Gestational Diabetes: Managing Risk During and After Pregnancy

Posted by Brigham and Women's Hospital October 6, 2015

The initial approach to treating gestational diabetes mellitus is to control a mother’s blood glucose levels with healthy eating and physical activity.

Contributor: Ellen Seely, MD, is the Director of Clinical Research in the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women’s Hospital and Professor of Medicine at Harvard Medical School.

Women who develop diabetes during pregnancy, known as gestational diabetes mellitus (GDM),  may need high-risk pregnancy care due to complications that can arise during pregnancy and childbirth. Women with GDM have an increased risk of preeclampsia, a condition that leads to pregnancy- induced high blood pressure. Preeclampsia is a serious condition that can result in early delivery. Women who have gestational diabetes also have an increased risk of cesarean section.

What Causes Gestational Diabetes?

GDM is a type of diabetes that occurs only in pregnancy. It comes on in the second half of pregnancy, and it goes away after delivery. Obesity is one of the main risk factors for GDM. In the United States, most health centers screen all women for gestational diabetes, because obesity is becoming so common in the overall population. It’s estimated that five percent of all pregnancies are complicated by GDM. The rates of GDM are even higher in Hispanic and non-white populations, ranging from 10 to 20 percent of pregnancies.

The primary treatment for GDM is to control a mother’s blood glucose levels with lifestyle changes such as healthy eating and physical activity. Lifestyle changes are effective in controlling blood glucose levels in about 60-75 percent of women with GDM. If the lifestyle changes don’t work, insulin therapy will be started to control a mother’s blood sugar for the rest of her pregnancy.

Gestational Diabetes and Your Future Health

While GDM goes away after pregnancy, the health risks to a mother and her child continue.. Research has found that 50 to 70 percent of women who have gestational diabetes develop type 2 diabetes later in life. Research also has found that babies born to mothers with GDM have a higher birth weight and may become obese during adolescence, increasing their risk of developing diabetes and other conditions, such as high blood pressure. Dr. Seely emphasizes that although women who have had gestational diabetes face an increased future risk for type 2 diabetes, they can take steps to decrease that risk.

In the video below, Dr. Seely discusses the health risks associated with GDM during and after pregnancy. Dr. Seely also describes Balance after Baby, a web-based pilot program designed to educate women on eating healthfully and increasing their physical activity, with the goal of helping them lose their pregnancy weight within a year of giving birth.

Learn more:

– Jamie R. 



Preeclampsia: Pregnancy Complication Raises Heart Disease Risk

Posted by Brigham and Women's Hospital February 14, 2013

Preeclampsia in expectant mothers leads to high blood pressure.

Today’s post is written by Dr. Ellen Seely, Director of Clinical Research, Endocrinology, Diabetes and Hypertension Division at Brigham and Women’s Hospital (BWH).

Recently, the serious nature of preeclampsia, a complication of pregnancy, was highlighted on the popular TV series, Downton Abbey. During an episode that aired in January 2013, Lady Sybil Crawley suffered complications from the condition before delivery and after giving birth. In expectant mothers, preeclampsia results in high blood pressure and increased levels of protein in the urine. In some severe cases, preeclampsia can lead to eclampsia (seizures) and an increased risk of death.

Doctors have known about eclampsia for many centuries though its direct causes are unknown. The only cure for a mother-to-be remains delivery of her baby. In some serious cases, an early delivery, at times requiring Cesarean section, may be recommended, despite the health risks of a premature birth for the baby.

Read More »