How Is Diabetes During Pregnancy Treated
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is.
Treatment focuses on keeping blood glucose levels in the normal range, and may include:
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A careful diet with low amounts of carbohydrate foods and drinks
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Exercise
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Oral medicines for hypoglycemia
What If I Need To Be Induced
Despite your best attempts to avoid it, induction might become medically necessary if you have gestational diabetes. This can challenge your attempts to have a natural birth, but you might avoid further interventions and a c-section. Theres a number of ways labour can be induced and, depending on the urgency of your situation, you might be able to negotiate as little intervention as possible.
During labour, your blood glucose will be monitored every hour to ensure it stays within safe levels. If your gestational diabetes has remained under control during pregnancy, through diet and exercise, its unlikely your blood glucose levels will rise. If you have been treated with insulin its more likely your blood glucose will increase during labour and, if that happens, you might need to have insulin and glucose administered through a drip.
Your baby will need continuous monitoring if medical forms of induction such as Pitocin or Syntocinon are used. This is because artificial oxytocin can cause your uterus to contract strongly and cause your baby to become distressed. Continuous monitoring will limit your ability to move, and might make it harder for you to cope with contractions. You can request an epidural, which might lead to further interventions and c-section.
How To Walk More Each Day
Below are some tips on how you can incorporate more walking into your life. It is important never to exert yourself.
- Walking to the local shops instead of driving.
- Start a walking group with family or friends perhaps meet at a regular time and day. This will help make sure youre committed and help you stay in touch with your loved ones.
- Take the stairs instead of the elevator.
- Stand and move while on the phone.
- Garden.
- Buy a pedometer , a small device you can clip to yourself that counts your daily steps. This will help you measure just how much walking youre doing.
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Caring Beyond The Here And Now
Cross said she hopes the data helps women considering pregnancy to take proactive steps to avoid GDM ahead of time.
She also hopes to keep these women tuned in to what they should do post-pregnancy for long-term health.
Human nature does play a role here.
Short-term outcomes can affect the baby, so they often get attention. Long-term is more difficult to spotlight, Cross said.
We are always talking about controlling the sugars short term, she said. Its the here and now that gets our attention.Risks from GDM such as a larger baby, birth trauma, and other complications make it easier for most women to hone in on things like changing their diet, exercising more, and keeping track of blood sugars.
I dont want to gloss over the importance of that short term, she said, but the long term is important, too.
Cross points out that once youve been diagnosed with GDM, its something to monitor for life.
Even if you are well controlled during pregnancy and dont end up needing insulin, this is a lifelong thing, she said.
Gestational Diabetes And Pregnancy
Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy.
Often gestational diabetes can be controlled through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin.
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Gestational Diabetes: The Overlooked Form Of Diabetes
May 09, 2017 12:00 AM
Office of Public Affairs
Did you know you could have diabetes and not realize it? Out of the almost 30 million Americans suffering from diabetes, over eight million cases are undiagnosed, and almost 1.5 million new cases of diabetes appear every year. As the onset of type 2 diabetes reaches epic proportions in American families, health experts continue to build awareness of the risks and rally for prevention.
But what about gestational diabetes? Although its easy to shrug off this form of diabetes that targets a specific portion of the communityand often remedies itself after giving birththe temporary condition, if left untreated, can produce permanent damage.
Treatments For Gestational Diabetes
If you have gestational diabetes, the chances of having problems with your pregnancy can be reduced by controlling your blood sugar levels.
You’ll be given a blood sugar testing kit so you can monitor the effects of treatment.
Blood sugar levels may be reduced by changing your diet and exercise routine. However, if these changes don’t lower your blood sugar levels enough, you will need to take medicine as well. This may be tablets or insulin injections.
You’ll also be more closely monitored during your pregnancy and birth to check for any potential problems.
If you have gestational diabetes, it’s best to give birth before 41 weeks. Induction of labour or a caesarean section may be recommended if labour does not start naturally by this time.
Earlier delivery may be recommended if there are concerns about your or your baby’s health or if your blood sugar levels have not been well controlled.
Find out more about how gestational diabetes is treated.
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Q What Is The Treatment For Gestational Diabetes
A. Treatment for gestational diabetes will focus on bringing your blood glucose levels within the normal range and keeping tight control of them. Most women can achieve good control with diet and exercise, but others may have to take insulin.
Your doctor may refer you to a diabetes specialist and will probably advise that you see a dietitian or a diabetes educator to help you with your diet. They will be able to advise you about low glycaemic index foods, and ensure that your dietary intake is rich in vitamins and nutrients for your growing baby. While it is important not to over-eat, it is also important not to under-eat, as this too can affect the babys growth.
Getting 30 minutes of moderate intensity physical activity on most, if not all, days of the week is safe and recommended for most pregnant women, including those with gestational diabetes. Your doctor or diabetes educator can advise you about what exercise you can do. Walking is one of the best and easiest ways to increase the amount of exercise you get. Try walking for 20 to 30 minutes 3 or 4 days a week to start with.
If diet and exercise measures dont give you good control of your blood glucose, your doctor may advise that you start on insulin.
Are You At Risk For Gestational Diabetes
You may be more likely than other women to develop gestational diabetes if:
- Youre older than 25.
- Youre overweight or obese and not physically active.
- You had gestational diabetes or a baby with macrosomia in a past pregnancy.
- You have high blood pressure or youve had heart disease.
- You have polycystic ovarian syndrome . This is a hormone imbalance that can affect a womens reproductive and overall health.
- You have prediabetes. This means your blood glucose levels are higher than normal but not high enough to be diabetes.
- You have a parent, brother or sister who has diabetes.
Even women without any of these risk factors can develop gestational diabetes. This is why your health care provider tests you for GDM during pregnancy.
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How Gestational Diabetes Can Affect You
As mentioned above, gestational diabetes often comes with no symptoms, so you probably wont know that you have it until the doctor diagnoses it. However, gestational diabetes can still have an effect on you.
Gestational diabetes can increase your risk of high blood pressure while youre pregnant. Also, you may have a larger baby, which can make delivery difficult or require a C-section.
Gestational diabetes can also put you more at risk for developing type 2 diabetes later in life.
Benefits Of Keeping Active
Physical activity helps to reduce insulin resistance. Regular exercise, like walking, helps to increase fitness and prepares you for the birth of your baby. Physical activity also helps manage blood glucose levels.
Remember, before starting or continuing any form of physical activity, always check with your obstetrician or midwife.
Its never too late to start moving, and there are many ways that you can keep active as a part of your everyday routine. Basically, anything that gets you moving is generally good for your diabetes and will also improve your overall feeling of wellbeing. For example, walking is a great way to move.
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What Causes Diabetes During Pregnancy
Some women have diabetes before they get pregnant. This is called pregestational diabetes. Other women may get a type of diabetes that only happens in pregnancy. This is called gestational diabetes. Pregnancy can change how a woman’s body uses glucose. This can make diabetes worse, or lead to gestational diabetes.
During pregnancy, an organ called the placenta gives a growing baby nutrients and oxygen. The placenta also makes hormones. In late pregnancy, the hormones estrogen, cortisol, and human placental lactogen can block insulin. When insulin is blocked, its called insulin resistance. Glucose can’t go into the bodys cells. The glucose stays in the blood and makes the blood sugar levels go up.
How Do You Know If You Have Gestational Diabetes
Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. You get the test at 24 to 28 weeks of pregnancy. If your provider thinks youre at risk for GDM, you may get the test earlier.
If your glucose screening test comes back positive, you get another test called a glucose tolerance test to see for sure if you have gestational diabetes.
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Can It Be Prevented
A proper diet can control GDM or prevent it from developing. The American Diabetes Association says that making healthy food choices that include fresh fruits and vegetables, limiting fat intake to 30 percent or less of daily calories, and tracking portion size can control symptoms. Healthy eating habits can go a long way in preventing diabetes and other health problems, they say.
Experts also recommend getting regular exercise and maintaining a healthy weight. Overweight and underweight women have an increased risk of premature labor, among other complications, says Erin A.S. Clark, MD, a maternal fetal medicine specialist at University of Utah Health. Ideally, your body mass index should be between 18.5 and 24.9 when you get pregnant.
Clark adds that if you are overweight, even a small amount of weight loss may improve your chances of a safe delivery.
The anticipation of a bouncy baby is a busy and exciting time. Amid the preparations, be sure to take the time to monitor your health. Todays choices to ensure the delivery of a healthy baby mean a bright future for you and your baby.
National Gestational Diabetes Register
The National Gestational Diabetes Register was established within the National Diabetes Services Scheme to help women who have had gestational diabetes to manage their health into the future. Women who have had gestational diabetes have a higher risk of developing type 2 diabetes later in life.
If you register on the National Gestational Diabetes Register, you and your doctor will be sent regular reminders to have diabetes checks. You will also receive information for you and your family to help you continue a healthy lifestyle.
Registration is free. Women who have been diagnosed with gestational diabetes, reside in Australia and hold, or are eligible to hold, an Australian Medicare Card are entitled to register.
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What Happens To The Baby If You Have Gestational Diabetes
If you have gestational diabetes and you do not control your blood sugar levels properly, it can affect the baby. The baby is prone to have high blood glucose levels that can cause complications in the delivery and afterward.
Infants that are born to diabetic mothers are usually larger in size than the normal babies. This causes hard delivery or often results in cesareans.
Besides that when the baby is born, he can have spells of hypoglycemia right after birth because during pregnancy the baby was used to get high sugar levels from the mother.
If you have gestational diabetes and you have not treated it properly your baby is exposed to have:
- Difficulty in breathing because of less mature lungs formation
- High red blood count that can thicken the blood
- High bilirubin level that can cause jaundice right after the birth
- Lethargy and sleepiness
- Trouble in feeding
How Can I Reduce My Risk Of Gestational Diabetes
There are no guarantees and about half of women who get gestational diabetes dont have any risk factors. But its always a good idea to adopt healthy habits.
- Watch what you eat: Your doctor or a nutritionist can help you make healthier choices in your diet. In general, eat less sugar and refined carbohydrates . Add more fiber to your diet .
- Step up your exercise: Talk to your doctor about what activities are best for you, but typically walking, swimming, yoga and other low-impact exercise is best.
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Guide For Healthy Eating During Pregnancy
Women with gestational diabetes are encouraged to:
- Eat small amounts often and maintain a healthy weight
- Include some carbohydrate in every meal and snack
- Choose foods that are varied and enjoyable that provide the nutrients you especially need during pregnancy. This means foods which include: calcium , iron , folic acid
- High in fibre
- Avoid foods and drinks containing large amounts of sugar
- Choose Basmati or Doongara rices they have a lower glycaemic index and will help you to stay fuller for longer.
- See a dietitian who can provide expert advice on the proper nutrients for you and your baby, as well as helping you make healthy food choices.
What Is Gestational Diabetes Mellitus
This form of diabetes occurs exclusively in womenpregnant women, to be exact. Women can be diagnosed with gestational diabetes having no history of diabetes at all. Doctors dont understand why it occurs in some women, but they know its affected by the hormones that support the unborn baby in the placenta.
These essential hormones help in the babys development, but they also contribute to insulin resistance in the mother. Without regular access to insulin, the mothers glucose cannot be converted to energy, so it builds up in the blood to dangerous levels. This is called hyperglycemia.
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Symptoms Of Gestational Diabetes
So, what happens if you have gestational diabetes? Unlike some types of diabetes, gestational diabetes has almost no associated symptoms. Thus, it can be difficult to know if you have gestational diabetes until you are tested for it.
A lack of noticeable symptoms doesnt mean that gestational diabetes is insignificant, though. This condition can still cause many complications for you and your baby.
Mothers with gestational diabetes are more likely to have high blood pressure while pregnant and are at a much greater risk for developing type 2 diabetes after the pregnancy ends. Additionally, once you have had gestational diabetes, youre more likely to have it again in subsequent pregnancies.
Uncontrolled blood sugar levels can lead to macrosomia or a baby who weighs much more than normal. Not only is this unhealthy for the child, but it can also make delivery much more difficult on the mother and baby or create the need for a cesarean section birth.
Additionally, if your blood sugar levels rise too drastically during labor, the risk of your baby developing hypoglycemia and other problems after birth is increased. Babies born to mothers with gestational diabetes are also at a greater risk of developing type 2 diabetes and related conditions such as diabetic neuropathy and foot problems in the future.
Is My Baby At Risk Of Complications Now I Have Gestational Diabetes
Gestational diabetes is a serious condition that can cause many complications. The advice given by your diabetes health care professionals should be taken seriously as uncontrolled or poorly controlled gestational diabetes can lead to severe complications. Having gestational diabetes itself automatically causes a higher risk of certain complications during pregnancy.
NOTE: The risk of complications is greatly reduced if gestational diabetes is diagnosed and managed properly throughout pregnancy
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The Most Common Complications
Even in mothers who have maintained good control of blood sugar levels throughout pregnancy, the most common complications are:
Health problems shortly after birth that require hospital care
- newborn hypoglycaemia and/or
- newborn jaundice
The most commonly seen complications in gestational diabetes babies weve had in the Gestational Diabetes UK Facebook support group have been neonatal hypoglycaemia and neonatal jaundice. Placenta deterioration, Polyhydramnios and IUGR have also been seen in the group a frequently and has led to mothers being induced or delivered earlier than previously planned.
Growing Baby Growing Impact
Gestational diabetes affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies born with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.
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