Parenting: Pregnancy

Insulin is a hormone that keeps the right amount of sugar in the bloodstream. Pregnant women need extra amounts of insulin because both the body and placenta make different hormones that partially block the effect of insulin.

Expectant mothers older than age 25 are more likely to suffer from gestational diabetes than are younger mothers. Therefore, women older than 25 are screened for the condition between the 25th and 28th weeks of pregnancy. A non-carbonated bottle of a sweetened beverage is given to the expectant mother to drink the day of her test. The drink tastes like a flat soda. The patient needs to have blood drawn exactly one hour after finishing the beverage, which needs to be consumed within 10 minutes. Timing is crucial to ensure that the tests results will be accurate. The blood test poses no risk to mother or baby. Laboratory results are usually available within one to two business days.

Mothers-to-be with high glucose levels after the screening test are given a glucose tolerance test, a three-hour test involving three separate blood withdrawals. This means more blood is sent to a lab and another day or two of waiting is required for the result.

If the test result confirms a high level of glucose, the mother's condition must be monitored carefully. Diet and exercise may control insulin levels. In cases of very high glucose levels, insulin injections are necessary.

Fetal complications due to poorly managed gestational diabetes may include birth defects, very large babies, premature deliveries and the likelihood of serious blood pressure problems, according to Dr. Philip Suarez, editorial advisor for Obgyn.net. These conditions may occur if a mother's condition is serious enough to require insulin injections and those injections are given inconsistently or not at all.

According to the American Diabetes Association, the birth of a big baby is hard on both the mother and baby. This sometimes occurs during gestational diabetes because the fetus produces extra insulin due to the extra sugar in the mother's blood. The extra insulin is stored as fat, normally in the baby's shoulders and/or trunk.

"Most women who develop diabetes during pregnancy will revert back to normal blood sugars within days after delivery," says James M. Proulx, attending staff physician in the department of obstetrics and gynecology at William W. Backus Hospital in Norwich, Connecticut There are a few women whose diabetes may continue and all gestational diabetics should be screened to assure that the condition has indeed resolved prior to the six-week postpartum exam. Since a woman who was diabetic during pregnancy is at risk to develop overt diabetes in the future, she should periodically be screened for this condition thereafter.

Stephanie Scodellaro and her husband, Roman, are the parents of 4-year-old Kyle. The Scodellaro family is awaiting the arrival of Kyle's brother or sister. Stephanie's recent glucose tolerance test shows an insulin level on the borderline of actual diabetes.

Stephanie's glucose level does not require insulin injections, but the elevated level of blood sugar is a concern. Her obstetrician referred Stephanie to a nutritionist for a consultation. Through diet strategies, Stephanie, her doctor and nutritionist are confident that a full-blown case of diabetes is not in the future.