What is Gestational Diabetes?

In simplest terms, diabetes is heightened resistance to insulin, a hormone that stabilizes blood sugar levels. All humans have some level of reaction to insulin, but this resistance changes during pregnancy – sometimes resulting in the presence of gestational diabetes (also known as diabetes during pregnancy) in surrogates. In fact, the American Diabetes Association estimates that as many as 9% of all pregnant women will develop it.

Causes of Gestational Diabetes

While the exact cause is unclear, most doctors believe that gestational diabetes is a hormone problem that begins with the placenta, an organ developed for the sole purpose of creating hormones that will help grow a baby. Estrogen, progesterone, human growth hormone and cortisol all rise during a pregnancy. When these become too high, they can override the hormones in the body that are used to break down insulin. The result is gestational diabetes.

Additionally, women may have a higher risk of developing gestational diabetes if they are:

  • Over 25 years of age
  • Carrying multiples
  • Carrying excessive weight
  • Non-Caucasian

If you do wind up with a diabetes diagnosis, it is important to understand there is nothing you could have done to prevent this. This is not a lifestyle or diet concern. 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.

Symptoms & Complications of Diabetes During Pregnancy

While symptoms are usually mild or nonexistent, some women experience fatigue, excessive thirst and blurred vision if they have gestational diabetes.

The cells of a woman who develops gestational diabetes perhaps more accurately referred to as “gestational insulin resistance” – cannot absorb glucose in the blood, resulting in a buildup of sugar in the bloodstream.

This causes the pancreas to work harder than it should, often to no avail. Glucose buildup can, and often will, cross the placenta and work its way into the developing baby’s blood. That will cause the newborn’s pancreas to work overtime and create more energy than it needs.

As a result, that fetus will store the extra energy as fat. This can lead to a variety of complications including high birth weight, damage to the shoulders as the baby exits the birth canal and an increased risk of obesity or type 2 diabetes later in life.

Gestational Diabetes Treatment

If gestational diabetes testing, which is typically performed around the 24th week of pregnancy, comes back positive, then you will be instructed to add a bit of exercise to your daily routine. You’ll also be asked to monitor your glucose levels with a home testing kit and keep a strict log of your food intake and sugar levels.

Some women are simply unable to control their blood sugar levels through diet and exercise and may need additional treatment. In these instances, you may be asked to take oral medication or inject insulin to keep your body’s chemistry in check. If this happens, it is not the reflection of poor diet or failure to follow your doctor’s orders. In the case of gestational diabetes, hormone levels are more closely related to a higher level of insulin resistance as the result of pregnancy hormone levels.

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 to ensure the condition has cleared up.

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: The Essential Guide to Assisted Reproduction (Conari 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.