Sometimes women who have gestational diabetes mellitus (GDM) need medication. Again, it’s not their fault. If the woman’s body cannot produce enough insulin to counteract the hormones of pregnancy, sometimes exercising and eating carefully are just not enough. There are two types of medication that can be taken for GDM: a pill called glyburide, or insulin.
Here’s an article about GDM that has a section on medication. Most pregnant women don’t want to experiment with medication. As a result there is not a lot of research on medications and pregnancy; therefore, many medications are considered not safe for pregnancy. This is often more because they haven’t been studied than because we know they aren’t safe.
At any rate, glyburide and insulin are both being used to manage GDM. The nice thing about glyburide is that it’s a pill. The nice thing about insulin is that it’s more effective for keeping blood glucose levels in the normal range. Whichever type of medication you decide to take, it is very important that you work with a diabetes educator or other health care professional who can teach you how to take it, how much to take, and how to manage the side effects (glyburide and insulin can both cause low blood glucose).
The purpose of managing GDM with exercise, healthy food choices and medication is to keep blood glucose levels in the normal range most – if not all – the time. High blood glucose levels can lead to problems for Mom and Baby. Because GDM develops later in pregnancy, the baby’s major organs have already developed. This means that there is much less risk to the baby than in pre-existing diabetes (more on that another time).
With GDM the risks to the baby include growing larger and having a difficult time being delivered. A large baby may have to be delivered by Caesarean section. Babies of moms with GDM are also at risk for jaundice and breathing problems. Here is an article that includes a section on risks to the baby.
If the mom’s blood glucose runs high, the baby will be “fed” extra glucose (calories) and grow large. The baby makes insulin in response to the mom’s blood glucose (the baby does not use the mom’s insulin) and insulin helps the baby store extra glucose as fat. During delivery, if the mom’s blood glucose level is high, the baby will make a bunch of insulin. Once the baby is out of the mom, the baby won’t have enough glucose for all that insulin; therefore, the baby is at risk for dangerously low blood glucose. For these reasons it is very important for the mom to keep her blood glucose in the normal range during pregnancy and delivery.
High blood glucose can also cause problems for the mom, including high blood pressure. Despite how scary all this sounds, the good news is that we know a lot about GDM and it is very possible to manage it, do very well and have a healthy baby. Stay tuned for GDM – part 4 coming up!