How Is Gestational Diabetes Managed
If you are diagnosed with gestational diabetes, its important to follow your doctors advice. Managing the condition and keeping your blood glucose levels under control helps avoid complications for both you and your baby.
You may be referred to an obstetrician and dietitian and may need more frequent antenatal appointments and regular monitoring of your blood sugar levels.
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 managed through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin.
Taking Insulin If It’s Needed
Even if you do everything your doctor tells you, you may still need to take insulin during your pregnancy to keep your blood sugar under control. This doesnt mean that your baby will be at any greater risk of complications it simply suggests that extra steps need to be taken to prevent fluctuations that neither diet nor exercise can fully control.
If insulin is prescribed, your doctor will show you how, when, and how much you would need if ever your blood sugar is high. This can often occur if you get sick or are under extreme stress. It is also important to be aware of the signs of hypoglycemia and the dangers of low blood sugar during pregnancy. While less common in women with gestational diabetes, the use of insulin can increase the risk considerably.
Ultimately, the goal is to keep your blood sugar under control no matter how much insulin it takes. Most women on insulin will take two shots per day, but you may get better control with three. With proper monitoring and guidance from your doctor, you should be able to attain the controls needed to ensure a normal, healthy pregnancy.
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Glycemic Targets In Pregnancy
Pregnancy in women with normal glucose metabolism is characterized by fasting levels of blood glucose that are lower than in the nonpregnant state due to insulin-independent glucose uptake by the fetus and placenta and by postprandial hyperglycemia and carbohydrate intolerance as a result of diabetogenic placental hormones.
Think About What You Drink
Its important to think about what youre drinking as well as what youre eating. Try to avoid sugary drinks. Diet or sugar-free drinks are better than sugary versions . Fruit juices and smoothies can also be high in sugar, and so can drinks labelled as no added sugar. Check the nutrition label or ask your healthcare team if youre unsure.
I had a bizarre craving for fresh orange juice when I was pregnant. But when I was diagnosed with gestational diabetes my midwife advised me to cut it out because of the sugar content.
As water contains no carbohydrate or calories, it is the perfect drink for pregnant women. Studies have also shown that drinking water could help control glucose levels. Drink a large glass of water with every meal and another glass in between meals.
“Water was key to keeping my glucose levels stable. I probably drank about 3 to 4 litres a day and walked for half an hour after dinner. My rule was a pint of water with every mefd and one immediately after. It worked for me and others I know.”
Find out more about how much water you should drink during pregnancy.
Can I Pass Gdm On To My Baby
If you are diagnosed with GDM, your baby may have blood sugar concerns, as well.
As you can imagine, babies who are used to chronic hyperglycemia do not transition well after birth, can become hypoglycemic after delivery and may need to be admitted to our NICU for management to keep their blood sugar up, Dr. Thung says. We test all GDM babies for hypoglycemia after delivery.
Good glycemic control can minimize these risks especially while in labor, Dr. Thung adds.
GDM runs in families. Typically, we do not expect GDM mothers to have immediately diabetic babies and that predisposition may be noted many decades later in adulthood, he explains.
How Might Diabetes Affect My Pregnancy
Diabetes during pregnancyincluding type 1, type 2, or gestational diabetescan negatively affect the health of women and their babies. For women with type 1 or type 2 diabetes, high blood sugar around the time of conception increases babies risk of birth defects, stillbirth, and preterm birth. Additionally, among women with any type of diabetes, high blood sugar throughout pregnancy increases womens risk of having a cesarean delivery and increases babies risk of being born too large and developing obesity or type 2 diabetes in the future.
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Gestational Diabetes Tests And Diagnosis
Gestational diabetes usually happens in the second half of pregnancy. Your doctor will check for it between weeks 24 and 28, or sooner if you’re at high risk.
Your doctor will give you a glucose tolerance test: Youâll drink 50 grams of glucose in a sweet drink, which will raise your blood sugar. An hour later, youâll take a blood glucose test to see how your body handled all that sugar. If the results show that your blood sugar is higher than a certain level, youâll need a 3-hour oral glucose tolerance test, meaning youâll get a blood glucose test 3 hours after you drink a 100-gram glucose drink. Your doctor can also test you by having you fast for 12 hours, then giving you a 75-gram glucose drink and a 2-hour blood glucose test.
If youâre at high risk but your test results are normal, your doctor might test you again later in your pregnancy to make sure you still donât have it.
How Do I Check My Blood Sugar Levels
Checking your blood sugar levels involves pricking the side of your finger with a special device called a lancet, and putting a drop of blood onto a test strip. This is then read by a blood glucose meter which tells you your blood sugar levels.
You should be given a blood glucose meter and taught how to check your blood sugar levels. If this hasnt happened, ask your care team for one straight away.
Your care team will tell you when to check. This is likely to include when you wake up in the morning and one hour after meals. If youre having two or more insulin injections, youre likely to be told to check before meals, one hour after meals and also at bed time.
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Testing For Gestational Diabetes
The standard is to do a two-step screening process. The first test is called a glucose challenge test which is done between 24 and 28 weeks when insulin resistance has already begun to increase, Dr. Thung says. If you fail this, you move to a diagnostic glucose tolerance test .
During both of these tests, you will be given a sweet liquid to drink. For the initial screening GCT, your blood will be drawn one hour later to evaluate how your body processes sugar. This can be done at any time of the day and you do not have to be on an empty stomach. If your glucose value is above the cut-off used by your provider , the test is followed by the diagnostic and time consuming three-hour glucose tolerance test .
The GTT is typically done in the morning after fasting all night, Dr. Thung explains. Four blood tests are performed. The first test is a fasting blood glucose. Once that is done, the glucose drink is given, and your blood glucose is tested at one-hour, two-hour and three-hour intervals.
If your blood sugar levels are once again above the cut-offs, then you will be diagnosed with GDM. We have now determined that with a high sugar load, your body cannot seem to produce enough insulin fast enough to keep your blood glucose in normal ranges. Fortunately most women do eventually get back to normal glucose levelsjust slower than women without GDM.
Can Gestational Diabetes Affect My Baby
If gestational diabetes is not well looked after it may result in problems such as a large baby, miscarriage and stillbirth. A large baby can create the risk of injury at delivery, caesarean delivery, forceps delivery and a need for the baby to be looked after in special care until the glucose level stabilises after delivery. Other complications may include pregnancy loss and premature delivery. If any problems occur, the hospital will care for you and your baby.
What Is Gestational Diabetes
Nycki Etherington was shocked when she was diagnosed with gestational diabetes mellitus . A slim 29-year-old, Etherington had no risk factors for the disease, which occurs when a womans pancreas isnt able to produce the extra insulin needed to keep increased blood sugar in check during pregnancy. Since GDM has no real symptoms , she had no warning signs.
Etherington was given an oral glucose tolerance test between 24 and 28 weeks, and, like almost 10 percent of pregnant women, received a positive result.
Youre having a babysubscribe to our Todays Parent Pregnancy by Week newsletter!Enduring yet another procedure during pregnancy can seem like an unnecessary inconveniencethe oral glucose tolerance test takes several hours to completeyet its essential to catch and treat this condition. Left unchecked, high blood sugar levels increase the risk of developing pre-eclampsia, which is life-threatening to both mom and baby. As well, women with GDM may give birth to very large babies, which can get stuck in the birth canal and require intervention, such as a C-section. However, as Winnipeg endocrinologist Pam Katz notes, the condition is highly manageable. In fact, if women with GDM are properly monitored and work to keep their blood sugar levels in check, most go on to have healthy pregnancies. With education and support, Katz says, most patients with gestational diabetes have a positive experience and a great outcome.
Dietary Management Of Gestational Diabetes Mellitus
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government.Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.|
|Recruitment Status : Not yet recruitingFirst Posted : November 14, 2022Last Update Posted : November 14, 2022|
The goal of this clinical trial is to test effect of dietary management program based on the nudge strategy in gestational diabetes mellitus patients. The main questions it aims to answer is whether the dietary management program is effective for the diet management behavior of gestational diabetes mellitus patients.
Participants will receive a 12 week dietary management program. The intervention group will receive a diet management program based on the nudge strategy, and the control group will receive a routine dietary management program. Researchers will compare two group’s glycemic control and pregnancy outcomes and to see if effective for the diet management behavior.Condition or disease
|Gestational Diabetes Mellitus in PregnancyDietHealthy||Behavioral: diet management program based on the nudge strategy||Not Applicable|
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Five Tips For Managing Gestational Diabetes
If you are diagnosed with gestational diabetes during pregnancy, its important to know that you are not alone. According to the American Diabetes Association, nearly 10 percent of all pregnancies in the U.S. are affected by gestational diabetes every year.
“The hormones that help develop your placenta can also produce insulin resistance. This makes it harder for your body to regulate blood sugar,” says Chloe Zera, MD, a maternal-fetal medicine specialist at BIDMC. “There are some potential risks to you and your babys health, but gestational diabetes is very manageable. Most people end up with a healthy pregnancy.”
Whether you have diabetes prior to getting pregnant or have gestational diabetes diagnosed during pregnancy, the key to managing your condition remains the same: keeping your blood sugar under control.
“Maintaining blood sugar levels requires some extra work,” Zera says. “Your healthcare provider will help you to come up with a plan that works with your life to help adjust your diet, lifestyle and medication when needed.”
People diagnosed with gestational diabetes are at increased risk for type 2 diabetes later in life. For that reason, you should be tested for diabetes at your postpartum visit. Make sure to let your primary care provider know so that you can get ongoing monitoring and advice on how to reduce your risks.
Here are five tips for managing your gestational diabetes:
What Are The Complications Of Gestational Diabetes
If your blood sugar levels remain high during your pregnancy, this may lead to pregnancy problems such as a large baby, miscarriage or stillbirth. Having a large baby can lead to complications and injury during the birth, and increase the chances of having intervention in labour such as a caesarean birth. But the baby will not be born with diabetes.
If you have gestational diabetes, you are at higher risk of developing high blood pressure while you are pregnant and a 50% increased risk of developing type 2 diabetes in the future. Your baby is also at greater risk of developing type 2 diabetes in later life.
To reduce your risk of developing type 2 diabetes:
- keep to a healthy weight
- eat a healthy diet
- be physically active
- check your blood glucose levels
You can also call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse for advice and support.
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Keeping Active With Gestational Diabetes
For women with gestational diabetes, moderate intensity physical activity can help to manage blood glucose levels. Moderate means a slight but noticeable increase in breathing and heart rate. If there are no specific obstetric or medical conditions, you should be able to safely exercise during pregnancy.
However, it is best to discuss this with your obstetrician or midwife prior to commencing any exercise regime in pregnancy.
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How To Manage Gestational Diabetes
When she was diagnosed, Etherington fretted about everything from what foods to eat to whether her baby would make it to term . She knew she needed to adopt a healthy eating plan and incorporate more exercise into her routine to help manage her glucose levels. To ease the transition, she attended free diabetes courses at Womens College Hospital in Toronto, where she learned about nutrition, obtained a glucose meter, and was taught how to prick her finger and interpret the results. I felt like a human pincushion, she says, recalling how squeamish she was at first about testing herself four times a day. It hurt for the first little while, until I got used to it.
Etherington became diligent about reading food labels, counting carbs and eschewing high-sugar foods for lower-sugar ones. Through trial and error, she found that potatoes, her favourite food, spiked her glucose levels so much that she had to cut them out completely, along with her beloved pasta and baguettes. It was difficult and stressful, she says. I had to measure everythingeven carrots. Some days, no matter how hard she tried to eat a healthy diet, shed still have a high blood sugar reading.
But despite the occasional elevated level, diet and exercise were enough to keep Etheringtons GDM under control during the pregnancy, as well as when she was pregnant with her second child.
Can Gestational Diabetes Be Prevented
Gestational diabetes often cant be prevented. But you can reduce your risk by being a healthy weight. If you are overweight before you fall pregnant, it is a good idea to try to lose some weight first.
If you are already pregnant and you are overweight, dont try to lose weight now. But its important to keep your weight gain within a healthy range. Your doctor can help you with this. Avoiding too much weight gain in the first two trimesters is a great way of preventing gestational diabetes.
If you have had gestational diabetes in a previous pregnancy, youre at higher risk of developing it again. Your doctor may do an oral glucose tolerance test at around 12 to 16 weeks to check your blood glucose levels, and then again at around 26 weeks.
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