Dealing with Gestational Diabetes

Pregnancy is a phase when a woman undergoes a number of changes, both physiologically and psychologically. Nurturing new life within is not an easy task, and the body needs to prepare and buck up to be the life-giver.

While motherhood is a delightful experience for most women, it becomes ever-important for women to take care of themselves during this phase. This includes being aware of the probable health-signals associated with pregnancy.

Gestational diabetes is one such condition that some women may develop during the second half of their pregnancy. While it poses some risks, the main idea is to know the what, why, and how of it, and take the necessary measures for safeguarding the health of yourself and your baby.
Here is all you need to know about gestational diabetes.

What is Gestational Diabetes?

Gestational diabetes mellitus (GDM) is high blood sugar that develops during pregnancy and usually disappears after giving birth. The pancreas cannot produce enough insulin as a result of pregnancy-related changes. Hence, your blood sugar levels may rise and fluctuate rapidly having detrimental consequences on you and your baby, if not managed well.
Thankfully, it is very much possible to manage GDM with conscious and consistent changes, but one needs to be aware of the condition.

One factor that makes this difficult is that gestational diabetes almost never shows any diabetes symptoms. Some women may show some symptoms similar to type 2 diabetes like increased thirst, higher frequency of urination, dry mouth, tiredness, and fatigue etc.

Getting tested for Gestational Diabetes

Whether you show the above symptoms or not, it is important to get yourself checked for the condition. During the initial antenatal appointment i.e. between weeks 8 – 12, you will be questioned to assess the risk factor. Thereafter, during the 24th and 28th weeks of pregnancy, a screening test called the oral glucose tolerance test (OGTT) is carried out.

Why does it occur?

The hormonal changes in the placenta during pregnancy are linked to the blockage of the insulin secreted by the mother. This leads to insulin resistance and high blood sugars.
Various other factors are also believed to contribute to gestational diabetes, some of them being:
1. A Body Mass Index (BMI) of 30 or more i.e. obesity.
2. Having had gestational diabetes in a prior pregnancy.
3. Hereditary i.e. your parents or sibling having had diabetes.
4. If you earlier had a baby that weighed 4.5 kg or more, the risk is higher.
5. Prediabetes.
6. Having a history of polycystic ovarian syndrome (PCOS).

Associated pregnancy risks

Gestational diabetes may lead to the following conditions, if not properly cared for.

Risks to the baby :

1. The baby may grow larger than normal in size, making normal delivery difficult.
2. The baby may develop low blood glucose i.e. hypoglycemia immediately after birth.
3. Greater risk of jaundice and respiratory distress syndrome post birth.
4. If diabetes is present at early stages of the pregnancy, there is a higher risk of miscarriage or birth defects.
5. Premature birth i.e. before week 37 of pregnancy.
6. Still birth (this is rare).

Risks to the mother :

1. Greater chance of preeclampsia, i.e. a condition with high blood pressure and protein in the urine.
2. Higher risk of developing type 2 diabetes after the pregnancy.
3. Too much fluid surrounding the baby leading to premature labour or problems at delivery.

Steps to take to manage Gestational Diabetes

Steps to control blood sugar levels is the way to manage GDM. The typical components of a diabetes management program are diabetes diet, active lifestyle modifications and exercise. In certain extreme cases insulin injections or tablets may be recommended.

Close monitoring of your pregnancy by involving your diabetes doctor is also a must-do. Here are a few dos in GDM care.

• In order to ensure that you do not have any GDM-related complications, you have to monitor your blood sugar levels four times a day. Maintain a log of these values and pass on these values to your diabetes doctor and your gynecologist.
• It is important to monitor your blood sugar levels two hours after your meals (postprandial).
• Maintain a diabetes diet as per the recommendations of your clinical nutritionist.
• Get physical activity daily as prescribed.
• Consult your diabetes doctor periodically for diagnostic checkups including urine albumin and blood pressure tests.
• Never miss out on your ultrasounds.
• For women who have higher body mass index, calorie restriction might be advised by the doctors and dieticians. So, stick to the plan and fight those cravings.

Remember, except for a few, managing GDM is all about self-monitoring of blood sugar levels and medical nutrition therapy. It is possible if you decide to extend the required support to yourself and your baby. It is merely a question of bucking up your will and staying on track so as to maintain a diabetic-friendly lifestyle, both during and after becoming a mother.

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