Gestational Diabetes during Pregnancy
If you have gestational diabetes during pregnancy it is advised that you consult a nutritionist that specializes in gestational diabetes. Your Doctor will be able to refer you to a nutritionist in your local area.
To effectively manage gestational diabetes, it is important that you control your blood glucose levels.
You can do this by maintaining a healthy diet as well as participating in a regular moderate intensity exercise program in consultation with your doctor.
What is Gestational Diabetes?
Gestational diabetes is a form of diabetes that occurs during pregnancy and usually goes away after the baby is born. It is diagnosed when higher than normal blood glucose levels first appear during pregnancy.
Statistics show that gestational diabetes is becoming more prevalent.
Between 5% – 10% of pregnant women will develop gestational diabetes and this usually occurs around the 24th to 28th week of pregnancy.
How Will I Know if I have Gestational Diabetes?
All women are tested for gestational diabetes as part of the 24-28 week routine examination with their GP.
If you live in a country where you do not receive such regular check-ups then it would be advised to speak directly to your doctor about being tested for gestational Diabetes.
Women who have one or more of the risk factors are advised to have a diabetes test when pregnancy is confirmed then again at 24 weeks if diabetes was not detected in early pregnancy.
Most women are diagnosed after special blood tests. A Glucose Challenge Test (GCT) is a screening test where blood is taken for a glucose measurement one hour after a glucose drink.
If this test is abnormal then an Oral Glucose Tolerance Test (OGTT) is done. For an OGTT a blood sample is taken before and two hours after the drink.
What Causes Gestational Diabetes?
When you are pregnant the placenta produces hormones that help your baby to grow and develop. These hormones also block the action of the mother’s insulin. This is called insulin resistance.
Because of this insulin resistance, the need for insulin in pregnancy is 2 to 3 times higher than normal.
If you already have insulin resistance, then your body may not be able to cope with the extra demand for insulin production.
And the blood glucose (sugar) levels will be higher resulting in gestational diabetes being diagnosed.
Risk Factors May Increase Gestational Diabetes:
1. Have a family history of gestational diabetes.
2. Previously had Polycystic Ovary Syndrome.
3. You have had gestational diabetes during previous pregnancies.
4. Are from a Vietnamese, Chinese, middle eastern, Polynesian or Melanesian background.
5. Are from an Indigenous Australian or Torres Strait Islander background.
6. Are overweight or obese.
7. Are over 30 years of age.
8. Have a family history of Type II Diabetes.
Symptoms of Gestational Diabetes
When you are pregnant you will experience all types of changes both mentally and physically and the when it comes to Gestational diabetes there are often no real obvious symptoms.
The best way to see if you have gestational diabetes is to visit your doctor for some tests.
If symptoms do occur, they can include:
- Unusual thirst
- Excessive urination
- Thrush (yeast infections)
Gestational Diabetes Video
Source: American Diabetes Association
How Do They Diagnose of Gestational Diabetes?
You will be advised by your doctor to have a pathology test which requires a blood sample to be taken before and after a glucose drink.
These tests are usually performed between 24 and 28 weeks into the pregnancy, or earlier if you are at high risk.
To diagnose gestational diabetes a pregnancy oral glucose tolerance test (POGTT) is recommended which involves taking a blood test after fasting overnight.
Next you have a drink containing 75 grams of glucose and blood is taken to be tested one and two hours afterwards.
Diagnosis of gestational diabetes is made if the fasting blood glucose is raised or the two-hour blood glucose is raised (or both).
What Happens Next if I Am Diagnosed with Gestational Diabetes?
Firstly, you will want to seek more information and your doctor will be your best resources to answer any specific questions you may have.
It is important to know that the majority of women with gestational diabetes have a healthy pregnancy, normal delivery and a healthy baby.
The treatment is healthy eating, physical activity and monitoring and maintaining a normal blood glucose level while you are pregnant.
Which is why PregActive takes a holistic approach to improving your overall health and wellbeing.
The Diabetes Team May Include:
The professional help you receive will depend on where you live and the medical services available. Often your antenatal care will include:
1. An endocrinologist who is a doctor that specialises in diabetes.
2. A diabetes educator who will educate you on how to monitor and manage your blood glucose levels.
3. A dietitian who will help you with a healthy food plan for your pregnancy.
4. Your doctor or General Practitioner (GP).
Gestational Diabetes Treatment
Gestational diabetes can often be managed with healthy eating and regular physical exercise or activity. For some women with gestational diabetes they will require daily insulin injections for the rest of the pregnancy.
The goal for Gestational diabetes treatment is to keep blood glucose levels equal to those of pregnant women who do not have gestational diabetes.
You will need help from your health care professional so that your treatment for gestational diabetes can be monitored, tested and changed as required.
By being able to successfully manage your gestational diabetes you will be increasing the likelihood of a healthy pregnancy as well as helping your baby avoid future poor health.
You will also be doing your part to avoid developing diabetes post-pregnancy and later on in life.
1. Eat a Healthy Diet
Eating a healthy diet when pregnant will benefit both you and your growing baby.
Eating will combined with regular activity will also assist you in maintaining a health pregnancy weight.
You will want to consume foods rich in calcium, iron, and folic acid. You should also avoid foods and drinks containing a lot of added sugar.
Your Dietitian will be able to provide you with specific guidelines on what you should and should not be eating.
2. Exercise Regularly
You need to control your blood glucose levels. Be sure to check with your doctor before starting a new prenatal exercise program.
3. Maintain a Healthy Pregnancy Weight
Through healthy eating, exercising and making the right lifestyle choices can help you to maintain a healthy pregnancy weight.
It is only normal to gain weight when pregnant but what is not ideal is when you gain too much weight that directly impacts not only on your health but also that of your growing baby.
4. Monitor Glucose Levels
It is essential that you continue to monitor your blood glucose levels as it will help show you if the healthy lifestyle changes you have made are effective or whether further treatment is required.
5. Take Required Medication
You may be required to take regular insulin injections to help keep your blood glucose level in the normal range.
Why Does Gestational Diabetes Need To Be Treated?
If a mother’s blood glucose levels are high then glucose passes through the placenta to the baby which may lead to the baby growing larger than the average baby.
Giving birth to larger babies can potentially cause more problems for both the mother and child during and following birth.
Another concern is that if gestational diabetes goes untreated then it can also lead to a greater likelihood of developing high blood pressure during the pregnancy which poses some additional health problems.
How Does Gestational diabetes Affect the Birth?
Your diabetes will be continually monitored throughout the pregnancy using tests such as an ultrasound, blood glucose and blood pressure.
If your diabetes has been well managed and there are no other problems then you should be able to go ‘full term’ and give birth naturally.
This again will be based on the advice of your doctor for your specific situation.
If the baby grows too large or if your doctor has any other concerns about the pregnancy they may suggest ‘inducing’ the birth one or two weeks early.
Sometimes a caesarean may be required if the baby is too large or if there are other obstetric concerns such as low placenta, breech presentation or previous caesarean delivery.
What Happens after My Baby is Born?
For most women their blood glucose levels usually return to normal quite quickly after the baby’s birth.
If you have been having insulin injections to help manage gestational diabetes, you can usually stop these injections once your baby is born. Your doctor will advise you on your specific situation.
Following the birth of your baby your blood glucose levels will be measured for a few days to ensure that they are within the normal range.
You will often be tested before breakfast and two hours after meals.
An Oral Glucose Tolerance test (OGTT) is done six to eight weeks after the baby is born to make sure that diabetes has gone away.
Following the birth of your baby, it is likely that your baby’s blood glucose levels will also be measured to make sure that their blood glucose is not too low.
If it is, this can be treated by feeding your baby breast milk or formula.
Breastfeeding is encouraged as this is best for you and your baby.
A baby whose mother had gestational diabetes will not be born with diabetes, but, they may be at risk of developing type 2 diabetes later in life.
What Happens if I Want to Get Pregnant in the Future?
If you have been diagnosed with gestational diabetes you are more likely to have it again in future pregnancies.
Your doctor will be aware of this and will likely request that an OGTT (Oral Glucose Tolerance Test) be performed early in any future pregnancy to look for gestational diabetes.
If this test is normal, then another OGTT will be done again later in the pregnancy (22 and 28 weeks) to make sure blood glucose levels are still normal.
How Does A Healthy Eating Plan Help Manage My Gestational Diabetes?
When you eat a healthy diet you will be able to:
- Manage your blood glucose levels within the target range advised by your doctor.
- Provide adequate nutrition for you and your growing baby.
- Achieve appropriate weight changes during your pregnancy.
How will a Dietitian Change My Diet?
A Dietitian will advise you on:
- Which foods you should eat.
- Which foods you shouldn’t eat.
- How much you should be eating.
- How often you should eat.
Avoid High Sugar Foods and Drinks
These quick and easy, and yes tasty foods; contain simple sugars that are easy for your body to absorb which can quickly raise your blood sugar.
Try and avoid fruit juice because it can raise blood sugar quickly. Your will also want to avoid cakes, cookies, candies, honey and pastries.
How Can I Improve My Diet?
1. Eat a good breakfast
It is important that you eat a good breakfast as it can help regulate your blood sugar levels throughout the morning.
Your Dietitian will advise you on what to eat but you should try to have a low-GI breakfast. You will want to avoid the high GI foods such as sugar-coated cereals or white toast and jam can quickly raise your blood sugar levels.
2. Variety is Important!
Your diet should contain a variety of approved foods otherwise you will struggle to stay disciplined if eating the same meal all the time.
3. Eat High-Fibre Foods
High-fibre foods tend to have a low GI and may help to keep your blood sugar levels from going too high after meals.
4. Continue to Eat at Regular Intervals
Your goal is to eat balanced meals at regular intervals each day and have the same amount of food at each one. This will help your blood sugar to stay more stable.
5. Keep a Food Diary
You will likely be asked to keep a record all of the foods and the amount that you eat each day as it will help you monitor your carbohydrate intake.
When you present your diary to your Dietitian they will be able o provide advice on how you are going.
The information in this post is for educational purposes only. It is not intended to replace the advice of your nutritionist, doctor or health care provider.