What is a Diagnosis of Gestational Diabetes? Should I Induce or Wait?

What is Gestational Diabetes or GDM?

Gestational diabetes mellitus, commonly referred to as GDM, is high blood sugar developed during pregnancy. Risk factors for gestational diabetes include having a body mass index higher than 25 and being older than 35. Some of the issues caused by having GDM can be; pre-eclampsia, fetal high blood sugar, first-time cesarean, having a large baby, and premature baby. Screening for GDM is important because a positive result can be treated with diet, exercise and medications. There is strong evidence from studies that treating gestational diabetes improves birth outcomes for mothers and babies. For example, treatment cuts the risk of large birth weight by 50% and shoulder dystocia by 60%. There are 2 main ways to test for GDM. Worldwide, most countries test by having the pregnant person drinks a 75 gram glucose solution and then test. In the U.S., most use a 2 part screening where the pregnant person drinks a 50 grams glucose solution and then test 1 hour later. If this screening tests positive, then a second screening is done. The mother drinks a 100 gram glucose solution and then given a diagnostic test after 3 hours.

Should I Induce or Wait for Labor to Begin On Its Own?

Did your care provider suggest an induction because you have GDM? From randomized trials, there is no evidence to support induction for Everyone that has GDM. However, there have been observational studies that have found benefits from induction at 39 weeks. The number of women with GDM who would need to be treated with an induction to prevent 1 death at 39 weeks was 1,500, and at 40 weeks was 1,300. According to an observational study, inducing labor at 39 weeks instead of waiting until 40 weeks is linked to a lower rate of Cesarean and fewer cases of pre-eclampsia and hypertension. Babies are less likely to be very large (more than 4,000 grams) and are less likely to have breathing problems than babies born at 40+ weeks. Babies induced at 38 weeks are more likely to have health problems. The studies did not take into account the factor of if mothers have well-managed blood sugar levels or not.

*This post is a synopsis of information from Rebecca Dekker from Evidence Based Birth. None of this information or anything on this website is medical advice. Please consult a medical professional for medical advice. Thank you!

Here’s a lot more information on GDM from Evidence Based Birth.

Here’s more information on Induction with GDM from Evidence Based Birth.