Gestational Diabetes FAQs
Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes. According to a 2014 analysis by the Centers for Disease Control and Prevention, the prevalence of gestational diabetes is as high as 9.2%.
We don’t know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin. She may need up to three times as much insulin.
Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels. This is called hyperglycemia.
How will I know if I have gestational diabetes?
Gestational diabetes usually has no symptoms. That’s why almost all pregnant women have a glucose-screening test between 24 and 28 weeks.
However, if you’re at high risk for diabetes or are showing signs of it (such as having sugar in your urine), your caregiver will recommend this screening test at your first prenatal visit and then repeat the test again at 24 to 28 weeks if the initial result is negative.
By the way, if you get a positive result on a glucose-screening test, it doesn’t necessarily mean that you have gestational diabetes. It does mean that you’ll need to take a longer follow-up test (a glucose tolerancetest, or GTT) to find out.
How can I tell whether I’m at high risk for gestational diabetes?
According to the American Diabetes Association, you’re considered at high risk for this condition (and should be screened early) if:
- You’re obese (your body mass index is over 30).
- You’ve had gestational diabetes in a previous pregnancy.
- You have sugar in your urine.
- You have a strong family history of diabetes.
Some practitioners will also screen you early if you have other risk factors, such as:
- You’ve previously given birth to a big baby. You’ve had an unexplained stillbirth.
- You’ve had a baby with a birth defect.
- You have high blood pressure.
- You’re over 35.
What will I need to do if I have gestational diabetes?
You’ll need to keep diligent track of your glucose levels, using a home glucose meter or strips. To keep those levels where they should be, you’ll want to:
Eat a well-planned diet. The American Diabetes Association recommends getting nutritional counselling who’ll help you develop specific meal and snack plans based on your height, weight, and activity level.
Your diet must have the correct balance of protein, fats, and carbohydrates, while providing the proper vitamins, minerals, and calories. Eating the right kinds of food in healthy portions is one of the best ways to control your blood sugar and prevent too much weight gain, which can put you at higher risk of complications. To keep your glucose levels stable, it’s particularly important that you don’t skip meals, especially breakfast, and that you avoid sugary items like candy, cookies, cakes, and soda.
Your doctor can help you set weight gain goals based on your weight before pregnancy.
A healthy diet focuses on fruits, vegetables and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and limits highly refined carbohydrates, including sweets.
Exercise. Regular physical activity plays a key role in every woman’s wellness plan before, during and after pregnancy. Studies show that moderate exercise also helps improve your body’s ability to process glucose, keeping blood sugar levels in check. Many women with gestational diabetes benefit from 30 minutes of aerobic activity, such as walking or swimming, each day. Ask your practitioner what level of physical activity would be beneficial for you. As an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping. Exercise can also help get you in shape for the hard work of labor and delivery.
Take medication if necessary. If diet and exercise aren’t enough, you may need insulin injections to lower your blood sugar. About 15 percent of women with gestational diabetes need medication. Some doctors prescribe an oral blood sugar control medication, while others believe more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.
Close monitoring of your baby. An important part of your treatment plan is close observation of your baby. Your doctor may monitor your baby’s growth and development with repeated ultrasounds or other tests. If you don’t go into labor by your due date — or sometimes earlier — your doctor may induce labor.
Dr. Rajiv Kovil
Consultant Diabetologist, Dr. Kovil’s Diabetes Care Centre
Dr. Rajiv Kovil is a Consultant Diabetologist at Dr. Kovil’s Diabetes Care Centre, the first Preventive Diabetes Centre & Diabetic Foot Clinic in Mumbai, KLS Memorial Hospital and Holy Spirit Hospital among others. He is a founder member of United Diabetes Forum, a forum of practising diabetologists in India. He has also written various articles on diabetes for medical journals such as Asian Journal of Diabetology and Medical Image. His Preventive Diabetes Centre & Diabetic Foot Clinic is an initiative to provide preventive diabetic measures as well as to function as a specialized Foot Clinic for diabetic patients not only in terms of equipment but more importantly in terms of expertise.
You may also like reading:
- How Diabetes during pregnancy affects the baby
- Criteria for diagnosing Gestational Diabetes
- All you need to know about Gestational Diabetes
- What not to do when you have diabetes
- Risks and complications of diabetes
- Diagnosis and treatment of diabetes
- Causes and symptoms of Diabetes (Types 1&2)
- Types of diabetes in India
- Are you at risk for diabetes?
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