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Posted December 08, 2021
Listen to this episode of the Healthy Vitals Podcast.
Dr. Katherine Wolfe discusses gestational diabetes.
Scott Webb: Most of us probably have a working understanding of type 1 and type 2 diabetes, but what exactly is gestational diabetes? And joining me today to answer that question and so many more is Dr. Katherine Wolfe. She's a maternal and fetal medicine specialist with Summa Health.
This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. So doctor, thanks so much for your time today. I think that most of us are probably familiar with type 1 and type 2 diabetes, but what exactly is gestational diabetes?
Dr. Katherine Wolfe: Gestational diabetes is when there's too much glucose, which is sugar, staying in the blood instead of being absorbed and used for energy. This can occur in about 13% of pregnancies today.
Scott Webb: Yeah. And my wife had that. And of course, initially I was alarmed, you know, when her OB-GYN said that to her. And then he said, "Ah, it's pretty common. Not a big deal. We know what to do." Wondering what is the testing? Like, how do you identify that it's gestational diabetes?
Dr. Katherine Wolfe: Women are screened for gestational diabetes by taking a Glucola test, and there's a variety of different ways to approach the testing. The most common test is a one-hour Glucola challenge. And if a mother has a high glucose result after taking that challenge, then the diagnostic test is a three-hour Glucola testing. If two values are abnormal on that three-hour testing, that is consistent with a diagnosis of gestational diabetes.
Scott Webb: Yeah. And are there any risk factors or is there anything that women can do to avoid developing gestational diabetes during pregnancy?
Dr. Katherine Wolfe: So being healthy prior to pregnancy is the best way to decrease your risk of gestational diabetes. So having a normal body mass index, exercising regularly and eating a healthy diet are ways to decrease the risk of gestational diabetes.
Scott Webb: All right. So yeah, so being as healthy as possible before you get pregnant, before you're carrying this other human around inside of you, that's a good thing. I get that. That sounds right. And does gestational diabetes affect the pregnancy in any way? You know, assuming that it's been diagnosed early and being treated properly, is there any real effect on the mom or the baby?
Dr. Katherine Wolfe: Yes. So gestational diabetes does affect both the mother and the growing fetus. So a portion of the glucose will diffuse across the placenta. So if mom has elevated blood sugars, the baby will also have elevated blood sugars. And that can cause the baby to grow very large, and that can decrease the motions of having a vaginal delivery. So if there's gestational diabetes, the rate of a C-section is increased. Additionally, the rate of having high blood pressure in pregnancy if you have gestational diabetes is increased as well as having preeclampsia.
Scott Webb: Yeah. And if a mom-to-be develops gestational diabetes during pregnancy, does that just sort of automatically mean that they're going to have to live with diabetes the rest of their lives?
Dr. Katherine Wolfe: No. Only about 70% of women with gestational diabetes will develop lifelong diabetes, but it doesn't usually happen immediately after delivery. And so usually after delivery, mom's blood sugars will go back to normal. But they do need to continue to be screened over the course of their life every one to three years, because they have a high risk of having type 2 diabetes in their lifetime.
They can reduce that risk by breastfeeding for three months or more. You can reduce your risk from 70% all the way down to 30%. So breastfeeding is very valuable for mothers as well as the baby. Babies that are breastfed are actually less likely to have type 1 and type 2 diabetes in their lifetime as well. Continuing healthy nutrition and regular exercise are additional ways to decrease your risk of having lifelong diabetes.
Scott Webb: And doctor, as we wrap up and I do appreciate your time, maybe let's just go over, you know, some takeaways when it comes to gestational diabetes, so that moms and families-to-be know exactly what they can do to be ready for pregnancy, and also to try to protect themselves against gestational diabetes. Um,
Dr. Katherine Wolfe: Well, getting ready for pregnancy, it's important for all moms to have healthy nutrition. A prenatal vitamin is recommended three months prior to conception. The most important part of the prenatal vitamin is the folic acid, which decreases the rate of birth defects. So moms have additional risk factors for developing gestational diabetes, such as being overweight or obese or being physically inactive, or if they had gestational diabetes before, had large babies over nine pounds or have a history of having glucose intolerance have an increased risk of gestational diabetes.
So those moms, we recommend they get screened early at their first prenatal visit. If those screens are normal, the normal screen is between 24 and 28 weeks. For moms that get diagnosed with gestational diabetes, the first line of treatment is nutrition. So we recommend that they meet with a dietician and a diabetes educator to go over a healthy diet in pregnancy. And then if they still have elevated blood sugars, we're going to recommend treatment to bring those blood sugars back down into a safe range for the developing baby. And treatment can consist of insulin, which is the first-line therapy, or we can try an oral medication to help decrease blood sugar.
Having well-controlled blood sugars in pregnancy is important for mom and baby, so that it will improve mom's pregnancy course if we have well-controlled sugars in terms of having less hypertension complications of pregnancy, also having babies that are of a normal size, increasing their chance of having a vaginal and uncomplicated delivery. And then babies that have well-controlled glucose exposure have a decreased risk of having neonatal complications.
So in an untreated gestational diabetic or someone who does not have blood sugars at goal, there's increased risk to have a NICU admission for the newborn, increased risk of having metabolic challenges, such as low blood sugar, jaundice, and having difficulty with breathing. So treatment is going to help both that mom and baby.
Scott Webb: Well, that's all good stuff, doctor. You know, screening, early diagnosis, treatment. You've talked about how important that is for the moms, for the babies and so on. So thank you so much for your time today and you stay well.
Dr. Katherine Wolfe: Thank you. You too.
Scott Webb: For more information on Summa Health's Maternity and Women's Health Services, visit summahealth.org/women.
And if you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.