What To Do For Gestational Diabetes

Can Gestational Diabetes Be Prevented

Its not possible to prevent gestational diabetes entirely. However, adopting healthy habits can reduce your chances of developing the condition.

If youre pregnant and have one of the risk factors for gestational diabetes, try to eat a healthy diet and get regular exercise. Even light activity, such as walking, may be beneficial.

If youre planning to become pregnant in the near future and youre overweight, one of the best things you can do is work with your doctor to lose weight. Even losing a small amount of weight can help you reduce your risk of gestational diabetes.

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.

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.

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How Is Gestational Diabetes Mellitus Diagnosed

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation.

In addition, women with diagnosed GDM should be screened for persistent diabetes 6 to 12 weeks postpartum. It is also recommended that women with a history of GDM undergo lifelong screening for the development of diabetes or prediabetes at least every three years.

Diet And Exercise For Gestational Diabetes

Take these simple steps to stay healthy:

Eat a healthy, low-sugar diet. Talk to your doctor to be sure youâre getting the nutrition you need. Follow a meal plan made for someone with diabetes:

• Trade sugary snacks like cookies, candy, and ice cream for natural sugars like fruits, carrots, and raisins. Add vegetables and whole grains, and watch your portion sizes.
• Have three small meals along with two or three snacks about the same times every day.
• Get 40% of your daily calories from carbs and 20% from protein. Fifty percent of the carbs should be complex, high-fiber carbs, with fat being between 25% and 30%.
• Aim for 20-35 grams of fiber a day. Foods such as whole-grain breads, cereals, and pasta brown or wild rice oatmeal and vegetables and fruits will help get you there.
• Limit your total fat to less than 40% of your daily calories. Saturated fat should be less than 10% of all the fat you eat.
• Eat a variety of foods to make sure you get enough vitamins and minerals. You may need to take a supplement to cover your bases. Ask your doctor if they think you should take one.

Exercise throughout your pregnancy. You can exercise when you have gestational diabetes as long as your doctor says itâs OK. Being active is a good way to help manage your blood sugar. Staying fit during pregnancy is also good for your posture and can curb some common problems, like backaches and fatigue.

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Problems Of Gestational Diabetes In Pregnancy

Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby:

An Extra Large Baby

Diabetes that is not well controlled causes the babys blood sugar to be high. The baby is overfed and grows extra large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-Section to deliver the baby. The baby can be born with nerve damage due to pressure on the shoulder during delivery.

C-Section

A C-section is an operation to deliver the baby through the mothers belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth.

High Blood Pressure

When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesnt go away, she might have preeclampsia. It is a serious problem that needs to be watched closely and managed by her doctor. High blood pressure can cause harm to both the woman and her unborn baby. It might lead to the baby being born early and also could cause seizures or a stroke in the woman during labor and delivery. Women with diabetes have high blood pressure more often than women without diabetes.

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Low Blood Sugar

How Is Gestational Diabetes Treated

Fortunately, you can eliminate virtually all of the potential risks associated with diabetes in pregnancy by carefully controlling your blood sugar levels.

If youre diagnosed with GDM, doctors and researchers recommend the following:

• Monitor your blood sugar level several times a day. Check first thing in the morning to get your fasting rate and then an hour after you eat each meal to make sure your blood sugar stays in a healthy range . Most doctors suggest that you buy a diabetes kit, which includes needles to prick your finger and a little machine that reads your blood sugar. Dont worry, the finger prick doesnt hurt, and its the most accurate way to tell how your body is processing various foods. Its empowering when you make healthy food choices and your blood sugar reading is good youre taking an active role in your own health .
• Meet with a registered dietitian. She can help you review healthy food options and make a meal plan. Many women stick to their gestational diabetes diet of well-balanced meals long after birth.
• Keep a food log. After each meal, write down everything you ate along with your blood glucose number. This helps you to better understand what foods are spiking your glucose levels so you can avoid them.
• Get moving. Go for a walk or take the stairs after a meal to lower your glucose levels.

Supplementary insulin can be given in shots, though the oral drug glyburide is being prescribed more and more often for GDM.

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What To Do If You Have Gestational Diabetes

These are general steps to get you started as you wait for specific instructions from your dietitian and endocrinologist.

1. Start a food log.It doesnt need to be specific. Log the foods and approximate amounts. Example: Breakfast 2 eggs, 2 sausage links, bottle of water.Heres a great food and glucose log printable. Tip print as 2 to a page, on landscape, and double sided if you can.

2. Eat every 3-4 hours.You may have to eat smaller portions at meal time so that youre hungry when snack time comes. Remember to always pair protein with carbs, even for snacks.

3. Track your blood sugar You need a glucose meter for this. Meters are sometimes covered by insurance, but if your insurance doesnt, you can buy one from any drug store. to your phone, or use this .Check your blood sugar as soon as you wake up , and 2 hours after each meal.

4. Eat a sensible breakfast.Breakfast sets the tone for your blood sugar for the day. A high-protein, low-carb breakfast sets you up for success.Example: eggs, meat, berriesVegan example: Walnuts, berries, coconut yogurt

5. Eat a bedtime snack.Since dinner to breakfast is a long fasting period, eating a bedtime snack is important to keep your glucose steady.

6. Get the free 6-day meal plan with shopping list.

7. Dinner for 3 weeksAfter the 6-day meal plan is finished, come back and get dinner for the following 3 weeks.

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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More Than One Test May Be Needed For Diagnosis

There are a couple of tests used to determine whether a woman has gestational diabetes. The first is called a Glucose Challenge Test. Depending on the results of this first test, a second test called a Glucose Tolerance Test may be necessary.

For the glucose challenge test, you do not need to fast before the appointment. There are two steps for this test:

• At the beginning of the appointment, youll be given about five ounces of a glucose solution to drink. The solution is syrupy and some women may find they do not like the taste.
• You stay in the office or lab setting for an hour to wait to have your blood tested. After the hour is up, blood is drawn from a vein in your arm. The blood will then be tested to see your blood sugar level.

If your blood sugar is too high , you might have gestational diabetes. To confirm the diagnosis, you will need to have a different test done.

The second test will be a glucose tolerance test. This test differs from the glucose challenge test in several ways even if the general idea is the same. For example, the glucose tolerance test takes three hours instead of just one and you must fast before the appointment. Then the process is as follows:

• A blood sample is taken at the beginning to determine fasting blood sugar.
• You will drink about eight ounces of the glucose solution.
• Your blood glucose level will be tested again one, two and three hours after you drink the solution.

Extra Appointments During Your Pregnancy

As soon as you arediagnosed with gestational diabetes you will be offered an appointment with a specialist team within 1 week. It will probably be at your local pregnancy diabetes clinic and you should start getting extra care straight away.

You should also have an HbA1c test to check your average glucose status over the last 2 to 3 months. This result can be helpful for understanding whether you had type 2 diabetes before you became pregnant.

You will have contact with the diabetes and antenatal team every 1 to 2 weeks throughout your pregnancy. This may be clinic appointments, or by phone or email to check that everything is fine.

“At first it was quite overwhelming. I was a borderline case but all of a sudden youve got a dietitian and an obstetrician. Before, it had been just the midwife.”

Michelle

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How Gestational Diabetes Can Affect Your Baby

When you have gestational diabetes, you must tightly control your blood glucose level. Talk to your healthcare professional regarding your individual blood glucose goals. Poorly controlled blood glucose levelsthat stay too high for too longcan cause complications for your baby.

Just because youve been diagnosed with gestational diabetes, that isnt a guarantee that your baby will have all of these complications. This is a list of what may happen if you dont manage gestational diabetes.

Heres how gestational diabetes can affect your baby at birth and right after birth:

Heres how gestational diabetes can affect your child later on:

• Development problems: Researchers have noticed that children whose mothers had gestational diabetes are at a higher risk for developmental problems, such as language development and motor skill development.
• Type 2 diabetes: Babies born of mothers with gestational diabetes are at a higher risk for developing type 2 diabetes later in life.

What Complications Are Associated With Gestational Diabetes

If your gestational diabetes is poorly managed, your blood sugar levels may remain higher than they should be throughout your pregnancy. This can lead to complications and affect the health of your child. For example, when your baby is born, he or she may have:

• a high birth weight
• low blood sugar
• shoulder dystocia, which causes their shoulders to get stuck in the birth canal during labor

They may also be at higher risk of developing diabetes later in life. Thats why its so important to take steps to manage your gestational diabetes by following your doctors recommended treatment plan.

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How To Monitor Your Blood Glucose Levels

Your medical team will give you a target range for your blood glucose levels. You will need to check these at home while you are pregnant.

You can purchase a blood glucose measuring kit from your local pharmacy or diabetes centre, or from Diabetes Australia in your state or territory call 1800 637 700 for help.

To test your blood glucose levels, you prick your finger with a lancet and put a small drop of blood onto a testing strip. Then you insert the strip into a meter, which reads your blood glucose level.

Alternatives To The Glucose Challenge Test

Your doctor may offer alternatives to the glucose challenge tests. For example, some women have difficulty drinking the highly concentrated syrupy drink, while others prefer not to consume that much sugar while pregnant. Regardless of the reason, please discuss with your doctor if you feel you would do better with a different screening method for gestational diabetes.

It is important that you are screened for gestational diabetes as there can be significant complications for both you and your baby if gestational diabetes is untreated. If you prefer an alternative test, please arrange this with your doctor rather than just skipping screening altogether.

Some common alternative options are:

• Other food options with 50g of carbohydrates .
• Hemoglobin A1C test.
• Blood sugar monitoring. You monitor and record your blood sugar levels at home using a glucometer multiple times a day. Usually, doctors will want two weeks of monitoring.

Not all doctors will offer all of these alternatives. If having an alternative glucose screening is important to you, make sure you discuss this with your obstetrician or midwife during your first prenatal appointment.

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It Might Develop Due To Pregnancy Hormones

According to the American Diabetes Association, there is no universally proven and agreed-upon cause for gestational diabetes. However, there are certain things that point to why a woman without diabetes develops diabetes while pregnant.

During pregnancy, the placenta produces hormones needed for the baby to develop properly, which is a good thing for the baby. But these hormones can cause insulin resistance in the mother. This makes it difficult for the body to use its insulin.

Follow A Healthy Eating Plan

Your health care team will help you make a healthy eating plan with food choices that are good for you and your baby. The plan will help you know which foods to eat, how much to eat, and when to eat. Food choices, amounts, and timing are all important in keeping your blood glucose levels in your target range.

If youre not eating enough or your blood glucose is too high, your body might make ketones. Ketones in your urine or blood mean your body is using fat for energy instead of glucose. Burning large amounts of fat instead of glucose can be harmful to your health and your babys health.

Your doctor might recommend you test your urine or blood daily for ketones or when your blood glucose is above a certain level, such as 200. If your ketone levels are high, your doctor may suggest that you change the type or amount of food you eat. Or, you may need to change your meal or snack times.

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Checking Your Blood Sugar

An important part of treating gestational diabetes is checking your blood sugar level at home. Every day, you will do a home blood sugar test one or more times. It may be overwhelming to test your blood sugar so often. But knowing that your level is within a target range can help put your mind at ease. Talk to your doctor about how often to test your blood sugar.

• Gestational Diabetes: Checking Your Blood Sugar

Gestational Diabetes Risk Factors

Youâre more likely to get gestational diabetes if you:

• Were overweight before you got pregnant
• Are African-American, Asian, Hispanic, Alaska Native, Pacific Islander, or Native American
• Have blood sugar levels that are higher than they should be but not high enough to be diabetes
• Have a family member with diabetes
• Have had gestational diabetes before
• Have polycystic ovary syndrome or another health condition linked to problems with insulin
• Have given birth to a baby who was stillborn or had certain birth defects
• Are older than 25

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