Diabetes and blood sugar management are hot topics in health in the last decade. One type of diabetes that isn’t talked about as often is the type that affects pregnant women – gestational diabetes.
It generally develops during the second or third trimester, and is known to affect about 4% of pregnant women in Canada. The good news is that in approximately 90% of cases, gestational diabetes disappears after the baby is born, so it’s not something the mother (or the baby) have to live with long-term.
What Causes Gestational Diabetes?
Like all forms of diabetes, it has to do with a change in the body’s processing of insulin, the hormone that allows sugar to be used as a source of energy. A woman’s body produces anti-insulin hormones which decrease the effects of insulin throughout the body.
In most cases, the body will react by increasing insulin production, but in the case of gestational diabetes this fails to occur. As a result, sugar accumulates in the blood resulting in hyperglycemia which can cause damage to tissues throughout the body.
Who is at risk?
Not all women experience gestational diabetes during pregnancy. Indications that you are more likely to it include:
- Past pregnancies with gestational diabetes
- You’ve previously given birth to a baby with a birth weight over 4 kg
- You are 35 years of age and older
- Being of Aboriginal descent (the incidence of gestational diabetes among Natives is between 8 and 18%)
- You are of African-American or Asian descent
- You are obese
- You are taking corticosteroids (medication)
- You are suffering from polycystic ovary syndrome (PCOS)
- You have a history of acanthosis nigricans (skin disorder)
Symptoms to watch out for
The tricky thing is that most women with gestational diabetes don’t present with any symptoms. In rare cases, some women may experience intense fatigue, excessive thirst and increased urination. If that’s the case for you, see your doctor.
How is it diagnosed?
A routine diabetes screening test is normally given to all pregnant women between the 24th and 28th week of pregnancy. For women with other risk factors (above) they are screened early in their pregnancy. If the results are negative, they are usually tested again later in the pregnancy.
Testing for gestational diabetes is done with a glucose tolerance test. The test begins with drinking a sweet solution. After an hour, the woman’s blood sugar is measured.
The test is considered positive if the results show levels greater than 10.3 mmol/L.
If the levels are between 7.8 and 10.2 mmol/L, another confirmation test is needed.
Are there additional concerns?
If gestational diabetes is left untreated (or isn’t controlled) it can lead to complications for both Mom and Baby.
Risks for the mother include urinary tract infections, high blood pressure, swelling and fatigue during pregnancy. They also have a higher risk of preterm and caesarean delivery.
Risks for the baby include a greater chance of being hypoglycemic (having low blood sugar) at birth, having jaundice, breathing problems and macrosomia (excessive birth weight). As well, the baby has greater risk of developing diabetes later on in life.
After giving birth, women with gestational diabetes have an increased risk of diabetes and cardiovascular diseases. Therefore, it’s common to re-evaluate within six months of delivery.
Nursing, exercising and healthy eating habits are encouraged to help reduce long-term problems.
How to treat gestational diabetes?
Once diagnosed with gestational diabetes, managing the condition is very important and will reduce complications for both Mom and Baby.
The best way to manage gestational diabetes is through diet and lifestyle changes. This includes dividing the mother’s intake of carbohydrates (sugars) over three meals and at least three snacks. This is in an effort to control blood glucose (sugar) levels.
Low calorie diets are not recommended as they deprive the growing baby of essential nutrients that are necessary for development.
Maintaining moderate physical exercise is also recommended. It’s a good idea to speak to your doctor to determine the intensity, frequency and duration of exercise that is right for you.
Medication is another treatment option. It’s generally used when the recommended blood glucose target levels are not reached within 2 weeks of diet changes. In most cases, this consists of daily insulin injections.
Ongoing Monitoring of blood glucose levels is a great way to determine if your other efforts at managing the condition are successful. This is done using a blood glucose monitor. This will help you to adjust insulin doses and to determine whether the changes you have made to your diet have been successful.
Gestational diabetes affects about 4% of pregnant women in Canada, though approximately 90% of cases disappear after the baby is born. It’s a condition that affects blood sugar levels in the mother. If left untreated it can have negative health effects for both mother and baby. Treatment options are very effective and include ongoing monitoring, diet and lifestyle changes and in some cases, medication.
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