What you should know about gestational diabetes
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What you should know about gestational diabetes
Type 1 and Type 2 diabetes are commonly known medical conditions by most of us. But there is another type of diabetes you may not be as familiar with – gestational diabetes. Gestational diabetes (GD) is diabetes that develops in pregnant women who did not have diabetes before becoming pregnant. For various reasons, GD occurs when a woman’s body is unable to make enough insulin during her pregnancy. Insulin is a hormone made by the pancreas that acts like a key to let blood sugar into the cells in the body to be used as energy.
What causes Gestational diabetes?
Every year, between 2% t0 10% of pregnant women in the United States are affected by GD. When a woman is pregnant, her body makes more hormones and goes through other changes, such as gaining weight. These changes cause the body’s cells to use insulin less effectively, a condition called insulin resistance which increases the body’s need for insulin.
Normally when we eat food, your body turns food into a sugar called glucose which is necessary to provide energy to the cells of your body. This glucose goes into the bloodstream causing your blood glucose to rise. The pancreas will detect this rise in glucose and in response, it releases the hormone insulin to help your body move glucose out of the bloodstream and into the cells to provide fuel.
This same glucose that comes from food breakdown also goes from the mother to the baby by way of the placenta. The baby uses this glucose for growth. Sometimes, the placenta prevents insulin from working like it should in the mother’s body which can result in the mother’s glucose level to rise too high. All women, regardless of having diabetes previous to her pregnancy or not, are screened for GD between the 24th and 28th week of pregnancy as GD usually develops around the 24th week. Any woman who is already at a higher risk for diabetes, may be screened earlier.
How are pregnant women screened for Gestational diabetes?
Screening usually occurs between the 24th to the 28th week of pregnancy. Women are given a sugary fluid to drink that contains concentrated glucose. An hour after drinking it, a nurse will draw blood to check glucose levels. If the glucose is elevated over 140 mg/dl or higher, the pregnant woman will need to come back for a three-hour glucose check. During this test, a woman’s blood glucose is tested one hour, two hours and three hours after drinking another glucose solution. If two or more of these values show elevated blood glucose, then the woman is diagnosed as having GD.
Women who have already had a previous pregnancy with GD, will be tested at an earlier stage of her pregnancy.
What risks can Gestational diabetes cause for the mother or baby?
Any woman who had GD is at a higher risk for certain complications, which makes it important that all women be screened for GD. One complication is developing high blood pressure also known as preeclampsia which can turn into a more life-threatening complication of eclampsia. Women with GD are also at a higher risk of having a large baby making labor and delivery more difficult which could result in a cesarean section. In addition, the mother is more prone to developing infections in the urinary tract and vagina.
The baby is also at a higher risk for complications which include the following:
· Being very large (9 pounds or more at birth) which can result in injury to the baby
· Being born early, which can cause breathing and other problems
· Having low blood sugar
· Developing type 2 diabetes later in life
Gestational diabetes usually goes away after your baby is born. However, about 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery. Visit your doctor to have your blood sugar tested 6 to 12 weeks after your baby is born and then every 1 to 3 years to make sure your levels are on target.
How is gestational diabetes treated?
An important part of treating GD is to discover it at its earliest stage so as to reduce complications with lifestyle management strategies. The majority of women with GD are able to control their blood glucose with a carbohydrate controlled meal plan of eating 3 meals and 3 snacks and exercise. However, some women continue to have elevated blood glucose despite following a healthy diet and getting exercise. For these women, taking insulin will be recommended.
Insulin is considered to the best first-line treatment for controlling blood glucose during pregnancy if diet and exercise alone are unable to do so. Women who need to use insulin may have to inject themselves up to four times a day with insulin.
All women with GD will be required to test their blood glucose levels with a blood glucose meter 4 times a day – fasting and one hour after breakfast, lunch, and dinner. They are considered in good control if they are able to manage their blood glucose equal or less than 90 mg/dl fasting, and equal or less than 140 mg/dl one hour after a meal.
How women who’ve had Gestational diabetes can reduce their risk of developing type 2 diabetes
A main concern for any woman who has had a diagnosis of GD, is of developing type 2 diabetes later on in life. About 50% of all women with GD will go on to develop type diabetes which will put them at an increased risk of heart disease, nerve damage, kidney disease, and vision problems.
To reduce this scenario from happening, it is important for these women to reach a healthy body weight after the delivery of her baby, eat a healthy diet made up of lots of plant-based foods, and to maintain a consistent, regular program of exercise.