Gestational diabetes

Gestational diabetes
Other names	Gestational diabetes mellitus (GDM)
Universal blue circle symbol for diabetes[1]
Specialty	Obstetrics and endocrinology
Symptoms	Typically few symptoms[2]
Complications	Pre-eclampsia, stillbirth, depression, increased risk of requiring a Caesarean section[2]
Usual onset	Most common last three months of pregnancy[2]
Causes	Not enough insulin in the setting of insulin resistance[2]
Risk factors	Overweight, previously having gestational diabetes, family history of type 2 diabetes, polycystic ovarian syndrome[2]
Diagnostic method	Screening blood tests[2]
Prevention	Maintaining a healthy weight and exercising before pregnancy[2]
Treatment	Diabetic diet, exercise, insulin injections[2]
Frequency	~6% of pregnancies[3]

Gestational diabetes is a condition in which a person without diabetes develops high blood sugar levels during pregnancy.^[2] Gestational diabetes generally results in few symptoms;^[2] however, it increases the risk of pre-eclampsia, depression, and of needing a Caesarean section.^[2] Babies born to individuals with poorly treated gestational diabetes are at increased risk of macrosomia, of having hypoglycemia after birth, and of jaundice.^[2] If untreated, diabetes can also result in stillbirth.^[2] Long term, children are at higher risk of being overweight and of developing type 2 diabetes.^[2]

Gestational diabetes can occur during pregnancy because of insulin resistance or reduced production of insulin.^[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.^[2] Diagnosis is by blood tests.^[2] For those at normal risk, screening is recommended between 24 and 28 weeks' gestation.^[2][3] For those at high risk, testing may occur at the first prenatal visit.^[2]

Maintenance of healthy weight and exercising before pregnancy assist in prevention.^[2] Gestational diabetes is treated with a diabetic diet, exercise, medication (such as metformin), and sometimes insulin injections.^[2] Most people manage blood sugar with diet and exercise.^[3] Blood sugar testing among those who are affected is often recommended four times a day.^[3] Breastfeeding is recommended as soon as possible after birth.^[2]

Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.^[3] It is especially common during the third trimester.^[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.^[3] A number of ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Islanders are at higher risk.^[3][2] However, the variations in prevalence are also due to different screening strategies and diagnostic criteria being used. In 90% of cases, gestational diabetes resolves after the baby is born.^[2] Affected people, however, are at an increased risk of developing type 2 diabetes.^[3]