Diabetes during pregnancy is also known as gestational diabetes. Find out how gestational diabetes may affect you or your baby and what you need to do if you experience this condition while pregnant.
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What Is Gestational Diabetes?
So, gestational diabetes is in fact diabetes that certain women experience during pregnancy. Between 2% and 10% of future mothers suffer of this type of condition, making it among the most common and widely spread affections of this period. This medical condition happens in women while pregnant because their body fails to secrete sufficient insulin to maintain the level of blood sugar at a normal level. Glycemia increases and exceeds the normal limits anywhere between the 24th and 28th weeks of pregnancy.
Gestational diabetes is different from other types of this condition, namely type 1 and type 2, by the fact that it`s experienced only while pregnant. The other 2 types, as soon as they are developed, they stick through the entire life of the person who is affected. Thus, most women who develop gestational diabetes, get rid of it along with birth. The issue would be that these women are in danger of experiencing the condition again or, worse, developing this condition in one of its types which persist throughout the entire life.
Signs & Symptoms
You have reasons of concern and visit your doctor`s office for a test of your blood sugar level if:
- You are always thirsty, even if you have just drank a glass of water.
- You are urinating frequently (this isn`t always a symptom of urinary infection).
- You feel hungry more frequently than usual.
- You have the sensation of blurred vision.
It`s true that frequent urination is a common issue while pregnant, and the feeling of increased appetite is known to expecting mothers is a common sign without really having anything to do with diabetes, but only your doctor and a few specific investigation can say for sure if you have any reasons of concern.
Throughout pregnancy, the uterus develops the placenta which in turn supports the fetal development, makes the connection between the mother and her baby and offers nutrition to the baby. The placenta contributes to the hormonal secretion, and some of the hormones make it difficult for insulin in the body of the mother to keep the level of blood sugar within the normal limits.
Therefore, these hormones lead to an evolution of insulin resistance, various changes in glucose tolerance occur, and the body of the mother produces even more insulin in order to protect itself and reduce the levels of glucose and allow it to reach the cells as an energy source.
Generally, the expecting mother`s pancreas may produce a high insulin amount while pregnant (at least 3 times longer than before pregnancy) in order to balance the hormonal effects.
When the future mother`s pancreas isn`t able to produce insulin to reduce the effect of these pregnancy-related hormones, an increase in blood glucose is achieved and, therefore gestational diabetes is installed.
Gestational diabetes may affect you more frequently when pregnancy is advanced or in the 2nd half of pregnancy when the body of the baby is already formed and is developing. However, if you experience high blood sugar at the onset of pregnancy, meaning the diabetes wasn`t diagnosed or was diagnosed improperly, then there`s a high risk of miscarriage or birth defects in the baby.
If you leave it untreated or don`t control it adequately, the baby might suffer. Your pancreas is forced to secrete more insulin, but it doesn`t manage to lower the levels of blood glucose. Although insulin doesn`t pass the placenta, glucose as well as other nutrients manage to pass.
Therefore, the baby will have an increased level of blood glucose, and his pancreas will secrete even more insulin in order to get rid of the additional amount of glucose. This means that the little one will have more energy than it requires to develop, which will be stored as fat.
Babies who are too fat may develop severe problems, like shoulder issues caused during delivery, and the mother might experience hypoxia, prolonged labor and injuries at birth. A deficient neurological development might be a severe side effect of hypoxia.
If you experience from hyperglycaemia in the 2nd half of pregnancy, diabetic fetopathy might be an illness of several neonatal disorders:
- Excessive birth weight.
- Electrolyte disorders.
- Hypertrophy of organs or tissues where the metabolism of glucose is dependent of insulin.
- Pulmonary immaturity.
- Excessive fattening.
Also, the baby might experience breathing issues. Babies with excessive insulin secreted later become children with an increased obesity risk, and adults might be diagnosed with type-2 diabetes. Excessive weight gain and overweight should be avoided as much as possible from the first month of the baby`s life.
In the case of diabetes that were left untreated, the baby gets too much glucose from his mother, so he`ll produce insulin in excess and risk developing hypoglycemia during the perinatal period. This is also it has to be checked the blood sugar of the baby in his early hours of life. And if the mother experience diabetes or if the level of glucose is too low, she needs to have glucose administered to her.
This condition can also occur on the last 100 meters as well. It you notice you at the limit, you should test yourself more often.
If you experience mild hyperglycemia in your last pregnancy weeks and don`t keep it under control, there`s even the risk for your baby to die in the womb. An average glucose on a daily basis causes leads to frequent cases of macrosomia, reduced levels of calcium and high level of bilirubin.
Birth complications, like induced birth, the necessity of C-section, perinatal haemorrhage, perinatal lesions, might occur as well. There`re frequent cases of preeclampsia and high blood pressure.
All this shouldn`t frighten you, but rather help you figure it out how essential is to diagnose this illness and treat it accordingly in order to give birth to a healthy child despite your medical condition.
Here are a series of questions that you need to think about to find out if you have any reasons of concern regarding the possibility of suffering of gestational diabetes.
- Do you have an excessive weight?
- Do you have relatives who suffered of diabetes?
- Do you over 35 years old?
- Did you gain too much weight in the first 6 months of pregnancy? At the beginning of your pregnancy, your doctor will tell how much more weight is normal for you to gain.
- Did you received a polycystic ovarian diagnosis or did I had other conditions associated problems regarding insulin production?
- Did I ever have high blood sugar before pregnancy?
- Did you generally have high blood sugar, heart issues or high cholesterol?
Regarding any previous pregnancies:
- Did you ever experience gestational diabetes?
- Did you experience a pregnancy loss?
- Did your previous baby/babies have more than 4 pounds at birth?
The test for gestational diabetes is known as the oral glucose tolerance test and is done between the 24th and 28th weeks of pregnancy.
You`ll have to visit your doctor to do this particular test. You shouldn`t eat or drink anything the night before and in the morning. A nurse will take a blood sample to have your blood sugar`s basal level. Then you have to consume a drink based on sugar and after 1 -2 hours, the same nurse will take a blood sample again to see how your body responded to the glucose load.
Therefore, the oral glucose tolerance test involves 3 levels of blood glucose:
- Without eating (normal <92 mg/dl).
- At 1 hour (normal <180 mg/dl).
- 2 hours after ingestion of 75 g glucose (normal <153 mg/dl).
According to American Diabetes Association, it`s considered that a patient suffers of diabetes if at least one of the 3 levels of blood glucose is greater or equal to the established threshold.
There aren`t any certain ways of preventing the occurrence of this condition. However, adopting some healthy nutritional habits, practicing at least 30 of moderate physical exercises, maintaining your weight in normal parameters and eliminating any excessive weight before pregnancy might help a lot in preventing gestational diabetes.
Some experts recommend adopting a healthy diet, which should follow the nutritional requirements of a pregnant woman. Moreover, there are some changes in the lifestyle to be made for the blood sugar to be maintained in acceptable limits. Most anti-diabetic drugs aren`t recommended during pregnancy. The treatment with insulin is reserved only in cases in which changing the lifestyle isn`t enough for a proper glycemic control.
Controlling Gestational Diabetes
- Monitoring the blood sugar 4 times per day (before breakfast and 2 hours after the meals);
- Monitoring the level of ketones in the urine
- Following some food recommendations – for instance, equal distribution of calories throughout the day;
- Physical activity – following the doctor`s recommendation;
- Weight control;
- Insulin administration, if the case requires. Insulin is presently the only treatment used during pregnancy.
- Hypertension control.
Blood Sugar Monitoring
Measuring the blood sugar a few times per day is useful for determining the efficiency that the lifestyle change has in controlling the blood sugar, or if the pregnant woman requires insulin administration to protect the fetus. The doctor will recommend keeping a daily food diary and measuring the blood sugar at home. Therefore, the measure in which the blood sugar can be controlled efficiently will be able to be evaluated and it will be made a decision regarding the necessity of performing some changes in the treatment plan. The purpose of monitoring is maintaining the blood sugar as close to normal as possible.
|The Time of the Test||Target Blood Glucose Values|
|Before breakfast||2 hours after your meal|
|Under 95 mg/dl||Under 120 mg/dl|
Physical exercises decreases blood sugar because it transports glucose to cells, where is used for energy production. Also, physical exercises increase the sensitivity to insulin, meaning that the organism requires a smaller amount of insulin to transport glucose to cells. Moreover, if practiced regularly, exercises may reduce some issues during pregnancy: constipation, insomnia, back pain and muscle cramps. Swimming, aerobic exercises and walking are recommended during pregnancy (depending on your case, the consultation of a doctor may be required). – Click this link!
If nutrition and physical exercises aren`t enough in controlling the blood sugar efficiently, insulin administration for decreasing the level of blood sugar is another option.
What Can I Eat If I Have Gestational Diabetes?
Nutrition is the first basic requirement regarding the treatment of this illness. As a general rule, besides the standard instructions regarding glycemic control and monitoring, the doctor will advise you a visit to a nutritionist who will establish you a diet that you`ll have to adopt. There`ll be a regime which respects all the theories regarding your condition, while allowing a normal baby development, which in turn will need a proper caloric and nutrient amount.
Your height and weight will be taken into consideration when you`ll receive recommendations regarding the number of calories you have to consume on a daily basis. When an average weight is concerned, the number will be anywhere around 2,200 to 2,500 calories/day. If you have an excessive weight, 1,800 calories per day will probably be sufficient.
Here`s how to slit a well balanced menu:
- 10% – 20% of calories need to come from proteins from vegetable sources, like beans, chickpeas or mushrooms, or animal sources, like meat, eggs, seafood or dairy.
- 30% of calories could be sourced from fat.
- 10% of calories could come from saturated fat.
- 40% of calories can come from carbs, like cereals, rice, bread, pasta, fruits and vegetables.