Gestational diabetes is high blood sugar which develops during pregnancy.It usually disappears after giving birth. Gestational diabetes can appear at any stage of gestation but is more common in the second half. It affects about 6 percent of all pregnant women.
Causes of Gestational Diabetes
Gestational diabetes is the result of changes that occur in all women during pregnancy. The increased levels of hormones such as cortisol, estrogen, and human placental lactogen, can interfere with your body’s ability to manage blood sugar. This condition is known as insulin resistance.
Usually, your pancreas can compensate for insulin resistance by increasing insulin production to about three times the average amount. If your pancreas cannot adequately increase insulin production to overcome the effect of increased hormones, your blood sugar levels will increase and cause gestational diabetes.
Gestational diabetes usually doesn’t cause any symptoms. It mostly comes to light when the doctor tests your blood sugar level during screening for gestational diabetes. The symptoms may show up if your blood sugar level gets too high (hyperglycemia).
The symptoms may include increased thirst, a dry mouth, tiredness, and need to use the toilet more often than usual. But some of these symptoms are normal during pregnancy. They aren’t certainlya sign of a problem. So talk to your midwife or doctor if you’re worried about any symptoms you’re experiencing.
Risks of Gestational Diabetes
Risks for the Baby
Risks of having a giant baby. If you have high blood glucose levels, it can cause high blood glucose levels in your child. The baby will produce more insulin in response which can make it grow larger than normal. This process is called macrosomia.
It increases the risk of birth trauma and shoulder dystocia, where the baby’s shoulder is stuck in your pelvis after the head has come out, which can squash the umbilical cord.Birth trauma can cause bone fractures or nerve damage to the baby. It causes severe bleeding for the mother as well as psychological stress.
Risk of premature birth. Gestational diabetes links up with an increased risk of preterm birth. One cause of preterm birth is damage to the placenta. During pregnancy your placenta produces a high level of hormones which affect the insulin action in your cells, raising your blood sugar levels.
As your baby grows, the placenta significantly increases its production of counteracting hormones. In the case of gestational diabetes, the placental hormones can mean a rise in the blood sugar to a level that affects the functioning of the placenta and the growth of the baby.
Risk of still birth at the end of pregnancy. For women of all ages the risk of stillbirth increases when the pregnancy goes over 42 weeks. Studies show that for women with gestational diabetes there is an increased risk of still birth, after 40 weeks and six days plus so. Please note that though your risk of stillbirth is increased, it is still low.
Respiratory distress syndrome. Respiratory distress syndrome occurs in babies who are born early. If your child has this syndrome, he may need help until his lungs mature and become stronger. Infants born to mothers who have gestational diabetes may experience respiratory distress syndrome even if they’re not pre-term infants.
Low blood sugar in the baby after delivery. There is a possibility of your child developing low blood sugar(hypoglycemia) shortly after birth because his insulin production is high. Acute episodes of hypoglycemia may provoke seizures in your child. You should promptly feed him. Also,timely application of intravenous glucose solution will boost your child’s glucose levels. If left untreated hypoglycemia can cause damage to the baby’s brain that can lead to developmental delays.
Type 2 diabetes later in life. If you have gestational diabetes, there is a higher risk of your baby developing obesity and type 2 diabetes later in life.
Risks for the Mother
Preeclampsia. Gestational diabetes causes high sugar levels that lead to preeclampsia, a kind of high blood pressure. If left untreated it slows down your child’s growth. It also increases the risk of preterm birth and placental abruption that causes the separation of the placenta from the uterine wall before delivery.
Diabetes. If you have gestational diabetes, there is a high probability that you may get it during future pregnancies. That’s not all; you can also develop type 2 diabetes when you grow older.
Don’t be alarmed!If you make healthy lifestyle choices such as exercising and eating healthy foods you can significantly lower your risk of future type 2 diabetes.
How to Reduce Risk
Determine your risk factors. The best way to approach the problem is to identify the risk factors for developing it. Before talking to your relatives about their diabetic history, it would be beneficial if you know about the differences between type 1 and type 2 diabetes.
Type 1 diabetes is an autoimmune disorder, while type 2 diabetes is closely related to lifestyle and eating habits. You can develop gestational diabetes if a close family member such as a parent or sibling has type 2 diabetes. Talk tothem to get a clear idea whether it applies to you.
Know your risk factors. There are some risk factors that you should think about and bring to your doctor’s attention. You may have a greater danger of developing gestational diabetes if you
- Have high blood pressure
- Are obese at the time of conception
- Had greater than average blood glucose levels before pregnancy or had signs of insulin resistance such as polycystic ovarian syndrome or acanthosis nigricans.
- Have given birth to large 9 pounds baby before
- Have a family history of diabetes
- Have given birth to a baby that was still born or suffering from certain congenital disabilities
- Have had gestational diabetes in previous pregnancies
- Are older than 30
- Have got your first period before the age of 11
- Felt depressed in the first two trimesters of pregnancy
- Had consumed a diet high in animal fat and cholesterol before pregnancy
- Come from ethnic backgrounds including Hispanic, African, Native American, Asian or Pacific Islander
- Sleep deprived
But half of the women who develop gestational diabetes have no risk factors.
Devise a pregnancy plan. It’s wise if you take some steps even before you become pregnant to manage your danger of developing gestational diabetes. Consult with your doctor even before you are pregnant. Request them to put together a pregnancy plan to help prepare you physically, mentally and emotionally.
Test your blood sugar as early as three months before you plan to get pregnant to know your baseline levels and to check if you fall in the normal range.
Try to lose extra weight before your pregnancy. Medical experts do not advise weightloss during pregnancy, so if you are overweight try to lose five to seven percent of your body weight before you become pregnant.
Make a doctor appointment. Meet your gynecologist early on in your pregnancy and frequently during pregnancy. It helps to look after the health of both your baby and yourself. If you’re at an average risk for gestational diabetes, have a screening performed during the second trimester between 24 and 28 weeks. If you’re at high risk, your gynecologist may recommend testing for diabetes during your first prenatal visit.
Be thoroughly prepared for your doctor visit. Being proactive and informed helps you to communicate your concerns to your doctor effectively. While making an appointment ask whether the physician will perform any tests such as blood sugar screening. Clarify your doubts about any food restrictions or fasting before the consultation.
Have a list of any medications or supplements you’re taking. Let your doctor know that you’re particularly concerned about gestational diabetes because of your family history or any other risk factors. Ask your doctor if she recommends any diet, exercise or testing plans for you to follow during your pregnancy.
Get tested. During your check-up, they’ll test you for gestational diabetes through an initial glucose challenge test and a glucose tolerance testing. In the original glucose challenge test, you have to drink a syrupy sugar solution. After an hour, they’ll test your blood to measure your sugar levels.
If the results show that your blood sugar level is higher than normal, then you’re at an increased risk of developing gestational diabetes. You’ll need a follow-up glucose tolerance test to determine whether you have gestational diabetes.
If your value is above 200mg/dl, then gestational diabetes is presumed. If the diagnosis is made early in the pregnancy, then your doctor might tell that you have pre-existing diabetes, not gestational diabetes.
For glucose tolerance test you’ll fast overnight and then have your blood sugar levels checked. You’ll have to drink a sweet solution with higher levels of sugar in it. The doctor will check your blood for every three hours. If two of the three sugar readings come back as greater than normal, your doctor will very likely diagnose you with gestational diabetes. Talk to your doctor about a regular testing schedule and method that works for you.
Reduce Your Risk Through Diet
Increase fiber intake. Whole grain bread, vegetables, fruits, cereals and whole grain crackers boost up your fiber intake. An extensive study found that each daily increase in fiber by 10 percent reduced the risk of gestational diabetes by 26 percent. Adding fiber supplements to your diet may also be helpful.
Eat more proteins. Proteins are rich in B vitamins that help prevent congenital disabilities; the best protein choices are plant based proteins, fish and sea food, chicken and other poultry, cheese, and eggs. Avoid fish such as shark, sword fish, tile fish and king mackerel because they contain high amounts of mercury that leads to brain damage in kids.
Enjoy fruits in moderation. Fruits are healthy. They are loaded with vitamins, minerals, and fiber but avoid sugary fruit juices. Fruits that are frozen, fresh or canned without added sugars are the best choices.
Avoid white foods. Try to avoid flour and sugar. Limiting starchy potatoes and pasta will also be beneficial to your health. These items are more likely to increase your blood sugar, so it is best to limit your intake of these foods to small quantities.
Portion sizes. Control your portion sizes and try to eat several small meals frequently. Have a 300 to 400 calorie meal once every 3 hours. The total of five such meals would make 1500-2000 calories.
Foods to include:
- Eggs or egg whites
- Fresh or frozen veggies
- Steel cut oats topped with berries
- Skinless chicken breasts
- Fresh fruits
- Steamed vegetables,
- Baked fish
- Unsweetened Greek yogurt
- Air-popped popcorn
Foods to avoid:
- Fast food
- Fried food
- Baked goods such as muffins, doughnuts or cakes
- Alcoholic beverages
- Sugary drinks
- Starchy foods such as potatoes
Reduce risk through exercise. Doing regular exercise helps to keep your glucose level healthy. Swimming and walking are good choices. It’s better to start working out before you’re pregnant. Studies had shown that women who were physically active 4 hours a week or 30 minutes a day before and during pregnancy could reduce their risk of gestational diabetes by seventy percent. Consult your doctor about the duration and type of exercise that will be suitable for you.
Low impact exercises are safe during the pregnancy period. Avoid any activity that is of high impact. Experts say that exercise shortens the duration of active labor.
Dr. Sheri Colberg, Ph.D., FACSM advises in diabetesincontrol.com to do walking, stationary cycle, conditioning machines, aquatic activities, prenatal yoga, prenatal exercises classes, seated exercises and slow running or jogging.
Avoid exercises that include activities like lying flat on the back, or any that increase the risk of falling or abdominal trauma. Avoid contact or collision sports, downhill skiing, horseback riding, soccer, basketball, outdoor cycling, scuba diving and most racquet sports.
Try to include short exercises into your daily activitiesto reduce the stress on your body, while still reaping the same benefits as 30 minutes of straight action. Make sure to monitor your heart rate while exercising and never exceed the recommended targeted heart rate for your age and weight.
Eat nutritious foods, avoid junk foods and never skip your meals. Exercise regularly, take your prenatal vitamins and see your doctor as often as recommended.
Get the required amount of sleep because a recent research study has found that poor sleeping habits increase the risk of gestational diabetes.
“Our results raise the possibility that good sleep habits could reduce the likelihood of developing hyperglycemia and GDM,” says senior author Assoc Prof Gooley, from the Neuroscience and Behavioural Disorders Programme at Duke-NUS.
Avoid hot temperatures and try to be in cold temperatures because the hot temperature can increase your risk of gestational diabetes.
If ever you’re diagnosed with gestational diabetes, don’t be afraid, you can have a healthy pregnancy, labor, and delivery with a healthy diet, good sleeping habits, and proper exercise.