By now you probably heard many stories and rumors about gestational diabetes. The confusion surrounding this disease is quite big, but now it’s time to shed light on this condition. Keep reading, and discover that as unpleasant as gestational diabetes might be, it’s far from being a disaster.
Knowing Gestational Diabetes: The First Step of Not Fearing
Gestational diabetes mellitus (also known as gestational diabetes or diabetes during pregnancy) is a condition in which a pregnant woman, who never had diabetes before conceiving, suddenly gets it. It usually erupts in the third trimester, and therefore testing for it is usually done between weeks 24-28.
One of the most common fears amongst pregnant women and women who try to conceive is gestational diabetes. It is a common topic of conversation amongst pregnant women, and by now it has turned to be a synonym for troublesome and difficult pregnancy, even though most women did not experience it on their own. Still, much like many other fears in the world of pregnancy (and in general!), it seems that a lot of the fear surrounding gestational diabetes originates from the unknown rather than actual facts.
Therefore, it is time to shed light on this condition, and tell the world that although having gestational diabetes isn’t pleasant, it’s not the end of the world or a certainty for unhealthy babies. Yes, gestational diabetes has its risks and it might force you to change your life style while pregnant and afterwards. But becoming familiar with this condition and the way to control it is the first step towards not fearing it, or living in peace with it.
Background to Gestational Diabetes: How does Food become Energy?
The best place to begin discussing about gestational diabetes is to understand the process of turning food into energy which takes place in a healthy diabetes-free body.
The key element in this process is a molecule called glucose. The glucose is the fuel of every cell in our body – our cells need it to operate properly. And how does the glucose get into our body from the first place? From food of course! To be more specific, mostly from foods which contain a high concentration of sugar (fruits, honey, chocolate, candy, and much more – even milk), and carbohydrates.
Our intestines break the food into glucose, which goes into our blood stream. From there, the glucose will find its way into our cells, to be used as an energy source. Now, here comes the tricky part – the glucose can only enter the cells after a hormone called insulin – which is found in the blood stream after meal – “unlocks” the cell by attaching to it. In a healthy body this process will happen smoothly. The problem begins when diabetes comes into the picture…
So what is Diabetes?
For people with diabetes, the body’s process of producing insulin in the pancreas or the body’s response to it is disturbed. In type 1 diabetes, the pancreas secretes little or no insulin at all, thus glucose can’t enter the cells. In fact, the body is in constant hunger since it can’t get the energy it needs from glucose. In type 2 diabetes, the pancreas secretes enough insulin, or even too much of it, but the body’s cells developed some sort of resistance in response to it. This can be compared to changing the lock on a door, so that the key (the insulin) can’t open it and allow people (the glucose) to enter the room (the cell). Either way, this malfunction causes the glucose to remain in the blood stream instead of getting inside the cells and fueling them.
Ok… and what about Gestational Diabetes…?
As mentioned above, gestational diabetes is a kind of diabetes which pregnant women sometimes develop. In a similar manner to diabetes type 2, in gestational diabetes the pregnant women’s cells develop resistance to insulin, thus preventing glucose to enter the cells and nourish them, and causing it to accumulate in the blood stream.
The reason for the outburst of diabetes during pregnancy is connected to the hormonal changes that occur in your body during pregnancy. Those hormonal changes are tremendous, so they can impact the regular activity of the pancreas (where insulin is produced), or affect the cells so they are more prone to develop insulin resistance.
It is important to mention at this point that in most cases gestational diabetes will not develop unless the woman is already at risk to develop diabetes in the first place. And indeed, women that had gestational diabetes have a 35 to 60 percent chance of developing diabetes in the next 10–20 years. This means that in a big sense gestational diabetes can be an expression of an existing tendency that the pregnancy surfaced.
High Risk Groups and Testing for Gestational Diabetes
Reported rates of gestational diabetes range from 2 to 10 percent of pregnancies. But much like many other health conditions, women from certain high-risk groups are more likely to get it than others:
- Overweight or obese women
- Women with diabetic relatives and/or family history
- Women with high blood sugar (conditions which are called impaired glucose tolerance and impaired fasting glucose)
- Women of certain ethnic backgrounds (such as African-American, Hispanic, Native-American, Aboriginal, Asian and several others)
- History of gestational diabetes in previous pregnancies
Immediately after pregnancy, 5 to 10 percent of women with gestational diabetes are found to have diabetes, usually type 2. Also, the risk for getting gestational diabetes increases with the mother’s age, especially from the age of 35 and onwards.
Testing for gestational diabetes is a relatively easy procedure which should be done by your physician. Since the condition usually erupts in the third trimester, the tests which will discover it are usually done between weeks 24-28. All pregnant women should be tested for gestational diabetes at this time. In addition, women of high-risk groups might want to ask their health care provider to perform test in the 1st and 2nd trimesters as well.
Risks and Complications of Gestational Diabetics
Since gestational diabetes usually erupts on the third trimester, usually this will be the time that diabetes will start affecting the mother’s and baby’s health. This means that the mother will not necessarily suffer from all of the short-term implications of regular diabetes, but unless treated properly, she might experience several difficulties. She should also notify the medical team which will perform the delivery about her situation, so that they can prepare for some probable birth complications.
The main reason for a big portion of those risks derives from the large size and weight a fetus of a woman with gestational diabetes might grow to (a situation known as macrosomia). The fetus can weigh above 9 lb 15 oz (4500 grams) regardless of gestational age! This unusual size might lead to many birth complications, which some of them are:
- Difficulty of having natural vaginal delivery (which may lead to caesarean section)
- Wounds and bruises for both the baby, especially in the shoulders
- Wounds and bruises in the mother’s cervix and vagina
- And more
In addition to labor complications, during the pregnancy the mother might experience:
- Spontaneous abortions
- Biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar nonketotic coma
- Inability to perform simple daily physical activities (such as quarter of a mile long walks, climb stairs, or housework)
- Depression
- Pre-eclampsia (a complication which causes high blood-pressure, related to high amounts of protein in the urine)
- Infection in the urine system
- Placental abruption
- Excessive amount of amniotic fluid
- Premature delivery
As for the baby, gestational diabetes might lead to several complications, while still in womb or later in life:
- Low glucose levels in the baby’s blood straight after delivery (hypoglycemia)
- Underdeveloped lungs (which may lead to breathing complications in the baby’s first days after delivery)
- Low levels of minerals in the blood after delivery (might cause cramping or muscle twitching)
- High chance of having diabetes further on in life
Preventing Diabetes Complications Tips
Here are some tips for preventing diabetes complications, by R.D. H. Liyan, Diet when Pregnant’s official nutrition expert:
“To prevent all kinds of diabetes complications, follow your doctor’s instructions and keep your blood sugar level as close to normal as possible. Here are some tips which will help you in that:
- Eat a variety of healthy foods. Avoid foods that are high in fat, cholesterol, salt and added sugar.
- Maintain a healthy weight. If you’re overweight, your doctor can give you advice on how to lose weight safely.
- Control your blood pressure and cholesterol levels (by appropriate diet plan and prescribed medications).
- Be physically active on a regular basis.
- Quit smoking.
- See your doctor regularly, even when you feel fine. Your doctor will check for early signs of complications.”
So What to Do if you have Gestational Diabetes?
As concerning as this list of risks and dangers of gestational diabetes might be, it is important to understand that if discovered early and treated properly, most chances are that you will have a smooth pregnancy and a healthy baby. Make sure that your physician will test you for gestational diabetes on weeks 24-28, and even earlier if you are in one or more of the high-risk groups mentioned above. If it turns out that you are diabetic, stay calm and positive, and follow your doctor’s instructions.
And what will your physician’s instruction be? You will probably have to check your blood-sugar level throughout the day, exercise and follow a healthy pregnancy diet, specially adjusted for women with gestational diabetes. He might also encourage you to consult with a professional dietitian who will help you with putting together the best diet for your pregnancy.
If you will follow all of your doctor’s orders, eat properly and exercise according to a special menu and exercise plan for women with gestational diabetes, your pregnancy will probably go smoothly and with no further complications. If your blood sugar levels are still too high after changing the way you eat and exercising regularly, you may need insulin shots. Man-made insulin can help lower your blood sugar level without harming your baby.
Gestational diabetes is likely to disappear by itself shortly after labor (don’t forget to get tested to make sure!).Still, even with a healthy pregnancy and baby, gestational diabetes has more to it – it is a warning sign. It is a message from your body, a signal that you should take better care of yourself or else one day you might find yourself with diabetes again. More than that, due to the genetic similarities between you and your baby, this warning sign applies to him or her as well…!
So don’t panic or stress if you have gestational diabetes. You can be reassured that most women who have gestational diabetes give birth to healthy babies. Just remember to follow the instructions given to you by your doctor, and chances are that both your baby will remain healthy. What you can do, and should start doing from now on for your own wellbeing, is start living healthier, with better diet and exercise in your daily routine. And if you want the best for your child as well, give him healthy food, and educate him about the importance of a healthy living!
