Understanding Gestational Diabetes

All pregnant women will be tested for gestational diabetes during their pregnancy. Even if you’ve had no prior issues with blood sugar levels in your personal pregnancies you will be tested during your surrogate pregnancy. You may be surprised to find that your sugar levels are elevated.

While being a surrogate does not raise the odds of developing gestational diabetes, there are certain elements of a surrogate pregnancy that may contribute to a more significant insulin resistance and, as a result, the development of gestational diabetes.

 

According to the Mayo clinic, the risk for developing gestational diabetes rises with the following factors:

·       Increasing maternal age, starting in women more than 25 years of age.

·       Multiples gestation

·       Excessive weight

·       Non Caucasian race

 

Since multiple pregnancies are more common in cases of IVF, and most surrogates tend to be over age 25, you will already be carrying a few extra risk factors than you did previously. You may have also gained additional weight during your medical cycle that you previously would not have gained. As a result of these factors, many women have elevated levels at the conclusion of their one hour glucose tolerance test.

If your one hour glucose tolerance test does come back elevated, know that this does not automatically mean you will be diagnosed with gestational diabetes. Instead, you will be asked to take a three hour version of the test. This test will be used to diagnose gestational diabetes, if present.

If you do wind up with a gestational diabetes diagnosis, it is important to understand that there is nothing you could have done to prevent this. This is not a lifestyle issue and you have nothing to feel guilty or ashamed about. Unlike type 1 diabetes, which is typically inherited, or type 2 diabetes, which typically is the result of excessive weight and poor diet, gestational diabetes tends to be linked to how the body regulates pregnancy hormones.

Perhaps more accurately named “gestational insulin resistance,” women who develop gestational diabetes stop being able to respond to insulin. As a result, the cells can’t absorb glucose in the blood, resulting in a buildup of sugar in the bloodstream. Again, pregnancy hormones play a large role in this body chemistry change. Pregnancy hormones like estrogen, progesterone, human growth hormone, and even cortisol (a stress hormone) rise during pregnancy. When these hormones become too high, they can override the hormones in your body that are used to break down insulin. The result is gestational diabetes. 

In most cases, gestational diabetes can be managed by closely monitoring your diet and adding a bit of additional exercise. You will be asked to monitor your glucose levels with a home testing kit and keep a strict log of your food intake and sugar levels, but may not need to change much about your lifestyle.

However, some women are simply unable to control their blood sugar levels, even with strict adherence to diet and exercise. Again, this is not your fault and not something to feel guilty or ashamed of. It is more closely related to a higher level of insulin resistance as the result of your hormone levels. In these instances you may be asked to begin taking oral medication or injected insulin in order to keep your body’s chemistry in check.

 

For most women, gestational diabetes will go away once the child is born. The American Diabetes Association advises women who developed gestational diabetes to have a two hour glucose tolerance test at six weeks postpartum in order to ensure that the diabetes has cleared up. Women who have developed gestational diabetes will be at an increased risk to develop type two diabetes later in life, so you should also plan to have your sugar levels tested every three years following delivery. 

 

Revised 5/15/18

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: An Essential Guide to Assisted Reproduction (Red Wheel Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.