Gestational diabetes is a type of diabetes that develops during pregnancy in individuals who did not have the condition beforehand, according to Dr. Tiffany Loftus, an OB/GYN at St. Joseph’s/Candler. This diagnosis typically occurs between 24 and 28 weeks into pregnancy, although early screening may be recommended for those with certain risk factors.
Dr. Loftus notes that the prevalence of gestational diabetes has been increasing, affecting about six to nine percent of pregnant women. She explains that this condition can present risks for both the mother and the baby.
During pregnancy, placental hormones such as human placental lactogen can interfere with how the body uses insulin, leading to insulin resistance and elevated blood glucose levels. As the placenta grows, it produces more hormones and increases the risk for insulin resistance. If the pancreas cannot compensate by producing enough insulin, gestational diabetes can develop.
“All pregnant people are screened for gestational diabetes because any woman is at risk,” Dr. Loftus says. Some factors increase this risk: being overweight or obese prior to pregnancy, having a family history of diabetes (especially in a first-degree relative), previous gestational diabetes, poor diet or sedentary lifestyle, and other metabolic conditions like high blood pressure or cholesterol.
“Appropriate nutrition and exercise are very important throughout pregnancy,” Dr. Loftus says. “The daily recommendation of getting at least 30 minutes of exercise five days a week still pertains to pregnant people. Maintaining healthy nutrition is important not only for preventing potential complications of gestational diabetes, but also other complications of pregnancy such as preeclampsia.”
Gestational diabetes often does not cause specific symptoms; it may only become apparent if the baby appears large for gestational age or there is excess fluid around the baby after diagnosis.
“Ideally, we would diagnosis it prior to any of those things occurring to prevent complications,” Dr. Loftus says. “That’s why it’s so important to screen every pregnant person.”
Screening usually takes place between 24 and 28 weeks for those without risk factors; individuals with risk factors are advised to undergo testing between 14 and 18 weeks:
– One-hour glucose tolerance test: The patient drinks a beverage containing 50 grams of glucose; blood sugar levels are checked one hour later.
– Three-hour confirmatory test: After fasting, patients drink a beverage with 100 grams of glucose; blood sugar levels are measured over three hours.
If two values from the confirmatory test are elevated, gestational diabetes is diagnosed.
Following diagnosis, physicians determine whether patients fall under A1 (diet-controlled) or A2 (requiring medication) categories based on their ability to manage blood sugar through lifestyle changes alone.
Complications associated with uncontrolled gestational diabetes include higher risks for gestational hypertension and preeclampsia in mothers, as well as delivery issues such as shoulder dystocia and increased likelihood of cesarean section deliveries—which themselves carry additional risks if blood sugars remain uncontrolled.
Babies born under these circumstances may face challenges such as excessive growth or low blood sugar after birth requiring further care.
“Ideally, you want to be as healthy as possible before getting pregnant to try to combat conditions such as gestational diabetes developing in pregnancy,” Dr. Loftus says. “I encourage women if they have any questions about nutrition and appropriate weight gain during pregnancy to talk to their OB/GYN so those topics can be further discussed.”
St. Joseph’s/Candler operates as a faith-based nonprofit health system that provides compassionate care across southeast Georgia and South Carolina Lowcountry through facilities including St. Joseph’s Hospital and Candler Hospital (official website). The organization offers specialized services such as women’s health care among others (official website), drawing from its long-standing history dating back to Georgia’s first hospital established in 1804 (official website). The health system emphasizes community outreach programs addressing local needs (official website) while maintaining recognition for nursing excellence through Magnet status (official website).
