Pregnancy is always a time of anxiety, excitement, apprehensions and of course pure unadulterated joy for most moms – even if it’s not their first time.Being diagnosed with gestational diabetes in the midst of this seemingly erratic time in your life can be overwhelming to say the least. But even after all the hundreds of blood tests, visits to the doctor, low carb snacks and missed pizzas, you have something amazing to look forward to, something which makes all of the above worth it – your “sweet” bundle of joy.
And it’s for your baby, that taking care of yourself during pregnancy with gestational diabetes is very important. The good news is that gestational diabetes can be controlled by healthy eating, exercising, and, if necessary, taking medications. Yes, you will be regulating and monitoring yourself a little more than you usually would during a normal pregnancy – but doing so can not only help you and your baby but also reduce your chances of developing Type 2 diabetes after giving birth.
What is Gestational Diabetes?
Being aware of the condition you are living with will help you tackle it all the better. So what exactly is gestational diabetes? Simply put, it’s a condition which can develop in expectant mothers between week 24- 28 of their pregnancy in which your body is not able to effectively process glucose. Glucose is a kind of sugar which comes from digested carbohydrates and which serves as the main energy source for the body.
Glucose moves from the digestive system into the bloodstream then travels throughout the body. A hormone called insulin (made by the pancreas) then carries glucose into cells where it is used for energy. In effect, insulin lowers the amount of glucose in the blood.
During pregnancy, the placental hormones can cause a condition known as insulin resistance. In this situation, to maintain normal blood glucose, the body will need to make more insulin so that glucose can enter the cells from the bloodstream. In women with gestational diabetes, the body fails to produce this extra amount of insulin needed. Therefore, the blood glucose level is high.
Who’s at Risk?
Gestational diabetes is more prevalent in women who:
- Are over the age of 25 years.
- Are overweight or obese.
- Has a family history of diabetes.
- Give birth to overweight baby before.
- Had gestational diabetes in previous pregnancy.
- Has previously been diagnosed with a hormonal disorder called polycystic ovary syndrome, also known as PCOS.
Just like every pregnancy is different so is everyone’s chances of developing gestational diabetes. Many women may get it in their first pregnancy and others in their fourth or fifth. There are usually no symptoms for gestational diabetes. It is detected using an oral glucose tolerance test (OGTT) which involves checking your fasting blood glucose level and also 2 hours after a standard glucose drink. If you have a higher risk of developing gestational diabetes like having had it in a previous pregnancy or a family history of diabetes, your doctor may conduct this test at the beginning of your pregnancy.
How can gestational diabetes affect me and my baby?
If managed efficiently, your pregnancy can go off without a hitch despite gestational diabetes. However, it is important to be aware of the complications that gestational diabetes can cause so you can work towards preventing them.
Gestational Diabetes and your baby
If left untreated or not controlled properly, gestational diabetes can lead to your baby:
- Developing macrosomia which means he/she may be larger than usual.When extra sugar is in your blood, the baby is “fed” extra sugar too. All this excess sugar can make the baby too big & fat and this can cause issues during delivery such as damage to the baby’s shoulders.
- Having low blood glucose (hypoglycemia) at birth. Because your baby is getting extra sugar, your baby’s pancreas make extra insulin.After birth,it’s hard for the baby to stop putting out extra insulin so the baby must be watched & treated in case the blood sugars drop too low.
- Being born premature.
- Developing a breathing problem known as respiratory stress disorder.
Babies of gestational diabetes pregnancies also have a higher risk of developing Type 2 diabetes later on in life. It’s therefore important to keep monitoring your baby closely with the help of your doctor.
From time to time, you may be asked to come in for ultrasounds, non stress tests ( which monitor your baby’s heartbeat when he/she is active) and kick counts to see if the baby’s movement is at regular intervals. It is always a time of change.Your body is changing as the baby grows. Because you have diabetes, these changes will affect your blood sugar level. Pregnancy can also make symptoms of low blood sugar hard to detect. During pregnancy, your Diabetes control will require more work. The blood sugar tests you do at home are a key part of taking good care of yourself & your baby before,during and after pregnancy.
Gestational Diabetes and You
Gestational diabetes can put you at a higher risk of:
- Developing preeclampsia, a condition in which you may have high blood pressure and elevated amounts of protein in your urine. Preeclampsia develops in the later part of your pregnancy and the only way to stop it is to give birth which may mean an emergency c-section in the case of many women.
- Developing type 2 diabetes after birth. It is thus very important to closely regulate your diet and exercise even after the baby is born to reduce your risk of type 2 diabetes.
- Having a c-section rather than a normal birth because the baby is too large
How do I control gestational diabetes?
Controlling gestational diabetes means keeping your blood glucose levels in check. Your doctor will ask you to check your blood glucose several times a day to ensure they are within range. It is crucial to keep up with checking your glucose levels as that is the main indicator of how your body is handling gestational diabetes.
Here is a rough guideline of what your numbers should look like. You should, however, consult with your doctor about the blood glucose level targets he/she would like to set for you.
|Blood Glucose Targets for Women with Gestational Diabetes|
Time of Day
Before meals and when you wake up
|95 or lower (5.3 mmol/L)|
1 hour after eating
140 or lower (7.8 mmol/L)
|2 hours after eating||
120 or lower (6.7 mmol/L)
To keep your glucose in check you will have to make sure to:
- Make sure you are eating healthy, take help of a registered Dietitian who can change your meal plan as your needs change during and after pregnancy.
- Get enough exercise ( as is permissible for pregnant women and directed by your doctor)
- Take your medication/insulin on time
What should I do to prevent myself from developing Type 2 diabetes?
Lifestyle changes will be key in preventing you for developing type 2 diabetes after the birth of your child.
- Try to maintain a healthy weight after birth. If you are overweight, aim to not put on too much weight during pregnancy to keep your blood glucose levels within a normal range.
- Keep up with your physical activity. Being active for even 30 minutes which can be divided into 2-3 times a day can help you stay healthy.
- Eat healthier. Focus on eating fresh foods like fruits, grains and vegetables and aim to cut out processed foods from your diet.
- If your doctor prescribes you medication such as metformin, make sure to take it regularly.
Remember, avoiding type 2 diabetes in future also means avoiding other related health issues such as heart disease and obesity.