Gestational Diabetes During Pregnancy
You’ve just found out from your health practitioner that you have gestational diabetes from a simple glucose tolerance test. Should you be concerned that you’ve been diagnosed with gestational diabetes? Yes. It means that you will need to take good care of your health by watching your diet to keep you and your baby in good health.
What is Gestational Diabetes?
Gestational diabetes is a condition developed during pregnancy, and is only a type of diabetes that non-diabetic women develop. Approximately 2 to 7 percent of expectant mothers develop this condition and is one of the most common health problems experienced during pregnancy.
Typically in your stomach and intestines, carbohydrates found in your food is turned into a sugar called glucose. Glucose is your body’s main source of energy and is transported to your body’s cell by a hormone produced by your pancreas (insulin). In diabetes, either your body is unable to meet demands and produce enough insulin to remove glucose from your blood or your cells cannot use it in the way they should. The glucose ends up building up in the blood, causing high blood sugar, otherwise known as diabetes. Some think that the woman is developing the right amount of insulin, but the effect of insulin is blocked partly by a variety of other hormones produced in greater amounts during pregnancy: progesterone, prolactin, estrogen, cortisol and human placental lactogen – which are made in the placenta. As the placenta grows, these hormones are produced in greater amounts.
Only 5 percent of pregnant women develop gestational diabetes, which is about 200,000 cases a year in the United States. Your risk for gestational diabetes increases with age and is more common among women who become pregnant after the age of 25, who are obese or overweight, have high blood pressure, or have a family history of diabetes. If you’ve had gestational diabetes in the past, you will also be at higher risk with the next pregnancy.
In addition, Native American, Hispanic, African American, South or East Asian, Pacific Islander or Indigenous Australian descents are more likely to have the condition.
The exact cause for gestational diabetes is unknown, but there are some clues. The placenta supports the baby as it grows in the uterus. Hormones from the placenta help the baby develop but but also block the action of the mother’s insulin in her own body. The insulin resistance makes it hard for the mother’s body to absorb the sugar and use insulin in the correct way. She may instead need up to 3 times as much insulin. If the woman’s body is unable to make and use all the insulin it needs for pregnancy, then the pregnant woman develops gestational diabetes. Without enough insulin to transport glucose to the body’s cell it cannot leave the blood and be converted into energy. The glucose will build up in the mother’s blood to high levels inducing hyperglycemia.
Gestational diabetes affects moms-to-be in late pregnancy, after the body of the baby has formed but is still continuing to grow. For this reason, gestational diabetes does not cause birth defects similar to women who had diabetes early or before pregnancy. But, left untreated or poorly controlled, gestational diabetes can hurt your baby. Your pancreas will be working overtime to produce insulin, but the insulin will be unable to lower the glucose levels in the blood. Insulin doesn’t cross the placenta, but glucose and other nutrients will and will cause the baby’s pancreas to compensate to make extra insulin. Since the baby is now getting more energy than it needs to grow and develop, the extra energy is converted and stored as fat. Thus, gestational diabetes can increase the size of the baby which may require a c-section when the baby is due.
Very few women actually need insulin injections when they have Gestational Diabetes (Gestational Diabetes Mellitus) if a proper diet plan is followed. The disease used to be a sneaky one until tests were introduced to screen all pregnancies (1 hour blood glucose drink). If the first test is failed, then a full 3 hour glucose gestational diabetes test is taken after a night of fasting. This test will determine for your doctor if you really do have gestational diabetes.
How will Gestational Diabetes Affect My Baby?
Most women who have gestational diabetes will go on to deliver a healthy baby, due to careful control of their blood sugar, finding a gestational diabetes meal plan, exercising and maintaining a healthy weight.
There are potential risks:
- Gestational Diabetes and Baby. (Excess growth) The extra glucose that crosses the placenta will trigger your baby’s pancreas to make more insulin and cause your baby to grow large (macrosomia). A large baby can bring complications to the delivery room as the baby can get wedged in the birth canal. A Cesarean birth will be more likely for women with gestational diabetes.
- Gestational Diabetes and Blood Sugar. (Low blood sugar) – Some babies with mothers with gestational diabetes can develop low blood sugar (hypoglemia) shortly after birth due to their own insulin production being high. Severe episodes of the problem may cause seizures in the baby. Prompt feeding and intravenous glucose solution can return your baby’s blood sugar level to normal
- Jaundice – Yellow discoloration of the skin and the whites of the eyes may occur if the baby’s liver isn’t mature enough to break down bilrubin, which is formed to recycle old or damaged red blood cells. Jaundice in itself isn’t a big concern, but must be watched with careful monitoring.
- Respiratory distress syndrome – If your baby is delivered early, a condition called respiratory distress syndrome can happen which causes difficult breathing. Babies born to women who have gestational diabetes, typically have more breathing problems than babies born at the same gestational age.
- Developmental problems – If you have gestational diabetes, your child may have an increased risk of motor skill development, such as jumping, walking or other activities that require balance and coordination. There is also an increased risk of attention problems or hyperactivitiy disorders.
- Preeclampsia - Gestational diabetes increases the risk of preeclampsia,, a condition characterized by high blood pressure and excess protein in the urine after the 20th week of pregnancy. If left untreated, the preeclampsia can lead to serious or even life-threatening complications for both mom and baby.
- Urinary Tract Infections (UTIs) – Women with gestational diabetes experience twice the number of urinary tract infections during pregnancy than other pregnant women, possibly due to the excess glucose in the urine.
- Future diabetes – If you have gestational diabetes, you have an increased risk of developing the condition in future pregnancies and type 2 diabetes when you get older. However, making lifestyle changes like eating healthy food and exercising can help reduce the risk of future type 2 diabetes. Women who have a history of gestational diabetes and have reached their ideal body weight after delivery, fewer than 25 percent will develop type 2 diabetes.
Managing Gestational Diabetes Diet
To help maintain a “normal” blood sugar level (60 to 120 mg/dl):
- Avoid sugar and foods high in sugar
- Eat complex (not simple) carbohydrates such as pasta, cereals, crackers, bread, potatoes, peas, rice, grains and dried beans.
- Avoid saturated fats such as butter, bacon, cream and whole milk cheese, and fatty meats
- Eat a snack before bedtime that is high in protein and carbohydrate based.
- Eat fiber-rich foods such as breads, fruits, vegetables and whole grain cereals.
Talk with your doctor about what type of exercising program is right for you. Women are typically encouraged to get at least three to four days a week, with each session lasting 15 to 30 minutes. Pregnant women should not take on very strenuous activity and should not become overheated.
If a woman is at a desirable weight for her body size and height, a weight gain of 25 to 35 pounds is recommended. For a woman who is 20 pounds overweight, a weight gain of 20 to 24 pounds is recommended. If she is underweight, then a weight gain of 28 to 36 pounds is recommended. Although, it depends on how underweight the woman is before getting pregnant.
After the Baby is Born
Blood sugar levels can return to normal quickly after the baby is born. About six weeks after the birth, you should get another blood test to check your blood sugar levels, which will also check for your risk of developing diabetes in the future.
Children born to women who had gestational diabetes have a higher risk for obesity, diabetes and an abnormal glucose tolerance. For the mom, there is a higher chance of developing type 2 diabetes later in age.
By eating a healthy diet and exercising regularly, you and your baby will both benefit.
More Information About Gestational Diabetes
Gestational Diabetes Diet – Gestational Diabetes and Blood Sugar Levels
Gestational Diabetes and Baby – Gestational Diabetes Meal Plan – Looking Ahead, After the Delivery
Page maintained by Susan Suarez
Page maintained by Susan Suarez