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Gestational Diabetes – What Is It, How Does It Develop?

Gestational Diabetes – What Is It, How Does It Develop?

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As indicated by the word Diabetes, you might have guessed that this is a condition involving a higher than normal blood sugar level (glucose) but what does it mean to have this condition? Well this condition is actually related to developing Diabetes during pregnancy. Approximately 4% of women develop this form of Diabetes during pregnancy. Although all women will have some type of impaired glucose intolerance as a result of the hormonal changes that their body will be going through, their higher glucose levels are not usually serious enough for the development of Diabetes. However for some women the hormonal changes as a result of the pregnancy places them at risk for developing Diabetes during their third trimester.

The cause is related to the placenta and the increased levels of certain hormones that are produced to actually help prevent the mother from developing low blood sugar. In essence these hormones produced help stop the actions of the naturally produced insulin. Since insulin regulates the level of blood sugar in the system, the hormones produced by the placenta counteract the insulin and result in a high blood sugar level. Over the course of a pregnancy progressive impaired intolerance is developed. The body tries to lower the blood sugar level by producing more insulin from the pancreas, however if the pancreas can not produce enough insulin to overcome the effect of the pregnancy hormone levels then there is a good chance that Gestational Diabetes will develop.

Although it may seem like a cruel joke from the big guy upstairs, there is some good news. Most women return to normal glucose levels within about 6 weeks after the birth of their child and the diabetes is no longer an immediate factor. You may need to take another test several weeks later to confirm but this is usually not required. However you are not out of the woods yet as women that develop Diabetes during pregnancy have a 60% greater risk of developing type 2 Diabetes later in life. So if you find yourself in this group it will be important for you to follow a healthy diet, exercise and maintain an ideal body weight to help reduce your risk.

Top risk Factors for Gestational Diabetes during pregnancy

  • Family history of Diabetes
  • Previous pregnancy involving a stillborn or baby over 9 pounds
  • 20% or more overweight prior to pregnancy
  • Member of a high risk group (Asian, Black, Native American, Hispanic)
  • Gestational Diabetes in a prior pregnancy
  • Previous impaired glucose levels (higher than normal glucose levels but no Diabetes)
  • Excessive amniotic fluid (called polyhdramnios)
  • Sugar in the urine

It is important to note that although these are the top risk factors many women that develop gestational diabetes have none of the top risk factors.

How I know if I have Gestational Diabetes?

The key is to first asses if you have a high risk for gestational diabetes. If you have some of the high risk factor previously mentioned then you should be tested as early as possible during your pregnancy. If you do not have any of the high risk factors then you should be tested between the 24th and 28th week of pregnancy. The important thing here is to be sure and discuss this issue with your doctor if you have a concern as there is no one solution for every person

The test for gestational diabetes is easy and relatively quick. It is called an oral glucose tolerance test and involves consuming a sweet liquid that is absorbed by the body quickly and causes the blood sugar levels to rise within 1 hours time. After an hour the blood is tested and a blood sugar level greater than or equal to 140 mg / dL is considered to be abnormal and additional test may be required to verify development risk.

What Are The Risks?

Gestational Diabetes can affect the development of the baby throughout pregnancy. If developed early in the pregnancy there is the risk of birth defects that affect the major organs as well as the brain. In addition, there is an increased risk of miscarriage. In the second and third trimester of pregnancy the diabetes can result in over nutrition to the baby and cause the baby to be larger than normal. Now while this may not seem to be a concern on the surface, a larger baby can cause additional trauma to the mother and shoulder trauma to the baby if delivered naturally, especially for smaller women. Most often this situation requires a caesarean type delivery. Finally a baby once delivered can suffer from hyperinsulinemia. A condition in which the blood sugar level of the baby drops to very low levels as they are no longer receiving high blood sugar levels from the mother. While this may seem frightening, it is important to remember that just because you may be at risk does not mean that you will experience any of these issues. With proper treatment there is no reason why you can not deliver a healthy baby. Trust you physician and if you do not understand … ASK QUESTIONS!

Ok …… Now What?

Managing Your Gestational Diabetes

Managing your gestational diabetes involves monitoring, exercise and diet. As an overview some of the best approach involves:

  • First and foremost, follow the guidelines provided by your doctor
  • Monitor weight gain
  • Take insulin, if necessary
  • Keep your high blood pressure under control
  • Monitor your blood sugar levels at least several times during the day (this may include monitoring urine for Keytones)
  • Keep a journal of monitoring results, glucose test, diet, exercise and general overall how you feel
  • Exercise as allowed by your physician

Diet Changes with Gestational Diabetes

While some of the steps below may take some effort on your part, they will go a long way towards you and your babies health.

  • Drink 64oz of liquids per day (min)
  • Ensure your diet includes sufficient vitamins and minerals. Consult your health physician regarding the use prenatal supplements to meet these needs
  • Consume foods high in fiber (20-35 grams per day)
  • Avoid large meals. Eating three small meals along with two snacks will help avoid blood sugar spikes
  • If experiencing morning sickness eat small servings of crackers or pretzels before getting out of bed
  • Avoid fried and greasy foods as your fat intake should be below 40% of your total calories

All the best

By Michael Larocque

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