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The word “gestational” is from “gestation,” which means “pregnancy.” Diabetes that develops in women during pregnancy is called gestational diabetes mellitus (GDM) or gestational diabetes, for short. Two main reasons account for the development of gestational diabetes. First, major hormonal changes occur in the body during pregnancy. These changes increase the body’s requirement for insulin. If the pancreas is not strong enough to produce the increased amount of insulin needed during pregnancy, the chances increase for the occurrence of gestational diabetes. In addition, hormones secreted during pregnancy tend to decrease efficiency of insulin, which, in turn, leads to raised blood sugar levels.

Nearly 2 to 5 percent of women who do not have preexisting diabetes develop gestational diabetes toward the end of the fourth month of their pregnancies. In most cases, gestational diabetes ends when pregnancy is over. However, the very presence of diabetes during pregnancy indicates the underlying weakness of blood sugar mechanism in these women. Such a condition increases their chances of developing diabetes, usually type 2 diabetes, in the future. Evidence shows that children born of mothers with gestational diabetes tend to become obese, and they are at increased risk of developing type 2 diabetes in their teenage years.

WHO GETS GESTATIONAL DIABETES

The risk of developing gestational diabetes increases in pregnant women:

• Who are high risk candidates of type 1 or type 2 diabetes.
• Who are 25 years or older when they become pregnant.
• Who had gestational diabetes in the past or have a family history of gestational diabetes in their mothers and sisters.
• Who gain abnormal weight during pregnancy. (A weight gain of about 20 to 30 pounds in pregnancy is, however, normal.)

CRITERIA FOR DIAGNOSING GDM
Sometimes there are strong reasons to suspect that certain women such as those who are obese or who had gestational diabetes in the past may again develop diabetes during pregnancy. But when these women are tested in a fasting state during pregnancy, their blood tests may not detect diabetes. To rule out the presence of diabetes in these high risk candidates, a detailed oral glucose tolerance test is administered.

For pregnant women, the ADA recommends a 3-hour oral glucose tolerance test during pregnancy (not the 2-hour test noted before) for diagnosing gestational diabetes. In this test, you drink 100 grams of glucose dissolved in water (100-gram glucose load). To begin, a blood sample is drawn from your vein in a fasting state, and then you drink glucose solution. After you have taken the glucose drink, your blood will be tested every hour for 3 hours to diagnose if you have gestational diabetes.

WHO GETS GESTATIONAL DIABETES
The risk of developing gestational diabetes increases in pregnant women:

• Who are high risk candidates of type 1 or type 2 diabetes.
• Who are 25 years or older when they become pregnant.
• Who had gestational diabetes in the past or have a family history of gestational diabetes in their mothers and sisters.
• Who gain abnormal weight during pregnancy. (A weight gain of about 20 to 30 pounds in pregnancy is, however, normal.) you have taken the glucose drink, your blood will be tested every hour for 3 hours to diagnose if you have gestational diabetes.

BLOO SUGAR VALUES
REPRESENTING GESTATIONAL DIABETES

Gestational diabetes will be diagnosed when measurement of blood sugar by a laboratory shows at least any two of the following blood sugar values in pregnant women in a 100- gram oral glucose tolerance test:

• Fasting blood sugar:   95 mg/dL (5.3 mmol/L) or greater
• 1-hour after drinking glucose solution:   180 mg/dL (10.0 mmol/L) or greater
  2-hours after:   155 mg/dL (8.6 mmol/L) or greater
  3-hours after:   140 mg/dL (7.8 mmol/L) or greater
  Source: American Diabetes Association