Pregnancy leads to hormonal changes that prevent the body from using insulin effectively, causing glucose levels to rise. Gestational diabetes occurs in up to 9% of pregnancies and is called gestational diabetes mellitus (GDM). It increases the risk of complications for both mother and baby.
Gestational diabetes can also be managed through diet and exercise, and medication
GDM can be prevented by ensuring a healthy weight before pregnancy and achieving normal blood sugar levels before conception. It can also be managed through diet and exercise, and medication. Women with gestational diabetes are at increased risk for developing type 2 diabetes later in life. Learn everything about managing gestational diabetes to protect both mother and baby.
Diagnosis of Gestational Diabetes
Most women with gestational diabetes don't have symptoms, so they might not know they have it. The condition is usually diagnosed in routine screening during the second trimester (24 to 28 weeks). During this time, the placenta starts producing hormones that can interfere with insulin and cause blood sugar levels to rise.
Doctors can screen for gestational diabetes by performing a glucose tolerance test. In this test, you drink a sweet solution and have a blood sample taken after an hour. If your blood sugar level is high, you will be diagnosed with gestational diabetes.
Monitoring blood sugar levels
The first step in managing gestational diabetes is to monitor your blood sugar (glucose) levels. This will help your healthcare provider determine if you need medications to control your levels, such as insulin or oral glucose-lowering drugs.
You will need to test your blood sugar level before and after meals and at other times as your healthcare provider recommends. You will also need to keep a record of your results. This record will let you and your healthcare team see how well you follow your diet and exercise plan.
Dietary interventions
A healthy diet can reduce a person's need for insulin and help manage gestational diabetes. A registered dietitian can help design a meal plan appropriate for each person's carbohydrate tolerance and conditions during pregnancy.
Carbohydrates are nutrients from grains, milk and yogurt, fruits, and starchy vegetables. They affect blood sugar levels more than other nutrients because they are broken down into simple sugars in the body. To keep blood sugar levels balanced, people with gestational diabetes must eat healthy meals and snacks that contain protein, fat, and carbohydrates in the proper proportions.
The diet should include plenty of fresh or frozen vegetables, nuts, seeds, and beans. These food choices can provide essential vitamins and minerals for the pregnant woman, her baby, and herself after the birth. In addition to a healthy diet, people with gestational diabetes should regularly monitor their blood sugar levels using a glucose monitoring kit, which involves pricking the finger to get a blood sample for testing.
Physical activity and exercise
Regular aerobic exercise, like walking, swimming, and cycling, can help keep blood sugar levels within the normal range. Resistance training is also a good option. The key is to start slowly and work up to what feels comfortable.
Exercise is a powerful tool for GDM management in conjunction with pharmacology and dietary interventions. It has the potential to significantly mediate the detrimental effects of hyperglycemia on both mother and fetus by controlling blood glucose levels.
No specific exercise prescription guidelines have been developed for pregnant women with GDM. However, research shows that when done under adequate supervision, it is safe and beneficial for pregnant women with gestational diabetes mellitus. Therefore medical practitioners should be able to refer patients with gestational diabetes to suitably qualified exercise professionals to assist in GDM management.
Complications
Gestational diabetes that isn't well managed can lead to high blood sugar levels, which puts the fetus at risk. This can cause the fetus to grow too large (macrosomia). Too big babies can get wedged in the birth canal during delivery, which may cause injuries to the mother or baby. They also have a higher risk of needing a C-section birth.
Diabetes can also increase the risk of high blood pressure in pregnancy or preeclampsia. High blood sugar levels in pregnancy can cause damage to the small blood vessels in the eyes or diabetic retinopathy.
A study found that women with gestational diabetes with reasonable glycemic control were less likely to have complications, such as macrosomia, shoulder dystocia, premature birth, and NICU stay. Glycemic control was defined as having fasting and 1-hour glucose levels of 95 and 140 mg/dL, respectively. Factors associated with better glycemic control included:
- Early gestational diabetes diagnosis.
- Frequent contact with an RPSC nurse.
- Self-monitoring of blood glucose.
Postpartum blood sugar monitoring
Women with gestational diabetes can reduce their risk of future type 2 diabetes by controlling their blood sugar levels. This is especially important because today's pregnant women are, on average older and heavier than those who were pregnant just a decade ago.
Following a healthy diet plan is the best way to control your glucose. This includes choosing the right kind and portion size of carbohydrate foods like cereals, pasta, bread, rice, potatoes, fruit, milk, and yogurt. It also includes avoiding unhealthy foods like biscuits, cake, and soft drinks.
If you have gestational diabetes, your healthcare team may recommend a continuous glucose monitor (CGM) to help you manage your health. This tiny sensor you wear on your skin can wirelessly send data to a receiver or mobile phone.
The Bottom Line
Diabetes has reached epidemic proportions in Indigenous populations worldwide. Identifying and treating gestational diabetes in the context of health system challenges, including poverty, food insecurity, colonization, and trauma, is crucial to reduce long-term complications and mortality from this disease in Indigenous women and children.
Gestational diabetes develops when there is too much glucose in the blood. A few simple blood tests usually diagnose it in the 24th to 28th week of pregnancy. If left untreated, gestational diabetes can lead to complications for the mother and fetus, including the need for a cesarean section due to a big baby or shoulder dystocia and an increased risk of developing Type 2 diabetes later in life. Exercise and a healthy diet can help manage the condition, but many women will also need insulin.
