Gestational diabetes : 6 things you need to know

About 1 in 11 people suffer from diabetes, which is one of the most common lifestyle diseases.

Therefore, we all know at least a little bit about it, the foods to avoid and the possible side effects. A close friend of mine delivered a baby girl after being diagnosed with gestational diabetes during her second trimester.I remember how she asked me about it since she assumed I had a medical background and a family full of diabetics, so I would also know about gestational diabetes.

As a result, there were only a few questions I could answer, which made me realize how little we know about a condition that affects about 9.2% of pregnancies.Due to her paranoia, my friend asked me to accompany her to her appointments with the gynecologist and endocrinologist.

The doctors were kind enough to explain to us in great detail, but there were still many questions that either we forgot to ask or went unanswered.

Her struggle with lack of information, stress and myths surrounding gestational diabetes continued until the time of her uneventful delivery. So that other women would not suffer from the same dilemma, I did some further research and suggested to my friend that she keep a close eye on her blood sugar levels.

The woman regularly checked her blood sugar at home with One Touch, and then started maintaining a strict diet chart to keep everything in check. I have even jotted down information on gestational diabetes for quick reference, to make sure I am completely informed and to be able to help other women I encounter.

Gestational Diabetes Mellitus [GDM] is four times more likely to occur in Indian women than in other women, making awareness of the disease all the more important.

Based on my research, here are six things everyone should know about gestational diabetes.

1. How does gestational diabetes develop?

During pregnancy, women can develop gestational diabetes, which usually goes away 4-6 weeks after childbirth.

Women who have gestational diabetes have high glucose levels during pregnancy.

Pregnancy-induced hormonal changes and other factors are believed to contribute to gestational diabetes.

Placental hormones can lead to an increase in blood glucose levels. The pancreas can usually handle that by making enough insulin. Otherwise, blood sugar levels rise and gestational diabetes can develop.

2. Risk factors for gestational diabetes

Factors that increase a woman's risk of contracting this condition include:

• These days, due to late marriages and career ambitions, it is very common to be older than 25 years old.

• Weight gain prior to getting pregnant is also very common.

• A history of gestational diabetes is also very common.

• Delivered an infant who weighed more than 9 pounds or 4kg in the past

• or has a parent or sibling with type 2 diabetes

• Personal experience with polycystic ovary syndrome (PCOS)

• Pre-diabetes, i.e. high blood sugar levels, but not high enough to be diabetic

3. How to diagnose Gestational diabetes

It is diagnosed through blood tests in the second half of pregnancy. A woman is usually tested between 24th and 28th weeks of pregnancy, but a doctor may decide to test earlier if there are risk factors present. Glucose challenge tests, glucose tolerance tests, and HBA1c tests are included. In addition, it is important to watch out for symptoms such as excessive thirst, hunger, and urination and inform your doctor.

4. Risk to the baby

Women with gestational diabetes who receive proper care and monitoring typically deliver healthy babies.

However timely diagnosis and management is necessary as there may be harmful effects on the fetus every month GD goes unnoticed.

Persistently elevated blood glucose levels throughout pregnancy can lead to -Elevated blood glucose levels in the fetus which can cause fetal overgrowth, possibly making delivery more complicated.

• Low blood glucose immediately after birth.

• Greater risk of jaundice

• Preterm birth and increased risk for respiratory distress

• A higher chance of stillbirth

• Greater risk of babies becoming overweight and developing type 2 diabetes later in life.

• If diabetes is present in an early pregnancy, there is an increased risk of birth defects and miscarriage compared to that of mothers without diabetes.

5. Effects of GDM on mother

Improper care, irregular monitoring and poor control can lead to –

Greater chance of needing a Cesarean birth (C-section), in part due to large infant size.

Increased risk of preeclampsia, a maternal condition characterized by high blood pressure and protein in the urine.

Increased risk of having type 2 diabetes after the pregnancy.

Most women with gestational diabetes who maintain normal blood sugar levels go on to deliver healthy babies.

After a baby is born, gestational diabetes usually goes away. Risk of developing Type 2 Diabetes can be reduced by following a good nutritional plan, exercising, and maintaining a healthy weight.

6. Prevention and management

There are no guarantees that gestational diabetes can be prevented but the more healthy habits before pregnancy, the better.

Eating healthy food which is rich in fiber and vitamins and low in fats and calories along with regular exercise to lose excess weight reduce the risk of developing GDM as well as risk of developing Type 2 Diabetes post pregnancy.

If you are diagnosed with gestational diabetes, what happens?

Doctors will likely recommend frequent checkups, especially during the last three months of pregnancy. Close monitoring of baby’s growth and development with repeated ultrasounds or other tests is an important part of the treatment plan.

Treatment includes:

Monitoring blood sugar: 

• The first step towards effective management is to constantly monitor glucose within the normal range.

• Patient may need to check blood sugar four to five times a day 

• Fasting blood glucose – right after waking up in the morning,

• After breakfast

• After lunch

• After dinner

• These testing periods are important because it allows knowing how efficiently the body's hormones are regulating the metabolism and uptake of glucose.

As a side benefit, knowing that you have to test makes you accountable for making healthier choices at each meal.

To keep glucose levels within a healthy range, a Gestational Diabetes sugar level chart should be maintained.

This may sound inconvenient and difficult, but gets easier with practice. Glucometers available now to give blood glucose readings are painless, nice and compact, and super easy to use.

Diet regulation and portion control: Based on personal information (weight and height) Body Mass Index (BMI) is calculated which is important to determine what would be a healthy weight gain for each pregnancy. Eating the right kinds of food in healthy portions is one of the best ways to control blood sugar and prevent too much weight gain for both mum and baby. A healthy diet focuses on foods that are high in nutrition and fiber and low in fat and calories and limit highly refined carbohydrates, including sweets.

Exercise: Regular physical activity plays a significant role in every woman’s wellness plan before, during and after pregnancy. Exercise lowers blood sugar by stimulating glucose to move inside cells, where it can be used for energy. Exercise also increases sensitivity to insulin, which means the body will need to produce less insulin to utilize the same amount of sugar.

As an added bonus, regular exercise such as walking can help relieve stress as well as some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping.

During pregnancy, all exercise should be done only with the consent of your doctor.

The woman may need insulin injections if diet and exercise are not enough to lower her blood sugar levels. However, only 10-20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Doctors may prescribe an oral blood sugar control medication, but some doctors feel oral drugs may not be as safe and as effective as insulin injections to control gestational diabetes.

Even though my friend was worried about her baby during pregnancy, there is a silver lining to every dark cloud. Due to regular monitoring and strict diet control, she did not gain excessive weight and even managed to come back to her pre-pregnancy weight quite easily.

Not being judgmental and even though it’s just a superficial comfort; when rest of life turns topsy-turvy with a little baby, it feels good to be back to your normal appearance.

Moreover, she swears that for someone like her who is anxious, it may have been difficult to go week after week, trusting God without actually knowing what the baby was doing.

In those last weeks of pregnancy, the additional monitoring at home and in the hospital helped her feel reassured that the baby was doing well.

Gestational diabetes is a serious condition that needs to be carefully managed; however, it does not mean one cannot enjoy pregnancy.

Women need to be kind to themselves if they have a condition that affects their unborn baby. It's important for family and friends to support and reassure the affected women that it's not their fault and can be managed with proper monitoring and care.

There is no truth to the myth that gestational diabetes means a big baby or a cesarean. With gestational diabetes, the vast majority of women can give birth vaginally without any interventions.

Having the right attitude, eating the right foods, and exercising regularly can lead to habits that not only make pregnancy easier, but will last a lifetime.