Gestational Diabetes

Why Women With PCOS Are at Greater Risk for Gestational Diabetes

Doctor using stethoscope on pregnant patients stomach
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Gestational diabetes occurs when women who have never had diabetes before develop an impaired ability to process glucose during pregnancy, resulting in high blood sugar. Women with polycystic ovarian syndrome (PCOS) are at greater risk for developing gestational diabetes, or GD.

High blood glucose associated with gestational diabetes can lead to complications including a high birth weight, preterm birth, respiratory issues at birth, low blood sugar, and jaundice. It can also cause problems for the mother and child at delivery.

Fortunately, a carefully balanced diet — with or without medication — can help manage blood sugar levels and prevent complications. 

Risk Factors and Symptoms

Women who are older than 25, have had gestational diabetes with prior pregnancies, who are overweight, who have prediabetes, or who have close family members who have been diagnosed with type 2 diabetes are at greater risk for developing gestational diabetes. Women with PCOS are a part of that group because of the association with insulin resistance and prediabetes.

Most women don’t experience any symptoms of gestational diabetes, though very rarely, they may notice excessive thirst and urination.

While the condition usually resolves after giving birth, a woman with gestational diabetes is more likely to develop type 2 diabetes later in life.

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.

Lifestyle Modifications and Treatment

Gestational diabetes can be treated with a combination of lifestyle changes (in mild blood sugar abnormalities) or medication. Your doctor will probably have you measure your blood sugar periodically through the day; once in the morning when you wake up and after each meal is typical, though you’ll want to follow your doctor’s instructions.

Lifestyle modification include cutting out processed and refined sugars and fried or fatty foods. Your diet should include mostly fruits, vegetables, lean proteins, and whole grains. With your doctor’s okay, light to moderate exercise should be included in your daily routine.

If lifestyle changes aren’t enough to regulate your blood sugar, your doctor may prescribe a pill to control your blood sugar or even insulin. The exact regimen will vary depending on your individual clinical circumstances and the doctor’s preferences and experience.

When to Call the Doctor

When your doctor explains your treatment protocol, he’ll likely give you guidelines as to what your blood sugar should be and when. He should also tell you when to call him or go to the emergency room if you have abnormal blood sugar results. Make sure to follow his instructions exactly if you have an abnormal result. In addition, don’t hesitate to call if you have any questions or concerns.

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Article Sources
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  2. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Definition & Facts of Gestational Diabetes. Published May 2017.

  3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & Causes of Gestational Diabetes. Published May 2017.

  4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Tests & Diagnosis for Gestational Diabetes. Published May 2017.

  5. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Managing & Treating Gestational Diabetes. Published May 2017.