Understanding Gestational Diabetes: How Gestational Diabetes Differs From Other Types of Diabetes

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How does gestational diabetes differ from other types of diabetes?
There are several different types of diabetes. Gestational diabetes begins during pregnancy and disappears following delivery. Another type is referred to as juvenile-onset diabetes (in children) or Type I (in young adults). These individuals usually develop their disease before age 20. People with Type I diabetes must take insulin by injection every day. Approximately 10 percent of all people with diabetes have Type I (also called insulin-dependent diabetes).

Type II diabetes or non-insulin-dependent diabetes (formerly called adult-onset diabetes) is also characterized by high blood sugar levels, but these patients are often obese and usually lack the classic symptoms (fatigue, thirst, frequent urination, and sudden weight loss) associated with Type I diabetes. Many of these individuals can control their blood sugar levels by following a careful diet and exercise program, by losing excess weight, or by taking oral medication. Some, but not all, need insulin. People with Type II diabetes account for roughly 90 percent of all diabetics.

Who is at risk for developing gestational diabetes and how is it detected?
Any woman might develop gestational diabetes during pregnancy. Some of the factors associated with women who have an increased risk are obesity; a family history of diabetes; having given birth previously to a very large infant, a stillbirth, or a child with a birth defect; or having too much amniotic fluid (polyhydramnios). Also, women who are older than 25 are at greater risk than younger individuals. Although a history of sugar in the urine is often included in the list of risk factors, this is not a reliable indicator of who will develop diabetes during pregnancy. Some pregnant women with perfectly normal blood sugar levels will occasionally have sugar detected in their urine.

The Council on Diabetes in Pregnancy of the American Diabetes Association strongly recommends that all pregnant women be screened for gestational diabetes. Several methods of screening exist. The most common is the 50-gram glucose screening test. No special preparation is necessary for this test, and there is no need to fast before the test. The test is performed by giving 50 grams of a glucose drink and then measuring the blood sugar level 1 hour later. A woman with a blood sugar level of less than 140 milligrams per deciliter (mg/dl) at 1 hour is presumed not to have gestational diabetes and requires no further testing. If the blood sugar level is greater than 140 mg/dl the test is considered abnormal or "positive." Not all women with a positive screening test have diabetes. Consequently, a 3-hour glucose tolerance test must be performed to establish the diagnosis of gestational diabetes.

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