Your sweet craving hits you hard; and you wish to get that chocolate cake right after your check-up. But, your report says your blood sugar level is high and just like that you are diagnosed with Gestational Diabetes.
You might have always associated diabetes with old age and must be breaking your head as to why you are diagnosed. Here’s the wisdom: Gestational diabetes is a type of diabetes that develops during pregnancy in women who don’t already have diabetes.
Did you know?
Indians stand at second highest number of people living with diabetes, especially highest in gestational diabetes in the world. The prevalence of gestational diabetes has been reported from 3.8% to 17.9% in different parts of India, in 2020.
Okay, I get it, the only numbers that bothers you now has gone beyond 140 mg/dl. The revelation could be jarring for you and now, questions like “what next?,” “how to treat it?,” “will it affect my baby?” and “is there a gestational diabetes diet?” might already be eating your head. Let me help you sort it out, by straightening the facts.
Gestational diabetes typically occurs when the surge of pregnancy-related hormones causes insulin to stop functioning properly, which makes it unable to breakdown the glucose and the term is ‘insulin resistance’. As a result, glucose builds up — eventually causing a person’s blood sugar level to rise to higher than 140 milligrams per deciliter (mg/dL).
It’s difficult to find any difference as gestational diabetes is mostly asymptomatic. Or, you might have had certain symptoms like frequent urination, extreme thirst and fatigue. Gosh, they’re way too similar to the pregnancy symptoms and can easily go unnoticed. So when you experience these symptoms at more than usual rate, inform your doctor.
To make sure it doesn’t go undiagnosed, healthcare providers will screen for gestational diabetes in all pregnant people in their first prenatal visit and then frequently after that. They take precautions, especially if you are at risk.
The risk factors include:
- being obese
- being more than 25 years old
- having a family history of diabetes
- having a history of gestational diabetes during a previous pregnancy
- gaining a significant amount of weight in early adulthood and between pregnancies
- Gaining an excessive amount of weight while pregnant
- being pregnant with multiples, such as twins or triplets
- having a previous delivery of a baby who weighted more than 9 pounds
- having high blood pressure
- having poly-cystic ovary syndrome (PCOS)
- taking glucocorticoids
Yup, the list sure is long. But the good news is, if you take control over them, you can keep gestational diabetes at bay. Making lifestyle changes including a mindful diet and exercises will help prevent it now and also in the long run.
How are you diagnosed for gestational diabetes?
After the first prenatal visit, the second testing will be done during 24-28 weeks of pregnancy. It is important to ensure second test as many pregnant women develop blood sugar intolerance during this period (24-28 weeks).
While the exact ways healthcare providers screen for gestational diabetes may vary, it’ll typically include:
Oral Glucose test:
75 gm glucose is to be given orally after dissolving in approximately 300 ml water whether the pregnant women comes in fasting or non-fasting state, irrespective of the last meal. Blood sugar is evaluated 2 hours after the oral glucose load. The threshold blood sugar level of ≥140 mg/dL is taken as cut off for diagnosis of GDM. You’ll need to undergo additional testing before being diagnosed with possible gestational diabetes.
I hear you screaming ‘Too much information at once and I am already paranoid!’ See the bright side, this transient condition gives a heads-up to modify lifestyle for your betterment.
Now that you are diagnosed, let's ponder over the treatment options, shall we?
70%-85% of people diagnosed with gestational diabetes are able to control it through lifestyle modifications alone. Hope this fact helps you calm down!
You will be put on Medical Nutritional therapy (MNT) and start with atleast 30 mins of exercise a day. Even a simple 15-minute walk after meals is shown to help manage blood sugar levels. So be active and stay on your feet! And, in more severe cases, there is always the option of medication.
Insulin is the first drug of choice for pharmacological management of gestational diabetes because it doesn’t cross the placenta, making it safe for you, during pregnancy. Metformin is an alternative which can be started at 20 weeks of pregnancy, if MNT has failed to control your blood sugar. It has both pros and cons. It does cross the placental barrier; but the risk of hypoglycemia is negligible, compared to insulin. So follow your physician’s prescription!
How does Gestational Diabetes affect your pregnancy and your baby?
When diagnosed and treated at an early stage, you can have a safe pregnancy. However, when neglected, it increases the odds of pregnancy complications like:
- A higher chance of needing a C-section
- Pregnancy loss
- High blood pressure or pre-eclampsia
- Pre-term birth
Your higher blood sugar affects your baby, too, since they get nutrients from your blood. Your baby stores that extra sugar as fat, which can make them grow larger than normal. ‘Macrosomic baby’ or ‘Fat baby’ is more likely to have certain complications:
- Injuries during delivery because of their size
- Low blood sugar and mineral levels when they’re born
- Neonatal Jaundice , a mild and transient condition characterized by yellow skin.
- Pre-term birth
- Temporary breathing problems
- Likelihood of type II diabetes
So your baby’s weight will be monitored carefully in pregnancy using ultrasound scans. If your baby is large, you may be advised to have an early induction (starting labor artificially) or planned c-section. So no sweets for two!
Hope the knowledge on Gestational Diabetes helped clear your head. The silver lining is that unlike diabetes, in gestational diabetes the blood sugar level returns to normal, post delivery. But if you’ve had gestational diabetes, you have a higher risk of getting type 2 diabetes. You’ll need to be tested for changes in blood sugar more often. So no sweets for two!
Do not let your cravings win all the time. Keep a check on your diet and lifestyle and everything should be fine!
Related: 5 things to consider before you start your gestational diabetes pill.
As a 2 time sufferer of gestational diabetes I appreciate you helping women prepare for this condition however there are certain facts, precautions and preventative measures like folic acid intake pre-conception, increased risk of spinal abnormalities in the baby and other notable concerns. Every health system perhaps handles this in a different way so good to provide a more well rounded summary if possible
All the best
Ankita
Sure Ankita, thank you so much for your inputs! Hope you and your babies are doing well. We’ll keep this in mind while writing!