Caitlin Whyte (Host): Welcome to Weekly Dose of Wellness. I'm your host, Caitlin Whyte, and joining me is Jennifer Ayala, the Director of the Childbirth Center at the Memorial Care Orange Coast Medical Center. Today we're diving into gestational diabetes and what every mom or parent-to-be should know.
Well, let's start with the basics. What exactly is gestational diabetes and how common is it among pregnant women?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: Gestational diabetes is a type of diabetes that develops only during pregnancy. It happens when the body can't make enough insulin to handle the increased blood sugar levels that occur as pregnancy hormones rise. And even though it can sound a little scary, it's quite common and affects about six to 9% of pregnant women in the United States. Another way of looking at it is that it affects about one out of every 10 pregnancies. But the good news is that with the right care and monitoring, most women with gestational diabetes go on to have healthy pregnancies and healthy babies.
Host: Beautiful. So what are some of the early signs or risk factors that might indicate a woman is at risk for developing gestational diabetes? How and when is gestational diabetes typically diagnosed during that pregnancy, and what should moms expect from a screening process if needed?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: Okay, I'll take this piece by piece here. So many women don't notice any obvious symptoms. Some may feel an increase in thirst or fatigue, but most will have no symptoms at all, which is why screening is so important. So while symptoms are rare, there are a few risk factors that can make gestational diabetes more likely.
And these risk factors include things like a family history of Type 2 diabetes, being overweight before pregnancy, being over 25 years old, having polycystic ovarian syndrome, which you may have heard being referred to as PCOS, belonging to certain ethnic backgrounds such as Hispanic, Black, Asian, or Native American can increase risk.
And also, if you've had gestational diabetes in a previous pregnancy, you'll have up to a 70% chance of having it with your subsequent pregnancies. You know, even though there are some very mild symptoms that you may experience, really an actual diagnosis can only be made through testing.
So when it comes to screening for gestational diabetes, it usually happens between 24 and 28 weeks of pregnancy. And the reason is, this is when normal hormonal changes of pregnancy start to have a greater effect on how our bodies process sugar. And so the testing process is quite simple, and your care team will guide you every step of the way.
The most common way of testing is the two step glucose challenge test, and it's a simple test and like its name, it has two steps. So first, you'll drink a sweet glucose drink and you'll have your blood sugar drawn an hour later. If that first result is higher than normal and the results, usually should not be any higher than about 130 to 140, you'll come back for a second test.
The good news is with this first test, you don't need to fast. So you can, eat breakfast, like usual. So as far as the second test goes, if you have to come back for a second test, this is what we call the confirmatory test. And this test is usually scheduled a few days later like I said, it's to confirm if you have gestational diabetes and it measures how your body handles sugar over a few hours after fasting.
And with this test, you'll need to fast for about eight to 12 hours. Uh, you'll have a fasting blood sugar drawn. And then you will drink the sweet glucose drink. Your blood will be drawn at one, two, and three hours after the drink. And if you have two or more blood sugar values over the normal range, you are considered positive for gestational diabetes.
Host: So besides that screening process, are there any preventative measures that women and people can take to circumvent a gestational diabetes diagnosis? And how does family history play a role, if any?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: Yeah, well, while you can't always prevent gestational diabetes, especially since genetics do play a role; there are some steps that can help lower your risks. And these steps include maintaining a healthy weight before pregnancy, staying physically active, before pregnancy and with pregnancy as directed by your healthcare provider.
Eating a balanced diet with lean proteins, whole grains, fruits and vegetables, and getting your regular prenatal care so that any changes in blood sugar are caught early. And as far as family history goes, it definitely does matter, since insulin resistance can run in families. But these lifestyle habits that I mentioned can make a big difference too.
Host: So now that we know all about the screening and preventative measures, what are the potential health impacts of gestational diabetes on both the mother or parent and the baby if left unmanaged?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: If gestational diabetes isn't well controlled, it can increase risk for both mom and baby. For moms, it can lead to high blood pressure, preeclampsia, and a higher chance of needing a C-section. It also raises the risk of developing Type 2 diabetes later in life. And for babies, high blood sugar can cause excessive growth, which makes delivery more difficult or low blood sugars for baby after birth.
Which can make baby tired and not feed well. Some babies may also experience breathing problems or jaundice. And jaundice can be related also to the not feeding well. But the key takeaway here is that with early diagnosis and good management, including nutrition, glucose monitoring, and sometimes medications, these risks can be greatly reduced.
If medications are needed, gestational diabetes is usually managed with insulin, but if your OB provider does decide that you do need to manage it through medications, the usual medication that is prescribed is insulin, but sometimes oral medications, such as metformin or glyburide, may be prescribed as well.
Host: And are there any common myths or misconceptions about gestational diabetes that you often hear from patients or their families?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: Yes. There are a few common myths that I have heard. So one of them is that having gestational diabetes means that you did something wrong. And this is not true. It's largely about how your body responds to pregnancy hormones. It's not a reflection of your choices. Another common myth is, once the baby's born, it's really no big deal.
And while gestational diabetes often resolves after birth, women who've had it do have a higher lifetime risk of developing Type 2 diabetes. So ongoing checkups are very important. And lastly, I've also heard that it's thought that delivery will have to happen early or that a woman cannot have a normal birth.
And I say normal in air quotes. Again, this is not true. With good blood sugar control, many women go full term and have normal deliveries as well.
Host: Now, if a gestational diabetes diagnosis does occur, would the pregnancy then be deemed high risk? And if so, how would that impact where you choose to deliver your baby?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: Well, gestational diabetes does make your pregnancy higher risk than average, but that doesn't mean it has to be a stressful experience for you. It just means that your care team will monitor you and your baby more closely through extra ultrasounds or non-stress tests during your pregnancy, and especially later in your pregnancy.
And if you have gestational diabetes, it's important to deliver at a hospital equipped for advanced maternal and newborn care like Memorial Care, Orange Coast Medical Center, or any Memorial Care Hospital for that matter. We have teams experienced in managing gestational diabetes safely for both you and your baby.
Host: Great. And to close this out today, Jennifer, if patients want to learn even more, where can they go?
Jennifer Ayala, MSN, RNC-OB, EFM-C, PMH-C: Well, if you'd like to learn more about gestational diabetes, including tips, recipes, and resources for managing your pregnancy visit, memorialcare.org/gestationaldiabetes, or you can also call 714-378-7000.
So just remember with knowledge, support, and good care, gestational diabetes can be managed effectively.
Host: Wonderful. Well, thank you so much. That was Jennifer Ayala sharing her insights on gestational diabetes. For more information, just like she said, you can go to memorialcare.org/gestationaldiabetes. And if you enjoy this podcast, please share it on your social channels and explore our entire podcast library for topics of interest to you. I'm Caitlin Whyte and this is Weekly Dose of Wellness. Thanks for listening.
