Understanding Gestational Diabetes
Are you pregnant or planning for pregnancy? This is an exciting time, but it’s also important to be informed. Gestational diabetes can affect any woman during pregnancy, even without a prior history of diabetes. In fact, it occurs in approximately 2-10% of pregnancies in the United States.
What is Gestational Diabetes?
Pregnancy brings significant changes to our bodies, including physical, hormonal, and emotional shifts. Alongside weight gain, our bodies undergo various adaptations to support the developing life within us. Insulin, a hormone produced by the pancreas, plays a crucial role in regulating blood sugar levels. During pregnancy, our bodies may become less efficient at both producing and utilizing insulin. This decreased responsiveness to insulin, known as insulin resistance, can lead to elevated blood sugar levels above the normal range of (70-99 mmol/L, and potentially result in gestational diabetes.
What Causes Gestational Diabetes?
There are many ideas about the cause of gestational diabetes, but the exact cause remains unknown. A likely contributing factor is the reduced effect of insulin in response to hormones secreted during pregnancy, such as estrogen, progesterone, cortisol, and human placental lactogen. The influx of these hormones can overpower and block the effects of insulin, commonly known as a contra-insulin effect.
These contra-insulin effects typically begin between weeks 20-24 of pregnancy. As the placenta grows, it produces more of these hormones, further reducing insulin’s effectiveness. While the pancreas should produce extra insulin to counteract these effects, it may not. When the pancreas is unable to produce the necessary additional insulin, gestational diabetes is diagnosed.
What are the Symptoms?
Who is at Risk?
- Age – Women over 25 are at a higher risk.
- Ethnicity – Those of African American, Asian, Hispanic, Indigenous American, or Pacific Islander descent have an increased risk.
- Health History and Lifestyle – Heart disease, high blood pressure, physical inactivity, poor diet, obesity, a personal or family history of gestational diabetes, PCOS, prediabetes, or a previous birth weighing at least 9 pounds can also elevate risk.
How is Gestational Diabetes Diagnosed and Treated?
If your healthcare provider suspects you have gestational diabetes, they will likely test your blood sugar in two steps. First, a glucose challenge test will be conducted, in which you will be asked to drink a sweet liquid and have your blood sugar levels taken after about an hour. If this level is elevated, your healthcare provider will then conduct a oral glucose tolerance test (OGTT), during which you will have blood sugar measured before you drink a sweet liquid, and then at one-, two-, and three- hour intervals after. This test is conducted only after the individual has been fasting for at least 8 hours prior and can confirm your diagnosis of gestational diabetes. At this point in time, you and your healthcare provider can begin to create a treatment plan that best suits your needs.
There are many steps that can be taken to treat and manage gestational diabetes, including self monitoring, diet, physical activity, and monitoring of your baby. It is important to routinely visit your healthcare provider for regular blood sugar testing, as well as monitor your blood sugar levels at home with a glucose meter. Along with monitoring, adopting a healthy dietary pattern and physical activity regimen will also help effectively manage your gestational diabetes. It is recommended that women with gestational diabetes avoid most processed foods and sugary drinks, and instead, choose a more balanced dietary pattern with adequate intakes of protein, carbohydrates, fat, and fiber. Blood glucose might also stay more consistent with consistent timing of frequent, smaller meals throughout the day.
Physical activity is another effective way of regulating blood sugar levels in women with gestational diabetes. It is important for pregnant women partaking in physical activity to ensure safety and appropriateness of exercise at all times. Creating a safe and enjoyable exercise plan for pregnancy should take a number of factors into consideration, including age, physical fitness level before pregnancy, overall health status, and weight. Consulting with your healthcare provider and discussing your personal goals, interests, and health status is a great way to formulate the perfect plan for physical activity during your pregnancy. Some examples of physical activity during pregnancy include brisk walking or light swimming. Additionally, monitoring the growth and development of your baby regularly will help ensure that your baby remains healthy and that any potential complications are caught as soon as possible.
Are There Potential Risks?
If left untreated, gestational diabetes has the potential to result in complications during pregnancy and birth that can affect both mom and baby. These complications include macrosomia, shoulder dystocia and other injuries during birth, maternal high blood pressure, preterm birth, C-sections, among others. During gestational diabetes, more glucose is being delivered to the fetus through the placenta, which likely can result in the baby growing “large for gestational age”. Babies weighing 8 pounds, 13 ounces (4,000g) and over are considered large for gestational age and are at an increased risk of experiencing injuries during birth due to their size. The most common birthing injuries infants experience are related to their collarbone, arms, and spinal cord. In addition to complications related to their size, babies also experience a higher risk of being born via C-section or prematurely. Mothers can experience high blood pressure during gestational diabetes due to increased stress and pressure on blood vessels throughout the body.
Why See a Registered Dietitian?
Meeting with a registered dietitian can greatly benefit your treatment and management of gestational diabetes, helping you feel confident and in control of your health. A registered dietitian can assist you in calculating your carbohydrate intakes throughout the day, efficiently portioning your meals in a way that works best for you, and making informed nutrition decisions. Whole Lifecycle Nutrition is here to assist you throughout your journey with pregnancy, gestational diabetes, and anything else that comes your way! Contact us here!
