In this week’s podcast, we discuss gestational diabetes (also called GDM, or gestational diabetes mellitus): what it is, why we care about it, and options for screening for it.

Gestational diabetes is a significant problem of pregnancy. We briefly go over risk factors for developing gestational diabetes: being overweight prior to pregnancy, belonging to higher-risk ethnic/racial groups, having a history of diabetes (you or a first degree relative), and being over age 25.

Risks of GDM to the birthing person include: birth trauma, increased risk of cesarean delivery, and development of type II diabetes or metabolic syndrome later in life. Risks to the baby include: hyperinsulinemia/hypoglycemia, cardiomyopathy, stillbirth, macrosomia, jaundice, respiratory distress, birth trauma, and lifetime risk of type II diabetes as well. Because of these risks, developing GDM in pregnancy will risk you out of home birth care in our practice.

We also discuss screening vs. diagnostic testing and recommendations for testing based on risk factors. We explain the one-step and two-step processes for testing, including glucose load recommendations.

We referenced our recent Research Roundtable where we discussed alternatives to Glucola for the glucose challenge. While some people tolerate Glucola well, others do not. A number of side effects, including nausea and vomiting, shaking, and irritability, are commonly reported with Glucola. Additionally, our health-minded clientele often want to avoid the chemicals, dyes, etc. in the Glucola. Options might include candy bars, jelly beans, Twizzlers, or a breakfast challenge with either pancakes, syrup, and juice or a smoothie.

Finally, we share some stories of gestational diabetes–both diagnosed and undiagnosed–in our practices as a way to convey our belief that this is an important issue that merits close attention and consideration.

We hope you enjoy this week’s podcast!

For more information about the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study, you can read it here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897007/