What You Need to Know about Gestational Diabetes

Gestational diabetes mellitus (GDM) is more commonly known as gestational diabetes or diabetes during pregnancy. It is a type of diabetes that occurs in women who previously didn’t have diabetes but experience elevated glucose levels during pregnancy.

Most women who develop diabetes during pregnancy do not become diabetic for life; usually the blood glucose levels of a woman previously diagnosed with GDM return to normal after giving birth. However, these individuals, as well as their children, are still at risk of developing type 2 diabetes later in life.

Making healthy food choices, exercising regularly, monitoring one’s blood glucose levels and keeping one’s weight down are just some of the ways that can help a woman avoid developing the condition.

In this article, you will learn more about GDM, but do bear in mind that this overview material shouldn’t replace the advice of your doctor or nutritionist-dietician.   

 

Causes of gestational diabetes
In normal circumstances, the glucose from broken down food is processed by the body with the help of insulin. However, the hormonal changes that a pregnant woman experience make her body cells less reactive to insulin. The problem occurs when the pancreas, which produces insulin, becomes unable to cope with this insulin resistance or higher insulin demand. The glucose levels in the body shoot up.

Are you at high risk for gestational diabetes?
Studies show that between 3 to 10% of women in the U.S., for instance, develop gestational diabetes. Incidence of GDM is generally higher among the following demographic groups:
•    Women who are 30 years or older
•    Women who are obese or with a body mass index (BMI) of over 30
•    Women with a family history of diabetes
•    Women who have high blood pressure
•    Women who have previously had GDM, have previously given birth to a large baby (8 pounds or heavier), have given birth to children with birth defects or have previously experienced a stillbirth (baby has died in the womb)

Diagnosis

Almost all pregnant women are encouraged to have a glucose screening test between 24 to 28 weeks into their pregnancy to properly diagnose GDM. However, if you have risk factors for gestational diabetes, your doctor may recommend that you have the test earlier, usually on your first prenatal visit.

An Oral Glucose Tolerance Test (OGTT) is the basic examination to determine a pregnant woman’s glucose level.  She is given a standard dose of glucose orally, then her blood tests before and after taking the glucose are compared.

Can gestational diabetes affect your child?
Most women with GDM who follow the general rules of eating a balanced diet, keeping a healthy weight and getting regular exercise give birth to healthy babies. However, if a mother’s glucose levels remain high, it may affect her pregnancy. For example, her baby may become larger than usual. This condition is known as macrosomia, and it may pose some challenges. A macrosomic baby may be so large that he needs to be delivered through a Caesarean section instead of being delivered naturally.

Other complications may include premature delivery, or the baby may develop jaundice and even respiratory distress syndrome. The baby may also end up having low levels of minerals or even low glucose levels in the blood (hypoglycemia), which is caused by the extra insulin the baby’s body continues to produce immediately after birth in response to the excess glucose in the mother’s body.

Lastly, children whose mothers had GDM are generally at higher risk for having abnormal glucose tolerance, obesity and diabetes in the future.

Management and prevention of gestational diabetes
Your doctor and your nutritionist-dietician can help you manage your gestational diabetes if you have been diagnosed with it or prevent developing the condition altogether. In general, you will need to monitor your blood glucose levels, eat a well-planned diet, engage in ample physical activity and maintain a healthy weight to manage or ward off gestational diabetes. You will also have to take insulin if necessary and monitor the health of your child before and after birth.

•    Monitoring your glucose levels. It is important to have your blood glucose levels tested if you’re planning to have a baby. It is best to have healthy glucose levels even before you conceive your child so that he can avoid developing birth and heart defects.

Gestational diabetes usually disappears after the baby is born, but to make sure that your blood glucose levels have returned to normal, your doctor may recommend that you take an OGTT six weeks after you deliver your baby. You will also be asked to have regular blood tests every 1 to 2 years thereafter.

Click here to learn more ways to manage and prevent gestational diabetes.

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Read on to learn more ways to manage and prevent gestational diabetes.

•    Eating a well-planned diet and maintaining a healthy weight. Your doctor and nutritionist-dietician can draft a healthy diet plan for you. Your nutritional needs may vary but in general, you should avoid items that are rich in sugar (cakes, soda, milk chocolate, candies, etc.); instead, you should eat meals that have the right balance of carbohydrates, fats, protein, vitamins and minerals (especially calcium and iron).

You should regularly eat nutritious foods that will not cause your blood glucose levels to shoot up or cause excessive weight gain. One way of ensuring this is by choosing healthy foods that have low glycemic index. For instance, when deciding on carbohydrates, choose brown rice over short grain white rice; the former has a glycemic index of only about 55 compared to the latter, which has a glycemic index of about 72.

As for your weight, take note that the amount of weight gain that is considered healthy for you will depend on the weight you had before pregnancy. Your doctor can help you determine this healthy weight gain level for you.

•    Ample, moderate physical activity. Proper exercise during pregnancy will help your body to improve its capacity to process glucose, which in turn, will help you control your sugar levels. You can engage in moderate exercises like walking, climbing the stairs or swimming for at least half an hour each day.

•    Take insulin if necessary. Your doctor may prescribe insulin shots to manage your blood glucose levels if they don’t stabilize with healthy eating and exercise alone.

•    Monitoring the health of your child. If you develop diabetes during pregnancy, your doctor may monitor your condition more intensively during the last two or three months of your pregnancy. A series of ultrasound tests and fetal heart monitoring may be recommended by your physician as early as the 28th week of your pregnancy, depending on the severity of your situation.

It is recommended to breastfeed your child because studies have shown that breast milk is beneficial to a child’s glucose metabolism and helps in preventing childhood obesity and diabetes.

It is also very important to help your child maintain a healthy weight, eat nutritious meals and stay physically active to ward off obesity and diabetes in the future.


SOURCE:
•    Thomas R. Moore, M.D. June 1, 2010. “Diabetes Mellitus and Pregnancy” EMedicine.Medscape.com

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