Gestational diabetes—which may start around the middle of pregnancy and end after delivery—is a health problem for some pregnant women. Who's at risk? Women with a family history of diabetes, obese women, those with a problem pregnancy, and women over age forty. Most women are routinely tested for gestational diabetes at about twenty-four to twenty-eight weeks.
Whether it's preexisting or gestational, diabetes during pregnancy increases the risk for high blood pressure and toxemia. Toxemia, accompanied by swelling, high blood pressure, and excess protein in urine, is dangerous. Women with gestational diabetes often have big babies, who may be difficult to deliver, and they may need a cesarean delivery. The risk for getting diabetes later in life is higher among women who develop gestational diabetes.
If you have diabetes, you can deliver a healthy baby. However, it's important for your doctor to monitor it carefully and prescribe treatment, typically a combination of diet and physical activity. A registered dietitian can help you develop an eating plan to control your blood sugar levels. See "Diabetes: A Growing Health Concern " in chapter 22. Controlling existing diabetes before pregnancy is important.
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