Gestational diabetes is a condition characterized by elevated blood sugar levels that are first identified during pregnancy. It impacts 2-10% of pregnancies in the United States annually and is a significant concern for many expectant mothers. One of the most pressing questions surrounding this condition is its genetic basis: Is gestational diabetes inherited? In this post, we’ll answer some of your questions around the topic.
Understanding Gestational Diabetes
Let’s listen in on a pregnant woman’s thoughts as she tries to get her head around something she’s heard about diabetes in pregnancy:
“I’ve heard my friends mention this thing called gestational diabetes and it worries me. It sounds serious. I mean, how do you even recognize the signs? I know type 2 diabetes can run in families. Is gestational diabetes something that’s passed down too? And could I be doing something to help avoid it? I just want to make sure I’m doing everything right for my baby.”
Maybe you’ve been having those thoughts too? We hope this information helps stem your worries.
Gestational diabetes occurs when your body can’t produce enough insulin to effectively manage blood sugar levels, leading to elevated glucose in your bloodstream. “Gestational” simply refers to the time when you’re carrying a baby in your womb.
This condition is distinct from other types of diabetes. It usually appears in the second or third trimester and typically goes away after the baby’s birth. The placenta produces a hormone that partially blocks the effects of insulin to help protect the baby from low blood sugar. This can lead to persistent elevated glucose levels that can be problematic.
This issue during pregnancy can affect both you and your baby, potentially resulting in
- higher birth weight,
- increased chances of early delivery,
- increased chances for Cesarean delivery,
- higher rates of ICU admissions for the baby, and
- a risk of developing type 2 diabetes in the future.
So, what part does genetics play in developing diabetes at this time?
Genetics and Gestational Diabetes
While genetics can influence the development of diabetes during your pregnancy – and those who have a family history of type 2 diabetes are more susceptible – genetics is not the sole factor. Lifestyle choices such as diet, exercise, and body weight also play critical roles in your risk of developing diabetes while you’re pregnant. And your lifestyle and upbringing are hugely influenced by your parents as well! So, it’s not all about genes!
However, to return to genetics, scientists have demonstrated a partial similarity between having some susceptibility to type 2 diabetes and gestational diabetes mellitus (to give it its full name). And you’re more likely to develop this condition if your parent(s) or near relative had diabetes.
It’s worth talking to your healthcare provider about all the lifestyle modifications you can reasonably make to improve your chances of not developing it. But if you do start showing raised blood sugar levels, your women’s healthcare specialist will help you manage it – and, as we said above, the condition typically resolves after delivery.
But apart from genetic risk and those lifestyle or upbringing factors, there are a couple of other challenges. One is anemia and the other is twin pregnancy. Both these have a small genetic factor behind them that can also link in to your diabetes risk.
Other Genetic Issues Associated with Gestational Diabetes
Anemia and Gestational Diabetes
During pregnancy, dealing with anemia can complicate the management of diabetes during pregnancy. Anemia – in the form “Iron-refractory iron deficiency anemia” – can be hereditary due to genetic mutations in how your blood uses iron.
Anemia in general occurs when your body doesn’t have enough healthy red blood cells. As you may know, insulin regulates the uptake of sugar from your blood. Lack of sufficient red blood cells can therefore affect your body’s insulin usage and blood sugar regulation. However, your healthcare provider will manage any signs of anemia when you attend for your regular prenatal care checkups.
Twins and Gestational Diabetes
Fraternal twins (rather than identical twins) can also run in families if you inherit a certain gene. So if you’re carrying twins for that reason, your risk of developing gestational diabetes increases indirectly. That’s because your body requires more insulin to manage the increased hormonal activity associated with multiple fetuses and a larger placental mass. Doctors believe that it’s these extra hormones that block the effectiveness of your insulin.
However, with a proactive approach to maintain optimal blood sugar levels and minimize complications, gestational diabetes during a twin pregnancy can be managed well.
If your genetic inheritance means you develop diabetes during pregnancy, insulin use then becomes a topic that we often field questions on.
Does Insulin Have Side Effects on the Fetus?
Insulin therapy is safe for managing gestational diabetes because insulin does not cross the placenta. While it helps lower your blood glucose levels, it doesn’t directly affect the fetus. However, the primary concern with insulin use is not the insulin itself but the potential for hypoglycemia (low blood sugar levels) in the mother, which, if severe and unmanaged, could indirectly affect your fetus’s well-being. Your healthcare provider will help you monitor and manage this.
It’s important to discuss your concerns about gestational diabetes and insulin, and explore alternative management strategies with your doctor, who will closely monitor your blood sugar levels.
There are numerous medications that can be used besides insulin to help control diabetes that have been shown to be very safe in pregnancy. So if diet alone isn’t controlling your blood sugars adequately, there is no reason to worry that insulin is the only alternative.
Continuous Glucose Monitoring for Gestational Diabetes
Continuous glucose monitoring (CGM) systems offer a modern approach to managing gestational diabetes by providing real-time data on blood glucose levels. Research has provided evidence on how these devices can potentially help reduce adverse pregnancy outcomes in gestational diabetes. This makes CGMs a valuable tool in the management arsenal.
Beyond Insulin: Alternative Gestational Diabetes Management Strategies
Besides insulin therapy, there are several effective strategies for managing diabetes during your pregnancy – and these focus on lifestyle modifications and monitoring:
- Eating a balanced diet that emphasizes whole grains, vegetables, lean proteins, and healthy fats while limiting processed foods and sugar.
- Regular exercise to help improve insulin sensitivity, which can lower blood glucose levels.
- In some cases, oral hypoglycemic agents (like metformin or glyburide) to help manage blood sugar levels, though they are less commonly used than insulin during pregnancy.
Have a Healthy Pregnancy with Stella Mattina
You don’t need to be afraid of developing gestational diabetes! Why not navigate your pregnancy with confidence under the guidance of a specialist women’s health provider at Stella Mattina? Contact us today to find a doctor near you.
Dr. Krum is currently in practice in Arlington, TX. He received his undergraduate degree at Texas A&M University, then attended UTMB Galveston for medical school, finishing in 1986, completing his residency there in 1990. Providing a full range of obstetrical and gynecological care, he specializes in the treatment of endometriosis and robotic surgery. He arranges his schedule so that same-day appointments are usually available.