Navigating gestational diabetes

Alyssa Burns never expected to develop gestational diabetes when she was pregnant with her first child in February 2020. Yet, at 27 weeks gestation, the diagnosis changed the course of her pregnancy.

“It came as a surprise to me because no one in my family or my husband’s family had experienced it before,” Alyssa says. “I’m a healthy person who exercises, so it was a big shock.”

According to Dr. David Dowling, a high-risk pregnancy specialist affiliated with Sharp Mary Birch Hospital for Women & Newborns, during pregnancy the placenta makes hormones that resist insulin and cause glucose to build up in your blood.

"In most cases, the body can make enough insulin to keep the blood sugar in the normal range," he says. "But in some patients, pregnancy hormones cause blood sugar to rise above normal, resulting in gestational diabetes.”

Every year, up to 10% of pregnancies in the United States are affected by gestational diabetes. Blood sugar readily crosses the placenta and high blood glucose levels in the mother can affect the health of the baby, who has to deal with processing these high sugar levels.

“Unfortunately, babies of women who have poorly controlled gestational diabetes can become larger than they should, which can result in complications during delivery as well as in the neonatal period,” says Dr. Dowling. “These babies also have a higher risk of developing diabetes later in life and becoming overweight or obese in childhood.”

As ways to lower your baby’s risk, Dr. Dowling recommends notifying your doctor if you have any history of diabetes, prediabetes or gestational diabetes so that you can be tested early in the pregnancy.

“Additionally, avoiding excessive weight gain in pregnancy and making sure that you are tested for gestational diabetes during the standard 24-to-28-week period is important,” says Dr. Dowling.

Along with normal life changes that come with pregnancy, Alyssa followed additional guidelines from her doctor:

• Diet — With gestational diabetes, it is important to track glucose numbers. In a natural diet of lower sugar consumption, pregnant women with the condition are advised to decrease sweets, soda, juice and carbohydrates such as potatoes and white rice.

• Monitor glucose levels — Along with a food log, monitoring glucose is done by regular finger pricks to check blood sugar levels. Alyssa tested her blood sugar three to four times a day.

• Exercise — Most effective after a meal to lower glucose levels, regular walks or low-impact exercise is recommended to help process consumed food.

Even though diet and exercise are often enough to control gestational diabetes, a doctor could suggest taking supplementary insulin to control it.

“They originally started me on insulin and then had to increase my dosage, which was frustrating because you feel like you are doing your best, but the hormones affect it and you can’t control that,” says Alyssa.

As her pregnancy progressed, Alyssa’s doctors were concerned about her body’s increasing requirements of insulin at night. They considered her pregnancy high risk and chose to induce her at 39 weeks at Sharp Mary Birch.

Melyssa “Mely” Burns was born Oct. 8, 2020. After Mely was delivered, Alyssa and her baby had their blood sugar levels checked and maintained healthy levels.

“As a high-risk pregnancy and first-time mom, I felt like I was in good hands,” she says. “And I couldn't wait to take Mely home to our dog and family who had been waiting to meet our newest addition.”