Gestational Diabetes - All You Need to Know
Posted in Diabetes
Each year in the U.S., between 2% and 10% of pregnant women experience gestational diabetes.
While this condition can complicate your pregnancy, it’s entirely possible to have a smooth pregnancy and a healthy baby. Hence, we go over the basics of gestational diabetes, how to get yourself screened, and what to do if you’ve been diagnosed.
What is Gestational Diabetes?
Gestational diabetes is a form of diabetes that can develop in pregnant women and cause health complications for both mother and child. Therefore, women with gestational diabetes show higher than normal levels of blood sugar and have a higher risk of DVT during pregnancy.
You could show symptoms of gestational diabetes even if you weren’t diabetic previous to getting pregnant. For most women, the issue goes away after giving birth. However, it does make you more likely to develop type II diabetes later in life.
Gestational diabetes can happen at any point during pregnancy, but it’s especially common during the second half. Accordingly, all pregnant women should be aware of their risk, and if they receive a diagnosis, they should take immediate steps to manage their condition. Otherwise, their state may cause irreversible harm to their own health or that of their child.
In fact, there are two different classes of gestational diabetes. Class A1 is generally mild and can be controlled through simple changes in diet. In contrast, class A2 is slightly more severe and requires patients to manage their blood sugar using oral medications or insulin injections.
What Causes Gestational Diabetes?
Our body regulates glucose levels in the blood using insulin, which is a hormone produced by the pancreas. After you eat, your blood sugar, or the level of glucose in your system, rises. Next, insulin helps your body to remove excess glucose by breaking it down for energy, or by storing it in muscles, fat cells, and liver cells.
When you’re pregnant, your placenta produces large amounts of hormones that build up in the body, including human placental lactogen (hPL). While these hormones help to ensure a safe and healthy pregnancy, they’re also known to cause insulin resistance.
As your body becomes more resistant to insulin, it becomes harder for your body to remove excess sugars after a meal. As a result, high levels of blood sugar can lead to a number of complications such as poor blood flow and swollen extremities from peripheral edema. Although wearing diabetic socks for women can help. For women that need a bigger size, try men's socks for diabetics for a better fit. Other problems that can occur include:
- An increased risk of heart disease and stroke
- Kidney disease
- Vision problems
- Nerve issues
- Circulatory damage
- Higher chance of a C-section
- Diabetic coma
If you allow your gestational diabetes to go untreated, you’re not only putting your own health at risk. High blood sugar can also cause damage to your child, as it relies on you for nutrients. Moreover, unborn babies can suffer health complications from gestational diabetes, such as:
- High birth weight
- Premature birth
- Respiratory symptoms
- Low blood sugar
- A higher risk of developing type II diabetes
Some people are more likely to develop gestational diabetes during the course of their pregnancy than others. Next, we go over the risk factors associated with gestational diabetes.
Your overall health is perhaps the most important indicating factor of whether you’re at risk of developing gestational diabetes. High blood pressure or other chronic complications can increase your risk, as can high blood sugar levels.
Consequently, if you were overweight or obese before pregnancy, you're more likely to develop gestational diabetes than women in a healthy weight range. For that reason, it's best to lose weight before you plan on becoming pregnant. Furthermore, doing so could reduce your risk of developing gestational diabetes and other health complications.
Your childbearing history can have an impact on your health during future pregnancies. Also, when it comes to gestational diabetes, you may be more at risk if any of your previous children were born weighing more than nine pounds. In addition, giving birth to a stillborn baby or one with particular birth defects may also raise your risk.
If you’ve been diagnosed with gestational diabetes during a previous pregnancy, there’s a good chance that the same thing will happen during subsequent pregnancies. Accordingly, be sure to let your doctor know and get regular screenings.
Besides previous pregnancies, age is another consideration. Older women are more likely than younger women to develop gestational diabetes during the course of their pregnancy. Indeed, your risk of developing the condition rises after age 25, along with an increased chance of other pregnancy complications.
As with many health conditions, family genetics plays a pivotal role in your risk of developing gestational diabetes. If you have a family history of diabetes, you may have a higher chance of developing insulin resistance during pregnancy.
Also, your ethnic background can also determine your risk. Most noteworthy, those with African-American, Asian, Hispanic, or Native American heritage tend to be more likely to develop gestational diabetes when pregnant.
Recent research has shown that women who conceived through in vitro fertilization, or IVF, are two times more likely to develop gestational diabetes when compared to natural conception. IVF is a procedure in which an egg is fertilized outside the uterus and then implanted using medical equipment.
While the reason behind the correlation between IVF and gestational diabetes isn’t completely understood, it’s most likely due to hormonal imbalances caused by the procedure. So all women who undergo this fertility treatment should be diligent in getting regular blood glucose screenings.
Often, women who have been diagnosed with gestational diabetes show few, if any, symptoms. At most, some women report feeling hungrier, thirstier, and needing to urinate more often. Also, some women also report fatigue and blurred vision.
More often than not, however, the only way to tell if you have gestational diabetes is during pregnancy screening tests. Even if you have healthy blood sugar levels and no history of diabetes, your doctor should still begin screening you at around 24 to 48 weeks. There are three types of screening tests that doctors can use to detect the onset of gestational diabetes:
Glucose Challenge Test
This is the simplest detection test and doesn't require any preparation, such as fasting. All you have to do is drink a sugary beverage and wait about an hour for it to raise your glucose levels. Afterward, you'll receive a blood test designed to look at glucose levels in the blood.
If the glucose challenge test reveals blood sugar levels of 140 mg/dL (7.8 mmol/L) or higher, you may need to do additional screenings. These tests can confirm the presence of gestational diabetes.
In contrast to the glucose challenge test, this one requires you to fast for 24 hours before your screening. Doing so ensures that nothing you eat will interfere with the results of your test.
Instead of giving you pure glucose for this test, your body will instead break down carbs for sugar. First, you have to drink a solution containing 75 grams of carbohydrates. Then, wait two to three hours to get a blood test to determine glucose levels. Lastly, your doctor will most likely diagnose you with gestational diabetes if:
- Your baseline blood sugar after fasting is 92 mg/dL or more
- After one hour, you have a blood sugar level of more than 180 mg/dL
- After two hours, your blood sugar level is higher than 153 mg/dL
In the two-step test, you don’t have to fast before your screening. First, your doctor will have you drink a solution with around 50 grams of sugar. Then, test your blood glucose levels after an hour. As the name implies, though, this isn’t the only step to the test.
Next, if your blood sugar ends up being more than around 130 mg/dL to 140 mg/dL, your doctor will conduct a followup screening on another day. Doing this helps to eliminate the possibility that your first results may have been a fluke.
However, during the second stage of testing, you will have to fast for 24 hours before seeing your doctor for your screening. After that, you'll then have a drink with 100 grams of sugar in it. Afterwards, you'll get blood tests at one, two, and three-hour intervals. You're likely to receive a positive diagnosis if:
- Your blood sugar level is more than 95 mg/dL to 105 mg/dL
- After one hour, your glucose levels read more than 180 mg/dL to 190 mg/dL
- After the two hour mark, your blood sugar is more than 155 mg/dL to 165 mg/dL
- After three hours, your blood sugar level is greater than 140 mg/dL to 145 mg/dL
Managing Gestational Diabetes
If you’ve been diagnosed with gestational diabetes, there’s no need to panic. With proper care, you can still have a smooth pregnancy and a healthy baby. The best thing that you can do is start to take steps to manage the condition immediately.
Every pregnancy is different, and no two treatment plans for gestational diabetes are quite the same. Your best treatment option will depend on your specific blood sugar level over the course of the day.
Therefore, you should always keep track of your blood sugar to ensure that it’s at a healthy level. In fact, you should check at least four times a day. Also, most doctors recommend testing yourself both before and after each meal.
Your doctor may ask you to perform regular urine tests checking for ketones. These compounds are produced when your body runs out of glucose and starts burning fat for energy instead. When they show up in the urine, it often means that your body isn’t responding properly to insulin cues, and isn’t shuttling enough glucose out of the bloodstream and into cells.
By keeping an eye on your condition, you can ensure that it doesn’t spiral out of control. You can keep both yourself and your child healthy by keeping your blood sugar levels in check and avoiding spikes or crashes.
However, some women have to rely on insulin or oral medications for daily treatment. Often, though, women are able to manage gestational diabetes through simple lifestyle changes. For example, a healthy diet and a regular exercise routine can help to keep your body functioning at peak performance throughout your pregnancy.
Improving Your Diet
Though it can be tempting to give in to cravings during pregnancy, you should stick to a healthy, low-sugar meal plan that trades unhealthy, processed snacks with natural options. Instead of getting your sugar fix from cookies or candy, enjoy natural foods that are good for diabetics such as fruits and vegetables.
In addition, it’s also best to cut back on carbohydrates. They’re broken down into glucose molecules in the body, which can contribute to high blood sugar. Primarily, you should try to avoid refined grains and instead stick to healthier carbs such as:
- Whole grains
- Brown rice
- Starchy vegetables
- Legumes such as peas and lentils
- Certain high-carb fruits
Most diets that are appropriate for people with type I or type II diabetes will also be a good choice for women with gestational diabetes. Indeed, it’s important to remember, however, that you’re not just eating for yourself. Consequently, you need to include all of the essentials that your baby needs in your diet.
You should include plenty of dairy for the protein and calcium that your baby needs to grow. However, try to avoid sugary dairy products such as ice cream and flavored milk. You also need to eat plenty of foods containing omega-3 fatty acids for proper brain development. Seafood is one of the best sources, though omega-3’s can also be found in nuts, dark leafy greens, and over-the-counter supplements.
Engaging in Light Exercise
Starting up regular exercise is a healthy choice for any individual, but it can be especially beneficial for pregnant women with gestational diabetes. Exercise not only helps to relieve common discomforts associated with pregnancy but actively improves metabolism. It also helps your body to regulate blood sugar levels more effectively.
Most experts recommend that pregnant women get at least 30 minutes of exercise every day. It’s best to stick with light to moderate intensity exercises that won’t pose a risk to you or your baby. Also, wear proper athletic shoes and comfortable clothing such as diabetic quarter socks or knee high diabetic socks during cold weather. Some of the best exercises for pregnant women include:
- Swimming laps
- Walking or jogging
- Elliptical, stair climbers, and other cardio equipment
- Dance or aerobics classes
- Yoga or Pilates
Before starting any workout during pregnancy, you should consult your doctor first. Women with complications or a more delicate condition may want to avoid intense exercise and limit their level of activity, especially later on in pregnancy. Always ask your doctor about the best treatment plan to help you safely manage your gestational diabetes.
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