Pregnancy and Gestational Diabetes

Diabetes is spreading across the globe like a wild fire. However, many people don't have the correct knowledge to tackle it. Diabetes is a condition where sufficient amounts of insulin are either not produced or the body is unable to use the insulin that is produced. There are 4 basic types of Diabetes:

• Neurogenic
• Nephrogenic
• Dipsogenic
• Gestagenic

Gestagenic DI or Gestational diabetes is a form of diabetes which affects pregnant women. It affects between 3% to 10% of all pregnant women and usually develops in the second trimester (sometimes as early as the 20th week of pregnancy). If the diabetes isn't treated, your baby may be more likely to have problems at birth.

What is Gestational Diabetes?

Gestational diabetes mellitus (GDM) is is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy. Gestational diabetes generally has few symptoms and it is most commonly diagnosed by screening during pregnancy.

No specific cause has been identified, but it is believed that the hormones that help the baby to develop also block the action of the mother's insulin in her body. As a result a mother may need up to three times more insulin for glucose to leave the blood and transform to energy. When body is not able to use insulin due to insulin resistance, it develops into Gestational Diabetes.

If the diabetes isn't treated, the baby is more likely to have problems at birth. For example, baby may have a low blood sugar level and jaundice. Extra blood glucose passes through the placenta that gives the baby a high blood glucose level. As a result, the baby's pancreases make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs, the extra energy is stored as fat. This can lead to Macrosomia i.e. "Fat" baby. Gestational diabetes can also affect women's health. Women with gestational diabetes are at increased risk of developing type 2 diabetes mellitus after pregnancy.

Gestational diabetes is a treatable condition and women who have adequate control of glucose levels can effectively decrease these risks. Most patients are treated only with diet modification and moderate exercise but some take anti-diabetic drugs, including insulin.

What are its Symptoms?

Symptoms may include:

• Blurred vision,
• Excessive weight gain,
• Fatigue,
• Frequent infections, including those of the bladder, vagina, and skin,
• Increased thirst,
• Increased urination,
• Nausea and vomiting.

Who are at Risk?

High risk groups include:

• Women over 30 years of age.
• Women with a family history of type 2 diabetes.
• Women who are overweight or obese.
• Women with a pre-diabetes condition.
• Women of some ethnic groups including Indian, Chinese, Vietnamese, Middle Eastern, Polynesian and Melanesian women.
• Women with a history of gestational diabetes in a previous pregnancy.

What should I do?

In some cases, gestational diabetes can affect your pregnancy and your baby. However, you can minimize the risks by making healthy lifestyle choices.

• Control Blood sugar level: Test your blood sugar level frequently to keep it under control. There are various Home glucose testing kits are available with chemists to help you conduct this test.

• Avoid high sugar food: Avoid foods and beverages with added sugar, corn syrup, honey, or jams and jellies. Read the labels of packaged foods to find the grams of sugar a serving has in it. Eat complex carbohydrates such as whole wheat pasta, rice, grains, cereals, crackers, bread, potatoes, dried beans and peas.

• Snack smartly: If you get hungry between meals, eat foods that are healthy for you, such as raisins (kishmish), carrot sticks or a piece of fruit. Whole-grain pasta, whole-grain breads and rice are also good for both you and your baby. Eat a snack before bedtime that is protein and carbohydrate based.

• Add more fiber to your diet: Choosing high fiber foods will help control your blood sugar and have regular bowel movements. High fiber foods are fresh fruits and vegetables, whole grain breads, cooked dried beans, and bran cereals.

• Exercise: Moderate physical exercises under the guidance of a physiotherapist will be helpful. Eat every few hours (5 meals a day) and try to take a 10-minute walk after every meal. Make it a point to work out as advised, regularly.

Some women with gestational diabetes will also need to take insulin to help manage their diabetes.  The extra insulin can help lower their blood sugar level.

Your blood sugar levels will most probably go back to normal quickly after your baby is born. It is advisable to get a blood test to check your blood sugar levels six weeks after your delivery.