normal. The fetus receives an infusion of sugar from the mother's bloodstream, putting on fat and creating a dependency that can cause a crash of blood sugar after delivery. Because of their large size, infants of diabetic mothers are at risk for premature delivery. For reasons also related to the baby's size, obstetricians sometimes decide to induce labor, especially if the mother's high sugar levels are a threat to the infant's well-being. If the baby cannot handle the stress of labor, delivery by cesarean section may become necessary.

Treatment for Gestational Diabetes is Patient-Centered

• Treatment of gestational diabetes involves careful monitoring of the mother's blood sugar, most often by her at home. Counselors will meet with the mother regularly, giving nutrition advice and adjusting medication as necessary. This type of support is essential for the mother to be able to confidently manage her condition. Patient compliance is paramount to good outcomes.

What Mothers Can Do to Decrease Risks

• Eat highly nutritious, whole foods in small, frequent meals throughout the day. Avoid empty calories, fast food and junk food. High-quality protein and high-fiber foods include lean meats; low-fat dairy foods; whole grains such as brown rice, quinoa and teff; fresh, raw vegetables and fruits; and good fats such as avocados, raw nuts and seeds.

  Monitor your blood sugar and take medication exactly as directed. Also, exercise regularly. Take daily, brisk walks or swim, as these activities not only lower blood sugar but help the baby move into optimal position for labor.

Considerations

• Medication alone cannot effectively manage gestational diabetes. Lifestyle changes by the mother and participation in her own care are necessary to prevent complications. Gestational diabetes typically affects subsequent pregnancies. Without adequate treatment, each baby will grow larger than the last. A mother with a history of gestational diabetes is at increased risk for Type II diabetes. Continuing better dietary habits and a regular exercise regimen after pregnancy can prevent the development of this disease.