Published: November 3, 2026
Estimated reading time: 5 minutes
Gestational diabetes was one of several reasons a second pregnancy was considered high risk for Mckenzie M. Stieneker, APRN, a nurse practitioner with Norton Children’s Heart Institute in Owensboro, Kentucky.Her experience shows what happens if you have gestational diabetes and how a care team can work together to make it manageable, even when you live two hours from a specialist.
Mckenzie had preeclampsia in her first pregnancy, followed by an emergency cesarean delivery (C-section). This time, she knew she likely would need maternal-fetal medicine care because of her history and advanced maternal age, described as pregnancy over the age of 35. Her blood pressure stayed normal during the second pregnancy, but she was diagnosed with gestational diabetes.
“On one hand, I was thankful,” Mckenzie said. “I felt like they kept a closer eye on my pregnancy. It was like I had extra hands on deck.”
Gestational diabetes is high blood sugar that develops during pregnancy. Having too much glucose (sugar) in your blood poses potential risks to both mother and baby.Complications of gestational diabetes include:
It is usually found through routine screening called a glucose tolerance test in the second trimester. The glucose tolerance test includes drinking a sweet solution, waiting for a period of time, usually an hour, then testing your blood sugar. Depending on the results, more screens may be needed.
What happens next depends on the person, but care typically includes:
For Mckenzie, a diabetes educator on her maternal-fetal medicine team helped her set up a glucose monitor.“Thankfully, I didn’t end up having to go on insulin,” she said. “I was able to control everything with diet.”
After delivery, a diabetes educator from Wendy Novak Diabetes Institute Perinatal Program visited her in the hospital to talk through what to watch for at home. About a month later, the educator called to check in.
“That was really nice, just to make sure I was still following up with my post-natal care,” Mckenzie said.
Mckenzie lives about a two-hour drive from Louisville, with an hour time difference. She also has a toddler and works full time. Her care team built a plan so she wouldn’t have to make that trip often.
She saw a local specialist in her hometown for ultrasounds, labs and blood sugar testing and her Norton Women’s Care obstetrician worked closely with them. Stress tests and other Louisville visits were scheduled for the same day with multiple specialists whenever possible.
“I felt like everybody worked really, really well together,” Mckenzie said. “It’s a great example of how specialists work together for the betterment of the patient.”
Mckenzie delivered at Norton Women’s & Children’s Hospital in Louisville, where pediatric specialists and a neonatal intensive care unit were available if her son needed them. After delivery, a pediatric neurology team reviewed her son’s ultrasound and confirmed that everything looked OK.
Her son, Paxton, lost about 10% of his birth weight, so Mckenzie stayed in the hospital a little longer. She had struggled to breastfeed her first baby, and lactation consultants and nurse practitioners helped her through the early days, including supplementing with formula and a plan for donor milk if she wanted it.
One night, a young nurse noticed Paxton was breathing a bit fast. She stayed with the family and called the on-call pediatrician.“I know she had other patients, but she took the time to make sure he was OK,” Mckenzie said. “It really meant a lot.”
Because Paxton was born right at Christmastime, nurses also arranged a visit from Santa so he could have a first photo.
“It seems like something so small,” Mckenzie said. “But when you’re away from your toddler at Christmas and have a baby in a kind of scary situation, it meant so much to our family.”
Mckenzie was 34 when she married, and she and her husband wanted children soon. Pregnant women who have babies at or after age 35 and older are considered advanced maternal age (AMA) patients. That just means some extra monitoring for mom and baby.
“Everybody’s life doesn’t fit into the same mold,” Mckenzie said. “I wouldn’t change how it happened.”
To women who are anxious about a pregnancy later in life, Mckenzie offers this advice: “Make sure you have a close relationship with your provider and that you feel comfortable with the care you’re receiving. You should know what’s going on, they should know what’s going on, and you should have a good plan.
“Nobody made me feel like an older mom. Everybody treated me with so much respect and was so happy for me.”