Am I Going to Develop Gestational Diabetes?

Well, like so many disorders, there is a genetic predisposition to diabetes. Family history is an important part of the antenatal history taken at your first visit. Do you have a close family member, parent or a grandparent who has Juvenile onset diabetes or maturity-onset diabetes or a sibling who has had gestational diabetes?

There are also some other medical disorders which are connected with gestational diabetes, such as patients who have polycystic ovarian syndrome. This group of women have a much higher chance of developing gestational diabetes during pregnancy.

Obesity in Pregnancy and Diabetes Risk.

There is a second group of patients who don’t have a family history and don’t have any underlying predisposing medical conditions. Women with poor lifestyle habits are often overweight and therefore have a higher risk of developing gestational diabetes. They often develop a degree of insulin resistance. This can be made worse as their weight goes up in pregnancy and also because the placenta is producing placental steroids. The metabolic changes that happen in pregnancy can swing the pendulum towards developing diabetes as patients put on weight.

When do we screen for Gestational Diabetes.

Gestational diabetes doesn’t usually develop early in pregnancy. For most patients it develops later on. A glucose tolerance test (GTT) is performed to diagnose Gestational Diabetes and it is usually performed between 26 to 28 weeks gestation.

If a patient has high risk factors such as a family history or if they have had gestational diabetes in a previous pregnancy or they have a history of polycystic ovarian syndrome, then we would recommend that the glucose tolerance test be performed at 16 weeks. If the early GTT is normal, then it would be repeated again at 26 to 28 weeks.