Part 2 of the gestational diabetes series looked at symptoms, diagnosis, and effects on the fetus. Read about how to treat this illness and find out the possible long term effects in the third and final part of the series.
Gestational diabetes (GD) is a serious disease which can result in short-term and long-term health problems in both mother and baby. Fortunately, the illness is highly treatable through lifestyle changes, although medication is sometimes necessary as well.
The goal of treating gestational diabetes is to keep the blood glucose level under control. The treatment plan may include the woman self-monitoring her blood glucose throughout the day, using a glucometer.
The first means of controlling blood glucose is through maternal diet. A dietician can help the woman develop an eating plan that takes into account her specific needs. The plan may include tracking when and how much carbohydrate is consumed; what types of carbohydrate are best, taking each food's glycemic index into account; and how carbohydrate should be combined with other foods to regulate glucose absorption.
Since exercise burns glucose, exercise after meals can help control the postprandial spike in blood glucose. For some women, diet and exercise alone are enough to keep blood glucose under control.
In some cases, medical intervention is necessary to reign in uncontrollable blood glucose. The most common intervention is insulin, which is given via injection. Some oral medications may be used as well. Glyburide, also called glibenclamide, is sometimes prescribed; it works by stimulating insulin production. Metformin has been studied for use in GD; it works by suppressing glucose production in the liver.
Women with GD may have delivery induced after 37 weeks (when the fetus' lungs are typically mature) but before 40 weeks (full term) to minimize the risk of macrosomia (a condition in which the fetus grows abnormally large). An ultrasound to estimate fetal size may inform the decision to induce delivery.
Long Term Effects
In rare situations, a case of apparent GD may actually be type I or type II diabetes which was undiagnosed before pregnancy. Outside of these situations, GD is cured immediately upon delivery of the placenta.
A woman who has experienced gestational diabetes is more likely to develop the disease in future pregnancies and also has an increased risk of one day developing type II diabetes. A person whose mother had GD during the pregnancy also has a higher risk of both obesity and type II diabetes. These risks can be minimized through lifestyle choices, including weight loss, healthy eating, and exercise. Little information is available on possible correlations between GD and other diseases.