Managing & Treating Gestational Diabetes
Some people develop high blood sugar during pregnancy. This condition is called gestational diabetes (GD). A healthy diet and exercise can usually keep it under control, but sometimes insulin is needed to help you manage GD.
What causes gestational diabetes?
Gestational diabetes comes from hormonal changes and the way our bodies convert food into energy.
A hormone called insulin breaks down the glucose (sugar) from food and delivers it to our cells. Insulin keeps the level of glucose in our blood at a healthy level. But if insulin doesn’t work right or we don’t have enough of it, sugar builds up in the blood and leads to diabetes. During pregnancy, hormones can interfere with the way insulin works. It may not regulate your blood sugar levels like it’s supposed to, which can lead to gestational diabetes. Genes and having overweight (a BMI greater than 25) may also play a role.
What are the symptoms of gestational diabetes?
Gestational diabetes doesn’t usually cause any symptoms. But some people experience:
● Frequent urination.
● Nausea.
● Thirst.
● Tiredness.
Diagnosis
If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester between 24 and 28 weeks of pregnancy.
If you're at high risk of diabetes for example, if you're overweight or obese before pregnancy; you have a mother, father, sibling or child with diabetes; or you had gestational diabetes during a previous pregnancy your health care provider may test for diabetes early in pregnancy, likely at your first prenatal visit.
Routine screening for gestational diabetes
Screening tests may vary slightly depending on your health care provider, but generally include:
● Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level of 190 milligrams per deciliter (mg/dL), or 10.6 millimoles per liter (mmol/L), indicates gestational diabetes.
A blood sugar level below 140 mg/dL (7.8 mmol/L) is usually considered within the standard range on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than expected, you'll need another glucose tolerance test to determine if you have gestational diabetes.
● Follow-up glucose tolerance testing. This test is similar to the initial test except the sweet solution will have even more sugar and your blood sugar will be checked every hour for three hours. If at least two of the blood sugar readings are higher than expected, you'll be diagnosed with gestational diabetes.
How does gestational diabetes affect my baby?
If you have gestational diabetes, your baby’s more at risk for:
● Increased birth weight (weighing nine pounds or more).
● Breathing problems at birth.
● Hypoglycemia. This can cause seizures in newborns.
● Obesity.
● Premature birth.
● Type 2 diabetes later in life.
Treatment
Treatment for gestational diabetes includes:
● Lifestyle changes
● Blood sugar monitoring
● Medication, if necessary
Lifestyle changes
Your lifestyle how you eat and move is an important part of keeping your blood sugar levels in a healthy range. Health care providers usually don't advise losing weight during pregnancy your body is working hard to support your growing baby. But your health care provider can help you set weight gain goals based on your weight before pregnancy.
Lifestyle changes include:
● Healthy diet. A healthy diet focuses on fruits, vegetables, whole grains and lean protein foods that are high in nutrition and fiber and low in fat and calories and limits highly refined carbohydrates, including sweets. A registered dietitian or a certified diabetes care and education specialist can help you create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.
● Staying active. Regular physical activity plays a key role in every wellness plan before, during and after pregnancy. Exercise lowers your blood sugar. As an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain,
muscle cramps, swelling, constipation and trouble
sleeping.
Blood sugar monitoring
While you're pregnant, your health care team may ask you to check your blood sugar four or more times a day first thing in the morning and after meals to make sure your level stays within a healthy range.
Medication
If diet and exercise aren't enough to manage your blood sugar levels, you may need insulin injections to lower your blood sugar. A small number of women with gestational diabetes need insulin to reach their blood sugar goals.
Some health care providers prescribe an oral medication to manage blood sugar levels. Other health care providers believe more research is needed to confirm that oral medications are as safe and as effective as injectable insulin to manage gestational diabetes.
Close monitoring of your baby
An important part of your treatment plan is close observation of your baby. Your health care provider may check your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date or sometimes earlier your health care provider may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.