Women with PCOS have an increased risk of developing GDM, regardless if they are overweight or not. Insulin levels significantly increase in the second and third trimesters of pregnancy as a normal part of pregnancy; the majority of women with PCOS already have high insulin levels. If not well managed, GDM can cause significant problems during pregnancy and labor for mom and baby. The good news is that diet and exercise modifications can help to prevent GDM. Here are some of the most effective ways to reduce your chances of developing GDM during your pregnancy.
Screening for Gestational Diabetes
All women are monitored for gestational diabetes with a routine blood sugar screening at 24 to 28 weeks. Since PCOS can result in higher blood sugar due to insulin resistance, women with the condition are often screened for gestational diabetes earlier in the pregnancy.
There are two different ways to screen for gestational diabetes – the glucose challenge test and glucose tolerance testing. Both methods require that you drink a sugary solution, though the amount differs depending on which test the doctor is using.
The glucose challenge test requires only a single blood draw at one hour after you drink the solution. You do not need to fast before this test. However, this test alone is not sufficient to diagnose gestational diabetes. If the test is abnormal, you’ll need to have the glucose tolerance testing.
During the glucose tolerance test, you’ll again drink the sugary solution (though you’ll need to drink more of it), with four blood draws: one before drinking the solution, and at one, two and three hours after finishing it. You will need to fast before taking this test.
If any of the tests show an elevated blood glucose level, you will be diagnosed with gestational diabetes. Some doctors will skip the glucose challenge test and use only the glucose tolerance testing.
Does PCOS Increase My Risk of Gestational Diabetes?
While it is a fact that women with Polycystic Ovarian Syndrome have a higher risk of developing gestational diabetes during pregnancy, is your PCOS the only cause of this condition? PCOS and pregnancy create the perfect storm for gestational diabetes because many women with PCOS are insulin resistant and being pregnant increases glucose intolerance in the body.
Women who don’t have PCOS also develop gestational diabetes which makes it logical to assume that other causes and factors might come into play. The processes that occur during a normal pregnancy can also raise blood sugar without any influencing factors. During pregnancy, your baby is connected to your blood supply through the placenta, which produces hormones that can impair the way insulin interacts with your cells. This can raise your blood sugar. As your pregnancy progresses the placenta puts out an increasing volume of insulin-blocking hormones, which can in the later trimesters develop into gestational diabetes. A few extra risks and factors can tip the blood sugar see-saw of pregnancy onto the gestational diabetes side even without considering PCOS.
Other factors and conditions that can increase the risk of gestational diabetes beyond Polycystic Ovarian Syndrome or rising blood sugar are
- Age: Women older than age 25
- Personal history: your risk of gestational diabetes is higher if you had gestational diabetes in a previous pregnancy or had a baby over nine pounds.
- A prediabetic condition before pregnancy
- Obesity: women with a body mass index of 30 or higher
- Ethnicity: Asian, black, American Indian, or Hispanic women have a greater risk of gestational diabetes
- Family history: Your risk of gestational diabetes increases if a close family member has Type 2 diabetes
If you do develop gestational diabetes during pregnancy due to PCOS or other risk factors, you can experience other complications beyond those stemming from Insulin Resistance and a rise in blood sugar.