Gestational Diabetes
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OVERVIEW
What is gestational diabetes?
Gestational diabetes is a type of diabetes that starts during pregnancy. If you have diabetes, your body isn’t able to use the sugar (glucose) in your blood as well as it should. This causes the level of sugar in your blood to become higher than normal.
Gestational diabetes can affect about 3-20 percent of pregnant women, depending on risk factors. It usually develops in the second trimester (sometimes as early as the 20th week of pregnancy). Most often, gestational diabetes goes away after the baby is born.
How can gestational diabetes affect my baby and me?
High blood sugar levels can be unhealthy for both you and your baby. If the diabetes isn’t treated, your baby may be more likely to have problems at birth. For example, your baby may have a low blood sugar level, jaundice, or your baby may weigh much more than normal.
Gestational diabetes can also affect your health. For instance, if your baby is very large, you may have a more difficult delivery or you may need a caesarean section. Gestational diabetes also increases your risk of developing preeclampsia, which is a condition that can be serious if left untreated.
SYMPTOMS
Many times, there are no noticeable symptoms for women who have gestational diabetes. This could be because some of the common symptoms of diabetes are also symptoms of pregnancy. These include:
- Frequent urination
- Fatigue (being tired)
- Nausea (feeling sick to your stomach)
Other symptoms can include:
- Unusual amount of thirst
- Blurred vision
- Bladder infections
CAUSES
Pregnant women sometimes develop gestational diabetes because of pregnancy hormones. These hormones interfere with insulin. They can make your body more resistant to insulin. When this happens, insulin cannot regulate the sugar (glucose) in your blood. This makes your sugar levels increase.
DIAGNOSIS & TESTS
How is gestational diabetes diagnosed?
As part of your prenatal care, your healthcare provider will recommend screening for gestational diabetes around 24 to 28 weeks of pregnancy. This could happen sooner if there is reason to believe you are at risk for developing gestational diabetes. If you have elevated glucose levels in your urine or other risks, your healthcare provider may recommend having the screening sooner.
During the glucose test, you’ll drink a syrupy-sweet bottle of glucose solution. A lab technician will take a sample of your blood. They will measure the amount of sugar in your blood.
If your blood sugar is too high, your healthcare provider may want to do further testing.
PREVENTION
Can gestational diabetes be prevented or avoided?
Gestational diabetes cannot always be prevented or avoided. According to Diabetes Canada you may be more likely to develop gestational diabetes if you:
- Are older than 35 while you are pregnant
- Come from a higher-risk ethnic group, such African, Arab, Asian, Hispanic,
Indigenous, or South Asian
- Use corticosteroid medication
- Have a family history of diabetes
- Have prediabetes
- Have had gestational diabetes in a previous pregnancy
- Gave birth to a baby that weighed more than 4 kg (9 pounds)
- Were overweight before your pregnancy
- Have polycystic ovary syndrome (PCOS) or acanthosis nigricans (darkened
- patches of skin)
There are things you can do to reduce your chances for developing gestational diabetes:
- If you are overweight, try losing weight before you become pregnant. (Do not try to lose weight if you are already pregnant.)
- Do not use pregnancy as an excuse to eat sugary foods, such as cakes, candy, and ice cream.
- Talk to your healthcare provider about safe exercises you can do while pregnant. Getting even a little exercise each day can do a lot to prevent diabetes.
TREATMENT
What can I do if I have gestational diabetes?
If you are diagnosed with gestational diabetes, lifestyle changes can help you control it. You will need to follow a diet suggested by your healthcare provider, exercise regularly and have frequent blood tests to check your blood sugar level.
Doing these things may not be enough to keep your blood sugar at a normal level. You may also need to take a medicine to help. There are several oral medications that can help control diabetes. Your healthcare provider may prescribe one of these. Or you may need to take insulin injections to lower your blood sugar.
You may be asked to see a specialist if you have to start taking insulin.
What changes should I make in my diet?
Your healthcare provider may ask you to change some of the foods you eat and see a registered dietitian to help you plan your meals. It’s important to eat well-balanced meals. You may need to eat less at each meal, depending on how much weight you gain during your pregnancy. Your healthcare provider or dietitian will talk to you about this.
Avoid eating foods that contain a lot of simple sugar, such as cake, cookies, candy or ice cream. Instead, eat foods that contain natural sugars, such as fruits. But cut down on drinking fruit juices, which have a high concentration of sugar. Also, avoid drinking soda or other sugary drinks.
If you get hungry between meals, eat foods that are healthy for you, such as raisins, carrot sticks or a piece of fruit. Whole-grain pasta, whole-grain breads and rice are also good for both you and your baby.
Why is exercise important?
Your healthcare provider will suggest that you exercise regularly at a level that is safe for you and the baby. Exercise will help keep your blood sugar level normal, and it can also make you feel better. Walking is usually the easiest type of exercise when you are pregnant, but swimming or other exercises you enjoy are also beneficial. Ask your healthcare provider to recommend some activities that would be safe for you.
If you’re not used to exercising, begin by exercising for 5 or 10 minutes every day. As you get stronger, you can increase your exercise time to 30 minutes or more per session. The longer you exercise and the more often you exercise the more in control you will be of your blood sugar.
You do need to be careful about how you exercise. Don’t exercise too hard or get too hot while exercising. Ask your healthcare provider what activities are safe for you. Depending on your age, your pulse shouldn’t go higher than 140 to 160 beats per minute during exercise. If you become dizzy or have back pain or other pain while exercising, stop exercising immediately and contact your healthcare provider. If you have uterine contractions (labor pains), vaginal bleeding or your water breaks, contact your healthcare provider right away.
What happens after my baby is born?
You may not need to have blood tests to check your blood sugar while you’re in the hospital after your baby is born. However, it may be several weeks after your baby’s birth before your gestational diabetes goes away. To make sure it has gone away, your healthcare provider will ask you to have a special blood test 1 or 2 months after you have your baby.
Living with gestational diabetes
Gestational diabetes increases your risk for diabetes in your next pregnancy and later in life. It is important that you continue to exercise, watch your weight, and eat a healthy diet after pregnancy. If you do these things, you may avoid diabetes when you’re older.
FOR MORE INFORMATION
IWK Health Centre – Women’s and Newborn Health
http://www.iwk.nshealth.ca/gdm
Health PEI
Diabetes Canada
56161