What is Gestational Diabetes?

How Can Gestational Diabetes Affect Your Baby?

• High glucose in the baby is converted to more energy than it needs to develop. This can lead to a large baby. Large babies are at an increased risk of shoulder damage during birth
• During pregnancy, this extra blood glucose is transferred to your baby, where it gets converted into fat. This increases the baby’s risk of developing obesity, high blood pressure, heart disease, and type 2 diabetes. Blood glucose levels usually return to normal after delivery. However, close monitoring of blood glucose is required after delivery as gestational diabetes increases your risk of developing type 2 diabetes later in life
• High levels of glucose during pregnancy causes the baby’s pancreas to make extra insulin. After birth, newborns can have low blood glucose levels due to this extra insulin production
• Low blood glucose levels increase the baby’s risk of breathing problems
• The baby may have low mineral levels in the blood. This problem can cause muscle spasms or cramps but can be treated by giving extra minerals to baby

Seven Things to Do if You Have Gestational Diabetes

Gestational diabetes, if ignored or left untreated can have serious consequences on both – your and your baby’s health in the long term. It’s obvious to feel anxious and concerned if you have been diagnosed with gestational diabetes or are at higher risk of developing this condition.

The good news is that you can work together with your healthcare provider to lower your rising blood sugar levels. However, it may not be as simple and quick as it may appear. Gestational diabetes demands a certain degree of self-management and strict control of some lifestyle factors. Following are some important things you should be doing once you are diagnosed with gestational diabetes.

 1. Check Your Blood Sugar Level

Knowing your blood glucose levels gives you an idea of how much glucose is present in your blood. This also helps your doctor to decide on the right diet and exercise plan to keep the glucose level under control.
American Diabetes Association recommends having a specific blood glucose level target at different times of the day.

• Before a meal (preprandial): 95 mg/dl or less
• 1-hour after a meal (postprandial): 140 mg/dl or less
• 2 hours after a meal (postprandial): 120 mg/dl or less

2. Eat a Healthy Diet

During pregnancy, it is always recommended to have a healthy diet that provides all the nutrients, vitamins, and minerals needed for your health and baby’s development.  Diet has always been considered to play a major role in controlling blood glucose levels. Women with gestational diabetes have special dietary needs. For instance, eating carbohydrates can increase your blood glucose levels.

Therefore, women with gestational diabetes need to consume appropriate amounts of carbohydrates. You can work with your healthcare provider or dietitian to make a meal plan that suits your lifestyle.
For more information on diet plans visit: http://www.nichd.nih.gov/publications/pubs/gest_diabetes/Pages/sub5.aspx

3. Exercise Regularly

Physical activity is a proven and effective way to control blood glucose levels. The effectiveness has been proven through some landmark studies, such as the Diabetes prevention program (DPP), which reports that reducing seven percent of weight through exercise and diet control can cut down your diabetes risk by nearly 58 percent.

Although there are no specific exercise guidelines recommended during pregnancy, women with gestational diabetes often need regular physical activity, such as walking, prenatal aerobics class, or swimming, to help control their blood sugar levels. When you exercise regularly, your body uses glucose without the need for extra insulin, which helps combat insulin resistance.

During pregnancy, you may be recommended to avoid vigorous physical activity because of other associated health conditions or complications.

4. Keep Your Weight in Check

During pregnancy, you will surely gain weight as you approach your delivery date. However, if you gain too much weight beyond what is considered normal, you may have to face a lot of pregnancy-related complications. Understand the complications you may develop due to excess weight gain in pregnancy.
A healthy weight gain is based on your pre-pregnancy BMI (see the chart below).

5. Don’t Miss the Insulin Shot

As you progress toward the end of pregnancy, your insulin resistance could increase. If that happens, your doctor might recommend you take insulin shots to help keep your glucose level under control.
The reasons why you may be recommended insulin shots could be:

• Your blood sugar level is too high
• Your blood sugar level is high too many times
• Your blood sugar level remains high, but you are not gaining much weight or are not eating poorly
• You cannot safely add physical activity to your treatment plan

It is best to record all your blood glucose levels at times suggested by your doctor. This allows deciding if you need to take insulin to control your blood sugar levels.

6. Get a Urine Test Done

During gestational diabetes, the body starts breaking fat for energy production when it is unable to get the required amount of glucose. This mainly happens due to too much carbohydrate restriction or when you skip your meals. 

The breakdown of fat may lead to the production of ketones, which can be found in the urine. You may have to get a urine test done by a health care provider or may have to do it every day at home to check the presence of ketones. When there are ketones present in the urine, it indicates that you are consuming too less carbohydrates and may have to adjust your diet accordingly.

7. Check Your Blood Pressure

Having high blood pressure during pregnancy increases your risk of developing preeclampsia, a condition in which you suddenly have high blood pressure, swelling in your face and hands, and the presence of proteins in urine.

 It usually starts after about 20 weeks of pregnancy and the symptoms subside when the child is born. Women who are obese have a greater risk of developing preeclampsia almost six times that of women having normal weight.

Having a Healthy Lifestyle before Conceiving Can Cut Down Your Risk of Gestational Diabetes

Healthy body weight, healthy diet, regular exercise, and no smoking before pregnancy can save you from Gestational Diabetes

Gestational Diabetes (GDM) is associated with a lot of complications during pregnancy. Women who develop GDM during pregnancy also hold a risk of suffering from type 2 diabetes in the future. In addition, studies suggest that children born to mothers with diabetes tend to be obese and are at risk of having chronic illnesses.

If you are diagnosed with GDM, you need to take special care so as to avoid complications. However, women who take efforts to maintain a healthy lifestyle even before they get pregnant can actually lower their risk of developing GDM.

A new study published in British Medical Journal suggests that women who focus on correcting their lifestyle before pregnancy can have less chance of developing GDM. During the study, the researchers gathered data for 14,437 women and found 823 pregnancies affected by incident GDM.

The researchers analyzed the lifestyle factors that were self-reported by each woman. Women who maintained a healthy lifestyle that included no smoking, at least 150 minutes of moderate to vigorous physical activity per week, and healthy eating showed a 41 percent lower risk of GDM.

Interestingly women who had a Body Mass Index (BMI) of less than 25 had a 52 percent lower risk of gestational diabetes compared with all other pregnancies. Women who had all four lifestyle factors (normal BMI, no smoking, healthy eating, and physical activity) showed an 83 percent lower risk of GDM.

Studies conducted in the past show that maintaining a healthy lifestyle can reduce hyperglycemia during pregnancy. Evidence also suggests that lifestyle interventions can reduce weight gain during pregnancy which is a major contributing factor to developing GDM.

How Does an unhealthy Lifestyle Before Pregnancy Contribute to the Risk of GDM?

During pregnancy, the body undergoes too many metabolic changes, especially in the third trimester, which includes an increase in lipid and glucose levels to transfer necessary nutrients to the fetus. Therefore, pregnancy actually exposes women to factors that are likely to cause glucose metabolic disorders.

Women with unhealthy lifestyles are hence predisposed to the risk of developing metabolic disorders; pregnancy further triggers or increases this risk. In women who do not have GDM, glucose tolerance stays within the limit even after increased metabolic stress during pregnancy.

However, women with GDM have a compromised capacity to adapt to these metabolic challenges of pregnancy.

The present study has focused mainly on the lifestyle before pregnancy, considering that a similar healthy lifestyle has been maintained during pregnancy. The study findings suggest that adherence to a healthful lifestyle in the period before pregnancy is associated with a substantially lower risk of gestational diabetes.

The study authors advise that although it is always challenging to change behavior, the time before and during pregnancy could represent an opportunity to change diet and lifestyle. Pregnant women are always ready to adhere to advice to improve their pregnancy and/or birth outcomes, and therefore the importance of maintaining a healthy lifestyle before conceiving must receive attention.

Reference: Zhang C, Tobias DK. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study.BMJ. 2014 ;349:g5450.

FAQs about Gestational Diabetes

1. Is it Safe to Breastfeed After Gestational Diabetes?

The American Diabetes Association recommends that women with Gestational Diabetes (GDM) should be encouraged to breastfeed. Very few studies have examined breastfeeding and subsequent obesity or diabetes in children born to women with GDM.

Some scientists suggest that lactation can be more difficult for women with GDM because both maternal diabetes and obesity are known to delay the onset of lactogenesis.

However, it is important to remember that breastfeeding provides important health benefits to both mother and child. Lactation lowers the risk of breast and ovarian cancer and possibly prevents the development of type 2 diabetes in women.

Children who are breastfed are protected from the risk of developing obesity, hypertension, cardiovascular disease, and diabetes later in life.

2. Does Gestational Diabetes Increase the Risk of Developing Type 2 Diabetes Later in Life?

Very much. Gestational diabetes is considered one of the risk factors that can lead to pre-diabetes and increase your risk for type 2 diabetes. Blood glucose levels usually return to normal after delivery, yet up to half of GDM patients can develop type 2 diabetes in the future.
However, it is possible to reduce your risk. You need to adopt some lifestyle changes such as physical activity and diet control. Learn more about DPP that helps you to reduce your risk of type 2 diabetes

3. Which Pregnancy-Related Complications can Occur in Women with Type 1 Diabetes?

Pregnancies affected by type 1 diabetes are at an increased risk for preterm delivery, preeclampsia (sudden rise in blood pressure of mother), macrosomia (excessive birth weight of the baby), shoulder dystocia (dangerous injury to baby’s shoulder, which occurs during birth), intrauterine fetal death, fetal growth restriction, cardiac and renal malformations.

To avoid such complications women with type 1 diabetes are recommended to have intensive glycemic control and preconception planning.

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