Some pregnant women suffer from diabetes during the most delicate days of their life i.e. during the gestational period. Approximately 6 to 7% of pregnant mothers suffer from what is called gestational diabetes.
What is Gestational Diabetes Mellitus (GDM)?
The time period during which a woman is pregnant and the fetus is developing is called gestation. When a woman, who previously may not have diabetes, develops high blood sugar levels during the gestational period is known to be a person with gestational diabetes. It is glucose intolerance during pregnancy.
Gestational diabetes is a condition which prevails during second trimester and stays till childbirth. It is referred to the pathological condition in which carbohydrate intolerance persists with high blood glucose levels and renders ill effects to baby and mother. It is a metabolic complication.
While most women can be managed with a special gestational diabetes diet that includes prescribed diet and exercise, some women might need a gestational diabetes treatment that includes medication.
Gestational Diabetes Symptoms
- Excessive hunger
- Excessive thirst
- Polyuria (large volumes of dilute urine)
- Polyphagia (excessive eating)
- Polydipsia (excessive thirst)
During pregnancy, the placenta secretes certain hormones due to which the cells of the mother’s body becomes resistant to insulin. Though these hormones are very essential for the growth of the fetus, they elevate the blood glucose levels and thus create gestational diabetes.
Who are at risk of developing GDM?
The mothers who fall into this category:
- Age of would be mother (advanced gestational age)
- Family history (parents/siblings with diabetes mellitus)
- Lifestyle (sedentary lifestyle)
- Dietary pattern (high-calorie diet with low fiber)
- Obesity (High Body Mass Index)
Complications to the fetus:
- Macrosomia (larger than average baby with weight more than 8 pounds).
- Preterm baby (a baby born with less than 37 weeks of gestation).
- Respiratory distress to the new born.
- Congenital malformations.
- Perinatal death.
- Still birth.
- Birth injuries.
- Brachial plexus injuries (injuries/trauma to the shoulder during child birth. This leads to nerve damage and disabilities).
- Neonatal hypoglycemia (deficiency of glycogen in the newborns).
- Elevated birth weight of neonate.
- Hyperbilirubinemia (Excess bilirubin in the blood. Bilirubin is a reddish yellow pigment that is formed during the breakdown of red blood cells).
- Shoulder dystocia (This is an obstetric emergency and can lead to the death of the fetus)
- Cord C-peptide more than 90th percentile (This can lead to hypoglycemia in the infants).
- Raised risk of impaired glucose tolerance.
- Higher chances of developing type 2 diabetes mellitus in later phases of life.
- More prone to develop hypertension at early age.
- Higher chances of developing dyslipidemia (abnormal levels of cholesterol, triglycerides, and other lipids).
- Higher chances of developing obesity.
Complications to mother:
- Hypoglycemia to mother.
- Progression of developing type II diabetes in later phase of life.
- Risk of preeclampsia.
- Gestational hypertension.
- Cesarean delivery.
- High risk of cardiovascular diseases.
- High risk
Screening for Gestational diabetes
Women must be screened at the very first visit to the doctor to rule out the development of GDM in later time frame of gestation. A short history may be an indicator:
- Type of physical activity involved.
- Family history.
- History of GDM.
- Raised risk as per ethnicity. South Asian and South East Asian women are prone to gestational diabetes.
GDM can be identified by certain diagnostic tests that are also recommended by ADA. They are:
- 75 g OGTT (oral glucose tolerance test) at 24-28 week of pregnancy. This test was recommended in 2011 by ADA after it was advised by the International Association of Diabetes and Pregnancy Study Group (IADPSG).
- Another way is two-step approach which comprises of two sets of glucose thresholds:
(a). Carpenter-Coustan (It is done by consuming 50 g Oral glucose challenge test)
(b). National Diabetes Data Group (NDDG) (It is done by consuming 100g OGTT).
Medical Nutritional Therapy for GDM
Dietary recommendations play a crucial role in controlling GDM. A typical gestational diabetes diet includes these dos and don’ts.
- Eat small and frequent meals.
- Add small portions of snacks in between the major meals.
- Add post dinner or Bedtime milk.
- Restrict the intake of simple carbs like raw sugar, corn syrup, fruit juice concentrate, baked foods, and cereals.
- Add raw veggies or salad in your diet.
- Add soup as a mid-evening snack.
- Take 2 fruits daily (but, avoid high sugary fruits).
- Avoid juices completely.
- Do not skip breakfast.
- Avoid sweets.
- Avoid processed and packed foods.
- Avoid desserts.
- Avoid artificial sweeteners.
- Avoid junk foods.
- Avoid confectionary and bakery products.
- Avoid cold drinks, soda.
- Say no to Alcohol.
- Limit oil intake. (500ml/month).
- Avoid fish that are high in mercury.
- Avoid red meat.
Eat smart today for a healthy baby tomorrow! Get consultation and guidance from our expert dieticians. Get a Gestational Diabetes Diet plan that’s customized especially for you. Contact your nearest Apollo Sugar Clinics today!