How Is Gestational Diabetes Treated
If youre diagnosed with gestational diabetes, your treatment plan will depend on your blood sugar levels throughout the day.
In most cases, your doctor will advise you to test your blood sugar before and after meals, and manage your condition by eating a nutrient-rich diet and exercising regularly.
In some cases, they may also add insulin injections if needed. If your doctor encourages you to monitor your blood sugar levels, they may supply you with a special glucose-monitoring device.
They may also prescribe insulin injections for you until you give birth. Ask your doctor about properly timing your insulin injections in relation to your meals and exercise to avoid low blood sugar.
Your doctor can also tell you what to do if your blood sugar levels fall too low or are consistently higher than they should be.
A balanced diet is key to properly managing gestational diabetes. In particular, people with gestational diabetes should pay special attention to their carbohydrate, protein, and fat intake.
Eating regularly as often as every 2 hours can also help you manage your blood sugar levels.
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Gestational diabetes can put mothers at risk of developing type 2 diabetes in the future. And while gestational diabetes often resolves by itself, the same cant be said for other types of diabetes.
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Who Is Most At Risk For Gestational Diabetes
While researchers arent certain why some women get gestational diabetes while others dont, they do know that you may be at an increased risk if:
In the U.S., about 90 percent of pregnant women have at least one risk factor for gestational diabetes, which is why universal screening is thought to be the most practical approach.
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What Is Gestational Diabetes
Any term with the word gestational refers to pregnancy. Thus, gestational diabetes occurs during pregnancy.
Diabetes is a condition that affects insulin production in the body. Insulin is a hormone thats responsible for absorbing glucose or sugar from the blood and transferring it to the cells for energy generation.
Because of various factors affecting insulin production, some mommies-to-be may experience abnormal blood glucose levels. This condition is known as gestational diabetes.
Gestational diabetes is of two types:
A) Hypoglycemia: This occurs when the blood sugar levels plummet and your body doesnt produce enough energy to perform properly.
B) Hyperglycemia: In this case, the blood glucose levels are too high, mainly because of low production or improper function of insulin.
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How Is Gestational Diabetes Managed
If youre diagnosed with gestational diabetes, you may need more frequent checkups during your pregnancy. Your healthcare provider will check your blood sugar levels regularly. You may need to monitor your blood sugar at home with a tool called a glucose meter.
Some women need medication to manage gestational diabetes. But most women can keep their blood sugar levels under control with diet and exercise.
How Is Gestational Diabetes Diagnosed
The American Diabetes Association encourages doctors to routinely screen pregnant women for signs of gestational diabetes. If you have no known history of diabetes and normal blood sugar levels at the beginning of your pregnancy, your doctor will likely screen you for gestational diabetes when youre 24 to 28 weeks pregnant.
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What To Do After Being Diagnosed
For many women, being diagnosed with gestational diabetes can be upsetting. However, it is important to remember that the majority of women with gestational diabetes have a healthy pregnancy, normal delivery and a healthy baby. The treatment is a healthy eating plan, regular physical activity and monitoring and maintaining blood glucose levels in the target range while you are pregnant. Read more about managing gestational diabetes.
Managing diabetes is a team effort involving the woman, her family and health professionals. Some of the health professionals that may form part of a diabetes health care team include endocrinologists, obstetricians, credentialled diabetes educators, accredited practising dietitians, accredited exercise physiologists, GPs and midwives.
Early Signs Of Diabetes
Both types of diabetes have some of the same telltale warning signs.
- Hunger and fatigue. Your body converts the food you eat into glucose that your cells use for energy. But your cells need insulin to take in glucose. If your body doesn’t make enough or any insulin, or if your cells resist the insulin your body makes, the glucose can’t get into them and you have no energy. This can make you hungrier and more tired than usual.
- Peeing more often and being thirstier. The average person usually has to pee between four and seven times in 24 hours, but people with diabetes may go a lot more. Why? Normally, your body reabsorbs glucose as it passes through your kidneys. But when diabetes pushes your blood sugar up, your kidneys may not be able to bring it all back in. This causes the body to make more urine, and that takes fluids. The result: You’ll have to go more often. You might pee out more, too. Because you’re peeing so much, you can get very thirsty. When you drink more, you’ll also pee more.
- Dry mouth and itchy skin. Because your body is using fluids to make pee, there’s less moisture for other things. You could get dehydrated, and your mouth may feel dry. Dry skin can make you itchy.
- Blurred vision. Changing fluid levels in your body could make the lenses in your eyes swell up. They change shape and canââ¬â¢t focus.
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How Do You Manage Gestational Diabetes
If you are diagnosed with gestational diabetes, it is important that you are supported and know what to do to manage it. Health professionals such as your doctor, a dietitian, a diabetes nurse educator, or sometimes, a diabetes specialist will help you understand what to do and will support you.
Family also can be a great support. It is important that your family understands gestational diabetes and how it is managed.
Management of gestational diabetes aims to keep blood glucose levels in the recommended range during pregnancy. This can prevent problems during birth and also helps reduce the babys risk of being overweight in childhood and developing type 2 diabetes later in life.
Management of gestational diabetes involves:
- monitoring blood glucose levels
- healthy eating. Referral to a dietitian is an important part of management. Often this will be organised for you via your health care team
- regular physical activity
Some women may need insulin injections to help manage their gestational diabetes.
What Are The Possible Disadvantages Of A Routine Screening Test
All screening tests and examinations have disadvantages as well as advantages. Even if there is a treatment that works, it doesnt necessarily mean that a routine examination for all pregnant women is a good idea. Routine tests for gestational diabetes are unnecessary in most pregnant women because their blood sugar levels are normal. And doctors might recognize that a woman is at greater risk of developing gestational diabetes anyway, while providing the standard care during pregnancy.
Being diagnosed with gestational diabetes can make women worry for no reason. Higher-than-normal blood sugar levels dont necessarily cause problems. Most pregnant women with slightly elevated blood sugar levels give birth to healthy babies with a normal birth weight. After receiving the , women are also advised to change their diet and measure their blood sugar several times a day. There isn’t always a real need to do this, though.
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Unusually Strong Cravings For Sweet Foods And Drinks
While big meals may leave you feeling sick, sugary snacks can have the opposite effect. Those with diabetes can have what seems to be a relentless appetite for sweets.
Why does this happen? Diabetes leads to dramatic fluctuations in blood sugar as the body loses much of its ability to self-regulate levels. When these levels drop, the brain thinks it is starving and craves quick and easy calories.
Extreme Fatigue And Lethargy
While not uncommon to feel tired during pregnancy, unmanaged diabetes will leave you feeling exceptionally weak and drowsy.
It is best described as extreme fatigue or lethargy, where you even feel like resting in bed during the middle of the day.
Why does this happen? With diabetes, sugar remains in the blood instead of entering the cells to provide energy. As a result you literally have less energy.
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Staying Aware Of Increased Cardiovascular Risk After The Pregnancy
While gestational diabetes usually resolves after delivery, women who have experienced it have a 68% higher risk of developing cardiovascular disease later in life than women who didnt have gestational diabetes. This risk is there whether the pregnancy was last year or 40 years ago. Women should be aware of their increased risk and be sure their healthcare providers are aware of their medical history.
The Riverside Womens Heart Center specializes in caring for women with this increased risk. To learn more about the cardiovascular risks from a high-risk pregnancy or to make an appointment at the Riverside Womens Heart Center, please visit www.riversideonline.com/womensheart.
What Does It Involve
In the challenge test, you drink a glass of water with 50 grams of sugar dissolved in it. One hour later, blood is taken from a vein in your arm to measure your blood sugar levels. If the value is below 7.5 millimoles per liter , the results are considered to be normal and no more tests are done.
If the results of the challenge test are abnormal, a glucose tolerance test is done. Unlike the challenge test, it has to be done on an empty stomach. In other words, you shouldnt eat anything for at least eight hours beforehand. You’re only allowed to drink still mineral water or tap water during this time. At the beginning of the test, a blood sample is taken. You then drink a sugar solution containing 75 grams of glucose dissolved in 300 ml of water. A blood sample is taken from a vein in the arm one hour later, and then again after two hours. If any of the following three blood sugar levels is reached or exceeded, gestational diabetes is diagnosed:
- After fasting: 5.1 mmol/l
- After one hour: 10.0 mmol/l
- After two hours: 8.5 mmol/l
The test results are documented in your maternity records. In Germany, the costs of the glucose challenge and tolerance tests are covered by statutory health insurers.
There are no known risks to the baby. Some women find the sugar solution unpleasantly sweet.
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Monitoring Blood Glucose Levels
Monitoring your blood glucose levels is essential. It gives you a guide as to whether the changes you have made to your lifestyle are effective or whether further treatment is required.
A diabetes nurse educator can teach you how and when to measure your blood glucose levels. They will discuss the recommended blood glucose levels to aim for.
Your doctor or diabetes educator can help you register with the National Diabetes Services Scheme for discounted blood glucose strips. Regular contact with your diabetes educator or doctor is recommended.
Tingling In The Hands Or Feet
A tingling sensation in the hands and feet is another sign of gestational diabetes. Similarly to blurred vision, it is more noticeable because it is not a typical symptom of pregnancy.
Why does this happen? Excess sugar in the blood can start damaging nerves and nerve-endings. The nerves in the hands and feet tingle most because they are furthest from the heart, making them harder for the body to access and repair.
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Your Diabetes Treatment In Pregnancy
Your diabetes team may recommend changing your treatment regime during pregnancy.
If you usually take tablets to manage your diabetes, you’ll normally be advised to stop these medications and switch to insulin injections.
If you already use insulin injections to control your diabetes, you may need to switch to a different type of insulin.
If you use an insulin pump you can continue to do so during pregnancy.
If you take medications for high blood pressure or high cholesterol, these may also need to be changed.
It’s important that you attend all your appointments so that your diabetes and obstetric teams can monitor your condition. They can react to any changes that could affect your or your baby’s health
You will need to check your blood glucose levels more frequently during pregnancy. This is because nausea and vomiting can affect them. Your diabetes team or midwife will be able to advise you on this.
Managing your blood glucose levels tightly may be associated with more episodes of low blood glucose . The diabetes team will help you and those close to you to recognise hypos and how to manage them. Talk to your GP or diabetes team.
What Are The Risk Factors For Gestational Diabetes
A number of factors increase your risk of developing gestational diabetes. These include:
- Being overweight or obese
- Having a previous case of gestational diabetes
- Having prediabetes
- Having a family member with diabetes
- Previously delivering a baby over 9 pounds
Being from a nonwhite race is also a risk factor. Women who are Black, American Indian, Asian American, Pacific Islander, and Hispanic are more likely to develop gestational diabetes.
Doctors arent yet sure why some women develop gestational diabetes and others dont, although being overweight seems to play a role.
Its likely that hormones also play a large part since, normally, hormones work to keep your blood sugar levels in check. During pregnancy, though, your hormone levels change. That makes it harder for your body to process blood sugar efficiently, and your levels rise as a result.
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Signs You Might Have Gestational Diabetes
Gestational diabetes is a type of diabetes thats diagnosed for the first time during gestation, or pregnancy.
Like other forms of the disease, gestational diabetes affects how your cells use glucose, the sugar that provides energy for your body, increasing blood sugar to levels that can affect both you and your babys health.
About 2%-5% of pregnant women develop gestational diabetes, and the numbers increase to 7%-9% for those more likely to have risk factors.
Theres good news, though. Pregnant women can help control their sugar levels by eating a healthy diet, exercising, and taking medication, if necessary.
But while your blood sugar generally returns to normal shortly after delivery, if youve had gestational diabetes, youre in a higher risk category for getting Type 2 diabetes. What this means is you need to have your blood sugar checked more often.
A board-certified OB/GYN, Dr. Hany H. Ahmed provides comprehensive womens health care at his office in Houston, Texas. He specializes in treating high-risk pregnancies, including women with gestational diabetes.
Dr. Ahmed can provide you with the targeted care you need for both yourself and your baby. Hed like you to be informed about this condition, so hes put together this guide to help you understand what your bodys going through during this challenging time.
Who Is At Risk Of Getting Diabetes
Type 1 diabetes is an autoimmune condition, and the causes arenât known, but people with a family history of the condition are at higher risk of developing it than those with no familial connection.
Type 2 diabetes is more common in people who are overweight , who have very low levels of physical activity and who eat an unhealthy diet.
âThings like family history, obesity, poor diet â and by poor diet, I mean processed foods, high-carbohydrate foods, ice-cream, soft drinks, processed food⦠theyâre all risk factors,â says Hamish.
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Ageing
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Women who are overweight and have polycystic ovarian syndrome
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Being older than 35 and from an Aboriginal or Torres Strait Islander, Pacific Island, Indian subcontinent or Chinese cultural background
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Having had gestational diabetes during pregnancy.
Living a healthy lifestyle can reduce your risk of developing type 2 diabetes â think: maintaining a healthy weight, moving regularly, eating a balanced diet and not smoking. If you have high blood pressure or cholesterol, managing those is also important.
Gestational diabetes does not usually cause any symptoms.
Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.
Some women may develop symptoms if their blood sugar levels gets too high , such as:
- needing to pee more often than usual
- a dry mouth
- tiredness
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