It can be scary to hear of all the things wrong that can happen in pregnancy. In this post series, I’ll go over some of the more serious diseases, so you know what the heck your doctor is talking about!
Disclaimer: This post and others like it is not to replace the advice of your midwife or doctor. Please follow their directions as they have the full picture of each unique, individual mama.
Diabetes happens when pancreas is not producing enough of the hormone insulin to keep up with the amount of glucose that is ingested. Glucose is essentially the energy form of carbohydrates. When too much glucose is present for the insulin to handle, this is called insulin resistance*. Carbohydrates are not just in cakes and cookies, but also healthy foods such as fruits and vegetables.
A pregnant woman is considered to have gestational diabetes when a woman has a normal insulin-blood sugar balance before pregnancy, but uncontrolled blood sugar during pregnancy. Currently, there is no conclusive cause for gestational diabetes but scientists reason that the hormones that help the development of the baby interfere with insulin’s pathway. These hormones therefore block insulin from doing its job properly. Approximately, 2-5% of pregnant women develop gestational diabetes.
There can be symptoms of fatigue, excessive hunger, excessive thirst and increased urination, but doesn’t that sound like just regular ol’ pregnancy? Most women do not have symptoms.
Risks and Dangers
Women pregnant over the age of 25, are overweight, have a personal or family history of GD, and are of a nonwhite race are at an increased risk of having GD.
There are many complications associated with uncontrolled gestational diabetes including:
- increased risk of surgical birth such as cesarean section,
- a large baby (macrosomia),
- the baby running out of room to grow (intrauterine growth restriction),
- uncontrolled blood sugar of the baby, and
- preterm birth that could result in respiratory distress due to the baby’s underdevelopment.
Mother also has increased risk of having preeclampsia during pregnancy and also, has an increased risk of acquiring diabetes later in life.
Between the 24th and 28th week of pregnancy, the pregnant woman is asked to drink a sweet drink that contains 50 grams of glucose. Blood will then be drawn one hour after to detect if insulin properly processed the ingested glucose. You are not required to fast for this test, but it’s best to avoid any overly starchy, sugary foods 1-2 hours prior to have the most accurate results.
If your blood glucose measures too high (usually at or above 140), you will need to take a further test called the Oral Glucose Tolerance Test. This test requires you to fast for 8 hours before drinking a solution containing 75-100 grams of glucose. Blood will be drawn at intervals of 2 hours to help your doctor determine if you’re in insulin resistance.
- Blood Sugar Monitoring: The health care team may ask that a woman check their blood sugar level first thing in the morning and about two hours after each meal. At first, this may be overwhelming but will become routine in time. Close monitoring will also occur during and after the birth.
- Healthy Diet: This consists of foods good proteins, vegetables and carbohydrates that are on the low glycemic index that do not spike your blood sugar too quickly that insulin cannot keep up. Foods that are higher in fat and/or fiber tend to be lower on the index. As a general rule, if the food is more cooked or processed, it is probably higher on the GI. Go here for more information about a healthy, diabetic diet.
- Exercise: Regular, doctor-approved exercise will insure that your body is using up any extra glucose and maintain that blood sugar-insulin level. Some great choices for exercise during pregnancy are quick-pace walking or swimming.
- Medication: If diabetes cannot be controlled by diet and exercise alone, a woman’s doctor will prescribe either oral or injection insulin to reach normal levels of blood glucose.
- Increases monitoring of baby: The health care team will be closely monitoring the growth and development of the baby with repeat ultrasounds. Sometimes inducing the birth early is required if the baby because the risk of complications.
How can GD be prevented?
Since research has not yet revealed a conclusive cause to GD, there is no clear way of prevention. One risk factor that is modifiable is excessive weight. Having a healthy body weight before becoming pregnant is optimal. If you are already pregnant, do not lose weight but aim to only gain the recommended weight and maintain a healthy lifestyle throughout the pregnancy.
Have you been diagnosed with Gestational Diabetes? Tell your story in the comments below!