Gestational Diabetes during Pregnancy
Gestational diabetes during pregnancy is quite common and usually resolves after the baby is born. Please always speak to you doctor if you have specific questions.
If you do have gestational diabetes then you will need to work closely with a Dietitian who will advise you on what to eat, what not to eat and provide you with a guided plan.
There are many common questions that arise for women who have been diagnosed with diabetes during pregnancy surrounding treatment and if there are any future health concerns.
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 where between 5% – 10% of pregnant women will develop gestational diabetes and this usually occurs around the 24th to 28th week of pregnancy.
What causes gestational diabetes during pregnancy?
One of the most searched questions in Google by pregnant women is: What causes gestational diabetes during pregnancy?
My goal with this post is to provide you with some answers to the most common questions. As always if you have gestational diabetes it is advised that you consult your doctor or a nutritionist.
The placenta produces hormones that supports the baby to grow and develop during pregnancy. These hormones also block the action of the mother’s insulin.
This is called insulin resistance. The need for insulin in pregnancy may be 2 or 3 times higher than normal because of this insulin resistance.
Gestational diabetes develops if the mother’s body is unable to produce the extra insulin. After delivery the insulin requirements return to normal and the diabetes usually resolves.
Who is at increased risk?
Risk factors of developing gestational diabetes are:
- Increasing maternal age – over 30 years.
2. Family history of type 2 diabetes.
3. Overweight or obesity.
4. Indigenous Australians.
5. Certain ethnic groups – Indian, Chinese, South East Asian, African women.
6. Previous gestational diabetes.
7. Previous difficulty carrying a pregnancy to term.
8. A twin or triplet pregnancy.
9. Women who have had Polycystic Ovarian Syndrome.
How is gestational diabetes diagnosed?
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.
How will diabetes affect my baby?
As gestational diabetes usually develops around the 24th to 28th week of pregnancy,the baby’s development is not affected. However, as glucose crosses the placenta, the baby is exposed to the mother’s high glucose level later in pregnancy.
This high level of glucose in the baby’s blood stimulates the baby’s pancreas to produce extra insulin. The extra insulin causes the baby to put on extra weight (fat).
The result of this may be a large baby that may need to be delivered early even if it is not mature enough. A large baby may also complicate the birth and can increase the risk of delivery through a caesarean section.
Problems Can also Occur Shortly after Birth
Once the baby is no longer exposed to the mother’s high blood glucose levels, the baby’s extra insulin can cause temporarily low blood glucose. This risk resolves when the baby adapts to lower blood glucose levels.
There is evidence that gestational diabetes which is not well managed can be associated with long-term health problems in the offspring including obesity, hypertension and diabetes.
The good news is that if gestational diabetes is well managed, these risks are greatly reduced.
Between 4 to 11%, depending on demographic area, of pregnant women will develop gestational diabetes. The majority develop gestational diabetes around the 24th to 28th week of pregnancy.
It is at this time that special blood tests are carried out, except for those women at high risk who may be tested earlier.
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)
What is Gestational Diabetes? Watch this Video.
Source: American Diabetes Association
What Happens Next if I have 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 well-being.
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 will show you how to manage 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 when Pregnant
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. It is Important to Stay Active and Exercise Regularly
It is important to stay active during pregnancy as it not only prepares you for the birth of your baby and beyond but it will also help to control your blood glucose levels. Be sure to check with your doctor before starting a new exercise program.
3. Strive to 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 if Prescribed – Insulin Injections
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.
Oral Glucose Test
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:
1. Manage your blood glucose levels within the target range advised by your doctor.
2. Provide adequate nutrition for you and your growing baby.
3. Achieve appropriate weight changes during your pregnancy.