Is gestational diabetes more common in second pregnancy

Follow a healthy eating plan to nourish you and your baby.

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes. Managing gestational diabetes will help make sure you have a healthy pregnancy and a healthy baby.

What Causes Gestational Diabetes?

Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy.

During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body’s need for insulin.

All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant. They start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.

About 50% of women with gestational diabetes go on to develop type 2 diabetes, but there are steps you can take to prevent it. Talk to your doctor about how to lower your risk and how often to have your blood sugar checked to make sure you’re on track.

Symptoms and Risk Factors

Gestational diabetes typically doesn’t have any symptoms. Your medical history and whether you have any risk factors may suggest to your doctor that you could have gestational diabetes, but you’ll need to be tested to know for sure.

Related Health Problems

Having gestational diabetes can increase your risk of high blood pressure during pregnancy. It can also increase your risk of having a large baby that needs to be delivered by cesarean section (C-section).

If you have gestational diabetes, your baby is at higher risk of:

• Being very large (9 pounds or more), which can make delivery more difficult
• Being born early, which can cause breathing and other problems
• Having low blood sugar
• Developing type 2 diabetes later in life

Your blood sugar levels will usually return to normal after your baby is born. However, about 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery. Visit your doctor to have your blood sugar tested 6 to 12 weeks after your baby is born and then every 1 to 3 years to make sure your levels are on target.

Testing for Gestational Diabetes

It’s important to be tested for gestational diabetes so you can begin treatment to protect your health and your baby’s health.

Gestational diabetes usually develops around the 24th week of pregnancy, so you’ll probably be tested between 24 and 28 weeks.

If you’re at higher risk for gestational diabetes, your doctor may test you earlier. Blood sugar that’s higher than normal early in your pregnancy may indicate you have type 1 or type 2 diabetes rather than gestational diabetes.

Prevention

Before you get pregnant, you may be able to prevent gestational diabetes by losing weight if you’re overweight and getting regular physical activity.

Don’t try to lose weight if you’re already pregnant. You’ll need to gain some weight—but not too quickly—for your baby to be healthy. Talk to your doctor about how much weight you should gain for a healthy pregnancy.

Treatment for Gestational Diabetes

You can do a lot to manage your gestational diabetes. Go to all your prenatal appointments and follow your treatment plan, including:

• Checking your blood sugar to make sure your levels stay in a healthy range.
• Eating healthy food in the right amounts at the right times. Follow a healthy eating plan created by your doctor or dietitian.
• Being active. Regular physical activity that’s moderately intense (such as brisk walking) lowers your blood sugar and makes you more sensitive to insulin so your body won’t need as much. Make sure to check with your doctor about what kind of physical activity you can do and if there are any kinds you should avoid.
• Monitoring your baby. Your doctor will check your baby’s growth and development.

If healthy eating and being active aren’t enough to manage your blood sugar, your doctor may prescribe insulin, metformin, or other medication.

You may do. Two out of three mums who have had gestational diabetes in one pregnancy go on to develop it in their subsequent pregnancies. The good news is, there's lots you can do to reduce your chances of getting it this time around.

There are many factors that affect how likely you are to develop gestational diabetes. While some of these, such as your ethnic origins, are out of your control, there are others that you can do something about. Making positive changes now will only benefit you and your next baby.

Be a healthy weight

Aim to be a healthy weight before you get pregnant. Try to bring your BMI (body mass index) below 25. A BMI of 25 or over is classed as overweight.

Try not to put on weight between pregnancies. If you knew your BMI before your last baby, try not to add more than three BMI points to your pre-baby score. Putting on weight may mean you're more likely to develop gestational diabetes again. It may also increase your risk of developing type 2 diabetes in later life.

Eat a healthy diet

Choose unrefined food or whole foods, such as wholemeal and wholegrain breads and cereals, brown rice and wholemeal pastas. Your body has to work hard to turn these carbohydrates into sugars, making them a healthier choice.

Make sure you eat plenty of fruits and vegetables too. Although try to keep fruit to mealtimes. Due to the natural sugar content, fruit eaten as a snack may increase your blood sugar level significantly.

Try to eat foods low in saturated fats. Trim meat well to remove any fat, and grill rather than fry foods. If you do fry food, use polyunsaturated or monounsaturated oils, such as olive oil and sunflower oil. These oils are great for salad dressings, too.

It'll help to keep gestational diabetes at bay if you eat regular meals at about the same time each day. If you want a snack choose complex carbohydrates such as bread, cereals, rice and pasta.

Take regular exercise

You can make a real difference by improving your fitness. Taking regular exercise in the year before you become pregnant will reduce your risk of developing gestational diabetes by about half.

Try to keep exercising once you're expecting as well. There are plenty of safe exercises to do during pregnancy, such as yoga, Pilates, walking and swimming.

Don’t smoke

Smoking increases and possibly doubles your risk of developing gestational diabetes. It's best to try to stop smoking before you get pregnant. Talk to your doctor if you're finding it hard to quit.

Space your babies

When you get pregnant is not always something that's under your control. But if you can, it is best to space your babies. Give yourself time to lose extra baby weight and achieve a healthy BMI.

Talk to your doctor well before you plan to get pregnant. Together, you can create a sensible exercise and eating plan that works for you. If your BMI is over 30, your doctor may also advise a higher dose of folic acid, which you should take for at least three months before you become pregnant.

Gestational diabetes rarely develops before 20 weeks. But because you've had it before, your midwife will arrange an early glucose tolerance test to check your sugar levels before you reach 20 weeks.

Learn how to prepare your body for another baby.

Helen Brooks is studio manager for Gravity Global, a B2B marketing agency. She was content editor for BabyCentre for more than two years.

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