What causes gestational diabetes?

Summary

This is a short conference talk in which Dr. Om explains where gestational diabetes comes from. Although it was given to doctors, the idea at its centre is simple and useful for patients.

He describes diabetes of every type as an imbalance between two things: how much insulin the pancreas can make, and how strongly the body resists insulin. In every pregnancy, insulin resistance rises. This is a normal change that helps send more fuel to the growing baby, and hormones from the placenta are part of the reason. Most women’s pancreas simply makes more insulin and sugar stays normal.

In some women, the pancreas has less reserve to begin with. Pregnancy then acts like a stress test, and the extra demand shows up as high sugar. Being overweight before pregnancy and low-grade inflammation add to the insulin resistance.

Two practical points follow. Sugar usually returns to normal after delivery, because insulin resistance falls quickly once the placenta is delivered. But because the stress test has shown a weaker reserve, these women have a higher chance of type 2 diabetes later, and their babies have a higher chance of being large at birth and of weight problems later. Regular sugar checks after pregnancy are therefore important.

Read the full guide on what causes gestational diabetes.