Gestational diabetes (GDM) occurs when a pregnant woman becomes diabetic during her pregnancy. The effects of poorly controlled gestational diabetes on the baby can include a large birth weight, possible injury to the baby during delivery and possible low blood sugar for a short while after delivery. Effects on the mother include difficult delivery (often necessitating Cesarean section or use of forceps) and an increased risk of developing type 2 diabetes later in life. Maintaining good blood sugar (glucose) levels during pregnancy can eliminate these risks for the baby and reduce the risk of a difficult delivery for the mother.
Assisting the pregnant woman and her family in achieving a healthy, safe pregnancy is a team effort including primary care and specialty physicians, nurses and other health professionals. When the diagnosis of gestational diabetes is made, the team expands to include other health professionals, a certified diabetes educator and a registered dietician. The goal of the certified diabetes educator and registered dietician is to equip women with the knowledge, skills and emotional support to manage gestational diabetes and deliver a healthy, normal-sized baby.
The following is a general outline of the topics and educational services provided to women with Gestational Diabetes through the Diabetes Services Department at Overlake Medical Center:
Treatment and Management Strategies
It is important that women with GDM learn to monitor their own blood-glucose levels at home. With appropriate blood glucose and urine ketone testing you receive immediate feedback about your condition and can positively impact it. Guidelines for safe glucose and ketone levels are provided. Technique and timing is critical for accurate monitoring, and this is taught in the first meeting with the certified diabetes educator.
Counseling by a registered dietitian is provided to ensure that you know how to choose foods which will support optimal blood-glucose readings and ideal pregnancy weight gain. Follow-up sessions after delivery address the need to return to a goal weight.
While exercise is very important in increasing insulin sensitivity during pregnancy, it must be done with care. The diabetes educator will make a careful assessment of each woman's baseline activity level and suggest safe and appropriate activities.
Women with GDM are often frightened by this diagnosis. The diabetes educator can take the time to listen to her concerns and provide information. They will stay in contact with each woman until delivery to provide encouragement and support.
Insulin therapy is implemented when the combination of diet and activity are not adequate to maintain appropriate blood-glucose levels. Diabetes educators teach the necessary skills of insulin administration and more frequent monitoring.
Cost and Access
The charge for a visit with the certified diabetes educator and the registered dietician are often reimbursed by insurance. Checking with your insurance benefits counselor is the best way to determine this. For those who are uninsured or underinsured, financial assistance is available through our financial counselors in the Patient Access Department.