How to correctly manage Gestational Diabetes in pregnancy


Gestational diabetes is a type of diabetes that women acquire during pregnancy when they did not have it before the pregnancy.

What is Gestational Diabetes?

  • Gestational diabetes occurs in 5-7% of all pregnancies.

  • Usually occurs in the second and third trimesters.

Gestational Diabetes Causes

As the baby grows, the placenta supports the baby and hormonal changes block the action of the mother’s insulin to work on her own body. This is called insulin resistance. Insulin resistance challenges the mother’s body to use insulin and causes mothers to use much greater amounts of insulin to compensate.

When the mother’s body cannot make and use the necessary amount of insulin needed for pregnancy, glucose cannot leave the blood to fuel the body. Therefore, glucose builds up in the blood and results in hyperglycemia.

Symptoms of gestational diabetes

  • Mothers usually do not have any symptoms

  • Mothers may present with swollen legs or hands (edema)

  • Mothers may have large-for-gestational-age infants (>90th percentile)

Complications of Gestational Diabetes in Pregnancy

  • Mother can still deliver a healthy baby after getting diagnosed with gestational diabetes if her blood sugar can get well controlled.

  • An extra large baby: uncontrolled diabetes causes the baby’s blood sugar to be high. This causes the baby to be “overfed” and grow extra large. When a baby is too big and exposed to a high insulin environment in the placenta, the baby can be born with nerve damage due to pressure on the shoulder during delivery and experience low blood sugar once delivered.

  • Gestational High blood pressure & Preeclampsia: gestational high blood pressure is defined as pregnancy-induced high blood pressure with onset after 20 weeks gestation. When a pregnant woman has high blood pressure, protein in the urine, and swellings in fingers and toes, she could have preeclampsia. This condition is dangerous and can harm both the mother and her unborn body. This leads the baby to be born early and places the mother at a higher risk of getting seizures or a stroke during labor and delivery. Pregnant women with gestational diabetes are more likely to have higher blood pressure than those without diabetes.

  • Low Blood Sugar: when mothers with diabetes take insulin or other diabetic medication incorrectly (maybe due to incorrect dosage from doctors, wrong instructions, etc), they can have too low blood sugar. Low blood sugar can be very serious and needs to be treated immediately. If a mother’s diabetes is not controlled during pregnancy, the baby can develop low blood sugar after delivery.

  • Higher chance of getting another gestational diabetes in the subsequent pregnancy.

Management

  1. Eat a healthy diet: patients should be on a diabetes specific meal plan. This meal plan should be discussed and created with a doctor and a dietitian.

  2. Exercise regularly: exercise can help to balance food intake and keep blood sugar under control. A pregnant woman should exercise regularly during and after pregnancy. This exercise should be at least 30 minutes of moderate-intensity for at least five days a week. These activities include swimming, brisk walking, bking and some forms of yoga.

  3. Frequently monitor blood sugar. Blood sugars levels can change quickly throughout the pregnancy, so it should be checked often to treat it as soon as possible.

  4. Take insulin if indicated. A doctor will order insulin if gestational diabetes requires insulin to maintain appropriate blood sugar level.

  5. Get tested for diabetes after pregnancy. Usually, gestational diabetes goes away after delivering a baby. This must be confirmed by testing for diabetes 6 to 12 weeks after the baby is born and then for every 1 to 3 years. If diabetes stays, now this diabetes is called type 2 diabetes. Even when the diabetes goes away, 50% of women with gestational diabetes acquire type 2 diabetes later in their lives. Therefore, all the women with gestational diabetes must continue to exercise and eat a healthy diet after pregnancy.