Gestational Diabetes

 Know Everything About Diabetes in Pregnancy – Blog By Experts

Pre-pregnancy Care to prevent Gestational Diabetes

A healthy pregnancy is one that should ideally involve a lot of planning. The entire pregnancy as well as the baby’s future health is all dependent on the mother’s health. This is exactly why it is said that pregnancy should always be by choice and not by chance. Everything may not be in our control but following proper and balanced nutrition and getting rid of any possible risk factors before conceiving will only increase the chances of a smooth pregnancy and delivering a healthy baby.

There are in fact a number of things that need to be taken into account with regard to health before starting the pregnancy journey. A preconception check up can greatly help to get any chronic conditions diagnosed in a timely manner. In the case that any anomalies are found this will also give you ample time to get it all under control before getting pregnant.

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Sugar Control in Gestational Diabetes

A gestational diabetes diagnosis does not have to make you forget to enjoy the blissful phase of pregnancy. The condition is certainly a serious one but it is not something that cannot be effectively managed with adequate care. A number of women have had smooth pregnancies and delivered perfectly healthy babies as well with gestational diabetes.

The important thing to remember before you embark on the gestational diabetes ride is to understand that this condition is nobody’s fault. Sugar control is the most important part about gestational diabetes management. With some easy and helpful steps, the sugar levels in pregnancy can be controlled smoothly without it being too stressful.

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Birth Defects and Gestational Diabetes

Gestational diabetes is a condition when the blood glucose level is elevated during pregnancy in a woman undiagnosed with diabetes prior to this. When not controlled and managed well this can be life-threatening as it is often associated with long-term complications affecting every system and part of the body. That said, it is also important to understand that a gestational diabetes diagnosis does not mean that the baby will surely be born with birth defects. Studies have proven that the likelihood of this happening is only if the mother’s weight before getting pregnant was in the overweight or obese range, with a body mass index (BMI) of 25 or higher.

Gestational diabetes is a condition when the blood glucose level is elevated during pregnancy in a woman undiagnosed with diabetes prior to this. When not controlled and managed well this can be life-threatening as it is often associated with long-term complications affecting every system and part of the body.

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Myths related to Gestational Diabetes

Pregnancy is always meant to be a positive experience for the mother-to-be and for those around her as well. While mothers want to do everything in their power to ensure that they deliver a healthy baby without any complications, there could be a bombardment of information, hacks, tips and advices from all around. It’s only natural for them to turn to researching on the various health conditions that could stand in the way of a healthy and smooth pregnancy. But it is always important to take it all with a pinch of salt as along with credible facts there are also tons of myths and misconceptions floating around. One such condition that is so prone to myths is gestational diabetes.

In fact, some of these misconceptions are so easily believable too especially if the mothers-to-be that are being misled are in the dark about the actual truth of the matter. The top most myth must be that gestational diabetes is a rare condition! Gestational diabetes is a phenomenon that is widely seen and when managed well they can go through their pregnancies safely and deliver perfectly healthy babies. Stats say that around 5 to 10 % of all pregnant women develop gestational diabetes.

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Dr Hema Divakar talks about various aspects of Gestational Diabetes and its Management

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FAQs on Diabetes in Pregnancy

Could there be birth defects in women with gestational diabetes?

A wide range of birth defects is often associated with diabetes that is contracted before pregnancy but when it comes to gestational diabetes only a limited group of birth defects was seen to be occurring.  Recent studies have shown that women who got gestational diabetes gave birth to children with birth defects only if their pre-pregnancy BMI was 25 or higher. Among the defects in children born to women with diabetes are heart problems, brain and spinal defects, oral clefts, kidney and gastrointestinal tract defects, and limb deficiencies. About 50% of the birth defect were linked to diabetes that was diagnosed before pregnancy. The reason why pre pregnancy diabetes boosted birth defects was attributed to the high blood sugar levels or hyperglycemia. The incidence of neural tube birth defects in the case of gestational diabetes was found to be approximately 20/1000 times whereas this figure in the normal pregnancy scenario would be 1/1000 times. Attention should be paid to the diet throughout the pregnancy so the blood sugar levels are always in check.

Is it wise to ‘eat for two’ with gestational diabetes?

The necessity of ‘eating for two’ during pregnancy is just a myth in both normal circumstance as well as when there is a diagnosis of gestational diabetes. Food portion and quantity should always be watched in order to avoid sudden sugar level spikes in the blood. The important thing is to take care that the daily calorie requirement is met, but this does not mean to eat indiscriminately. Ensure to track carbohydrate intake along with the blood glucose. If the blood glucose is consistently high, reduce the intake of sugars and complex carbohydrates and increase the intake of fiber.  Monitor your carbohydrate intake by keeping a food diary or smartphone calorie tracking Apps. Especially in women with gestational diabetes, the ‘dawn phenomenon’ is when there is a natural rise in blood sugar caused by a surge of hormones in the middle of the night or early morning which triggers the liver to dump sugar into the bloodstream. The best way to keep this in check is to eat a high-fiber, low-carb and low-fat snack before bed.

How to gain weight safely with gestational diabetes?

Especially in women with gestational diabetes, extra care should be given as to keep the total weight gain not more than 6 to 8 kg. In fact, there will not be any significant weight gain in the first trimester and the weight gain only happens from 2nd and 3rd trimester. When pregnant, women who were of a normal pre-pregnancy weight should consume 30 Calories/kilogram/day, based on their current pregnant weight. Women who were obese prior to becoming pregnant can reduce this number by up to 33%. These women should consume about 25 Calories/kilogram/day based on their current pregnant weight Since Gestational Diabetes can further increase weight gain, so a low sugar diet should be strictly adhered to in order to keep complications at bay. Come up with a meal plan that can provide the body with a lower amount of sugar to take better control of overweight gain. There could also be some foods that contain natural sugar like carrots or raisins so these can be replaced with other less sugar alternatives.

How is obesity related to gestational diabetes?

Around 80% of all cases of type 2 diabetes are linked to obesity. There have been studies that show that developing type 2 diabetes from obesity is more common if most of the fat is carried in the belly. Other factors that have been shown to lead to increases in both diabetes and obesity are related to lifestyle like gorging on high calories foods, sedentary life, less sleep and so on. Such risk factors are the top things that could pave the path for gestational diabetes. Women who are on the heavier side prior to conception can have the possibility of gestational diabetes as the pregnancy progresses and if the weight gain is not kept in check. Glucose is the body’s main source of energy. After a meal, some of the glucose is used immediately, and the remainder is stored inside cells for later use. Insulin is the hormone that regulates the storage process by placing glucose inside the cells. The amount of fat in the body appears to aid this whole process greatly. This fat may block insulin from placing glucose inside the cells. The more fat in the body, the less well insulin works and the more glucose builds up in the blood.

What are ways to manage gestational diabetes?

With gestational diabetes the key to avoid complications for both the mother and the baby is to managing the condition effectively and keeping the blood glucose levels under control at all times. The best way to manage gestational diabetes is to ensure that the right lifestyle is followed like eating a nutritious and balanced diet, monitoring what carbohydrates are consumed, controlling the weight gain, and exercising or walking every day. You may need to monitor the blood glucose levels at home. The doctor can advise on the frequency of testing in a day based on the specific condition. If diet and exercise doesn’t seem to help then medications may need to be taken. Both insulin injections and metformin pills have been shown to be safe for the unborn baby. If there is prediabetes before being pregnant, then the doctor will say if any of the medicines need to be changed. The risks of not treating gestational diabetes could be much higher so this should not be taken lightly.

How often should sugar levels be tested in gestational diabetes?

Women diagnosed with gestational diabetes should regularly test their blood sugar levels. Even if gestational diabetes hasn’t been diagnosed and if the women are at a higher risk or categorized as borderline, or those that have had gestational diabetes in previous pregnancies may also be advised to test and monitor levels.  Monitoring is the best way to know blood sugar levels and how much glucose is left in the blood after eating and therefore being passed on to the baby. The doctor will advise on the best testing schedules depending on various factors like severity of condition, age, weight, BMI, pregnancy stage etc. The typical testing schedule could be one hour post meals, two hours post meals, pre meals, pre meals and one hour post meals, alternating days between pre and post meals or even random testing so many times a day or week or in some cases testing by fasting which should be taken immediately on waking in the morning or some doctors may also ask for readings before bed.

What is the best work out in gestational diabetes?

Staying active is one of the most important steps in managing gestational diabetes. Exercises or work outs can vary from person to person and this often depends on their specific activity levels or stamina. A safe thing to do would be a 10-minute walk after every meal. The more exercise is done the more insulin gets activated and sugar will be in control. This should be maintained throughout the pregnancy if there is gestational diabetes as long as there is a go ahead from the doctor. Being active is a good way to help manage blood sugar and it is also good for general posture and can curb some common problems like backaches and fatigue. If in a fairly good health try to aim for 30 minutes of moderate activity most days of the week. Check with the doctor if the activity chosen is safe to do in the pregnancy stage. Exercise can lower the blood sugar so always have a form of quick sugar like glucose tablets or hard candy to help with that.

Do diabetes medications harm the baby?

Irrespective of the diabetes being Type I, Type II, or Gestational the condition can affect the unborn child if timely treatment not taken and sugar levels not managed. More than the drugs used to manage diabetes the condition itself could be more dangerous for the baby’s health. Once the condition has been diagnosed, right from the start the baby will be considered in pregnant woman’s diabetic treatment. Insulin is the best treatment for pregnant diabetics who need more help managing their blood sugar levels. It does not harm the baby in any way. Up to 1 in 5 women with gestational diabetes will need to take tablets or have insulin injections to control their glucose during pregnancy. Women with diabetes should take a higher dose of 5 milligrams (mg) of folic acid each day while trying to get pregnant and until they are 12 weeks pregnant. Taking folic acid will prevent the baby from developing birth defects, such as spina bifida. Insulin injections, either with or without a drug called metformin are the commonly prescribed medications in gestational diabetes.

Does folic acid intake reduce gestational diabetes risk?

Many studies have found that Folic acid supplement can greatly reduce the risk of gestational, or pregnancy-related, diabetes. Folic acid is the synthetic form of folate, or vitamin B9, which is found in leafy green vegetables, nuts, peas, beans and other foods and this is taken during pregnancy to prevent the risk of conceiving a child with a neural tube defect, a class of birth defects affecting the brain and spinal cord. Gestational diabetes can increase a woman’s chances for caesarean delivery and for blood pressure disorders during pregnancy. It also raises the risk of cardiovascular disease and type 2 diabetes later in life. Folic acid is absorbed more easily into the body, compared to the naturally occurring form of the vitamin. Some studies have found that insufficient folate is associated with insulin resistance which is the difficulty using insulin to lower blood glucose that could lead to the development of type 2 diabetes in non-pregnant people.

What are some myths associated with gestational diabetes?

There are many myths surrounding the Gestational Diabetes condition and one of them is that it is caused mainly by eating sweets and sugar. But that is not the case as being overweight before pregnancy, age more than 25 years or rapid weight increase during pregnancy could also be the reason for this. Another myth is that with good control of sugars there is no difference between the pregnancy survival rate for women with and without diabetes. The true fact is that the most important aspect of gestational diabetes is to achieve good blood sugar control throughout the pregnancy as poor sugar control can harm both mother and the baby. Some believe that Gestational diabetes is not a serious disease. But diabetes alone is responsible for an increased number of deaths when compared with breast cancer or AIDS. Hence timely care is extremely critical to monitor and control the blood sugar level during pregnancy. All think that every pregnant woman will have to take insulin if she is diagnosed with gestational diabetes. But this is not always the case. Many pregnant women with gestational diabetes can control sugar levels with just diet and exercise as well.

Want to know how you can control high sugar levels during pregnancy?

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