Gestational Diabetes in Pregnancy

Gestational diabetes is caused as a result of increased blood sugar levels during pregnancy. It is believed that upto 10% pregnant women get affected by this in the U.S. You needn’t have ever been diagnosed with diabetes in order to get this during your pregnancy.

What is Gestational diabetes?

The two types of gestational diabetes are Class A1 and Class A2. The former can be controlled through exercise and diet, however, those with Class A2 need medication and insulin in order to manage it. Check out our recommendations on healthy options for eating and drinking during pregnancy.

After delivery, gestational diabetes goes away, though it increases your chances of getting Type 2 diabetes at a later stage in life. It can also affect the health of the baby, so you need to take certain steps to ensure the well-being of you and your baby.

What causes Gestational Diabetes?

Insulin is a hormone, produced by the pancreas when you eat; insulin helps regulate the level of glucose in your blood by moving it to the cells which use it for energy. What happens during pregnancy is that the placenta makes hormones that cause glucose levels to rise in the blood. Normally the pancreas are able to manage the glucose levels by sending out enough insulin. However, if it is unable to produce enough insulin, the sugar levels in the blood rise, causing gestational diabetes.

When do you get Gestational Diabetes?

Gestational diabetes is diagnosed between the 24th and 28th week of pregnancy. According to the Centre for Disease Control and Prevention (CDC) 6 to 9% pregnant women tend to develop gestational diabetes?

What are the signs of gestational diabetes?

Most women don’t have active symptoms or gestational diabetes signs and tend to find out about it during a routine prenatal screening.

However certain common patterns have been noticed which include:

Being thirstier than usual
Being hungrier and eating more than the regular
Excessive urination frequently
Fatigue which maybe confused for pregnancy fatigue

How do you diagnose GD?

If you are high risk category then your doctor will check you earlier than usual; else the time for getting this test is between 24 to 28 weeks in the second half of the pregnancy.

The test is called a glucose tolerance test which involves the consumption of a sweet drink with glucose, required to increase the blood sugar levels and see how the body handles the increased levels. Post one hour of consuming the drink, a blood glucose test is conducted to see the blood sugar levels. If the result is higher than a particular level another test called the 3-hour oral glucose tolerance test is conducted. The pattern of test is similar to the above-mentioned test but the drink has a higher content of glucose and the blood glucose test is conducted post 3 hours.

If these tests are normal but your fall in the high-risk category, the doctor may test your blood glucose levels from time to time.

”If you are eating healthy and have good habits like staying active and maintaining a healthy pregnancy weight but have a family history of diabetes or are at an advanced maternal age, there is nothing you can do really to prevent developing gestational diabetes.”

How to prevent gestational diabetes?

If you are eating healthy and have good habits like staying active and maintaining a healthy pregnancy weight but have a family history of diabetes or are at an advanced maternal age, there is nothing you can do really to prevent developing gestational diabetes.

For those who are overweight, leading an inactive lifestyle devoid of exercise and not eating a nutritional diet a few steps can help reduce the risk of getting gestational diabetes.

The following lifestyle changes can help reduce the risk of both gestational diabetes and type 2 diabetes, before conception as well as while you are pregnant.

Staying active is a great way to keep the blood sugar in control. Doing something as basic as a 15-minute walk post each meal helps the body to burn sugar.
Eating a healthy and well – balanced diet which is high in fiber, fruits, vegetables and lean protein. Stay away from trans-fats and saturated fats – this should help develop healthy eating habits for life. Low-carb diets have been proven to help keep blood sugar in check throughout the pregnancy, you can read more here
Keep a check on your weight and maintain a healthy pregnancy weight and BMI. Take the help of your practitioner to achieve this.

What problems can Gestational Diabetes cause for you and your baby?

If you have gestational diabetes and you are not being able to control the blood sugar levels, it could cause problems for both you and the baby.

An Extra-Large Baby and C-Section

Uncontrolled diabetes leads to high blood sugar levels in the baby causing the baby to be over-fed and bigger in size. This causes discomfort to the mother-to-be during the last few months of pregnancy and can lead to a problematic delivery for both the baby and mother. In such cases a C-section is needed to deliver the baby leading to a longer recover period for the mother post birth. Due to shoulder pressure while delivery, the baby can be born with nerve damage.

High Blood Pressure or Preeclampsia

Preeclampsia is a critical issue that needs to be closely monitored by the doctor. Preeclampsia is when the pregnant woman has high BP, protein in the urine and her fingers and toes start to swell often. High blood pressure can be harmful for both the unborn baby and the mother-to-be. It can lead to seizures or strokes during the time of birth in the woman and also lead to a premature birth of the baby.

Low Blood Sugar or Hypoglycaemia

Consumption of diabetes medication and insulin can lead to low blood sugar in people. This is serious and can even prove to be fatal if not monitored and treated at an early stage. The baby is prone to developing low blood sugar post birth incase the mother’s diabetes was not controlled during the pregnancy – in this case the baby’s blood sugar needs to be monitored post-delivery.

Tips for women with GD – GD Diet and Exercise

1. Gestational Diabetes Diet

- Get a healthy meal plan from a dietician that will also help control the blood sugar while pregnant. Ideally follow a meal plan for someone with diabetes and watch portion sizes.
- Choose naturally occurring sugars like raisins, fruits, carrots etc. instead of sugary snacks like ice cream, cookies and candies. Eat whole grains and vegetables.
- Eat three small meals and two or three snacks daily at fixed times. Control your portion sizes.
- Try and include about 20-35 grams of fibre daily. Foods high in fibre are oatmeal, whole-grain breads and cereals, wild rice, brown rice, fruits and vegetables.
- Fats should constitute less than 40% of the daily calories. Avoid trans and saturated fats.
- Eat food rich in vitamins and minerals and take supplements as prescribed by your doctor.

Many women have found low carb diets to be helpful with managing gestational diabetes. Eat whole foods, get nutrients from fruits, vegetables and proteins and steer clear of processed carbs and sugar.

Though research is still on about this low-carb phenomenon and nothing conclusive has been established, according to pregnant women a low-carb, high protein and high-fat diet worked and helped control Gestational diabetes. It has helped them to avoid insulin and lose excess weight and deliver healthy babies.

The reason behind the Low- carb diet logic is the effect of carbohydrates on Glycaemic index. This is a rating system that shows you the effect of carbohydrates on your glucose levels by measuring how fast glucose is released in the bloodstream. Just replacing some of the carbs that you eat with high fiber foods helps bring down the glucose levels. Foods that include sugar and white flour like cake, biscuits and other confectionary items, breakfast cereals, cold drinks/ sodas, white bread, potatoes, white rice etc. should be avoided. Foods with low Glycaemic index are preferred – wholegrain foods, some fruits and vegetables and a few pulses.

However, if you are on certain medication for diabetes, you may consult your doctor or nutritionist to prescribe the best diet for your condition

2. Exercise Regularly

Exercise helps to keep a check on the blood sugar. Check with your doctor about the recommended form of exercise during pregnancy and post-delivery. At least some form of moderate physical activity – around 30 minutes daily, like swimming, yoga and walking could be suggested and this will keep you fit and manage blood sugar.

3. Keep a check on your blood sugar

Since the amount of energy required by your body during pregnancy changes from stage to stage, the sugar levels change very frequently. It is important to monitor the blood sugar as advised by the doctor. You may be required to take insulin as well to control the blood glucose levels.

Get Tested for Diabetes after Pregnancy

Gestational diabetes may or may not go away post-delivery. It is important to get tested between 6 to 12 weeks post the delivery of your baby and every 1 to 3 years, thereafter. Diabetes may reappear in the form of Type 2 diabetes at a later stage. It is important that you follow a healthy and active lifestyle to prevent or delay this condition.

Getting the right prenatal care is very important. Apart from screening you for gestational diabetes a doctor can best advice on the healthy habits like food, activity and optimum weight that one must adopt in order to heave a healthy pregnancy. With the right guidance and adoption of a healthy lifestyle, you are good to go!!

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