Pregnancy is the time when a woman has to take extra care of herself to avoid any harm to the growing fetus or even herself. Of the many conditions to keep an eye on during pregnancy, diabetes is the most important. A high blood sugar is harmful to the pregnant woman and the growing baby and may complicate the pregnancy and the birth process.
Understanding gestational diabetes
During pregnancy, the fetus gets all the nourishment from the mother through the placenta, a structure that connects the baby with the uterus of the mother. The placenta also secretes various hormones, which may interfere with the normal functions of other hormones in the mother. Usually, the pancreas secretes hormone insulin, which helps the body use sugar for energy production. In pregnant women, the hormones from the placenta may interfere with the function of insulin, thereby elevating the levels of blood sugar. As a result, a woman who was non-diabetic before pregnancy may develop high blood sugar when pregnant. This condition is called gestational diabetes. Gestational diabetes, if untreated, is harmful to the mother as well as the fetus. The sooner the treatment starts, the better it is for the health of the mother and child. In most cases, gestational diabetes disappears once the child is born.
The chances of getting gestational diabetes are higher in people who are overweight, who are above 25 years of age, who have a family history of diabetes, who are Asian American, Hispanic/Latino, African American, American Indian, or Pacific Islander because of the genes susceptible to gestational diabetes in these ethnic races, who have given birth to a baby before that weighed more than nine pounds, and who have a previous history of gestational diabetes, miscarriage, and repeated infections.
There are different tests that are done to diagnose gestational diabetes. The fasting blood sugar test is done when the patient is fasting, drinking only water for 8 hours. The random blood sugar test is done at any time of the day. In the screening glucose tolerance challenge test, the patient is given a sugary drink, and then the blood glucose level is checked after an hour. This test can be done at any time of the day.
Another test for diagnosing gestational diabetes is the oral glucose tolerance test. You are asked to fast for 8 hours before the test. For the test, blood is drawn when the subject is fasting. Thereafter, you would be asked to drink sugar water, and then your blood sugar would be tested every hour for 3 hours. A fasting blood sugar above 95 mg/dl, at 1 hour above 180 mg/dl, at 2 hours above 155 mg/dl, and at 3 hours above 140 mg/dl, indicates gestational diabetes. All diagnostic tests are generally done between 24 and 28 weeks of pregnancy, which is the time when gestational diabetes can occur in pregnancy.
Managing gestational diabetes
To manage gestational diabetes, firstly, modifications in diet are essential. With the help of a dietician, a well-balanced diet plan to lower blood sugar has to be made. Foods rich in sugar, like cookies, desserts, sweets, candies, and sweet juices, have to be avoided. Carbohydrate foods like pasta, bread, potatoes, cereal, and rice are good for the mother and the baby. They should, however, be taken in limited quantities. Eating many small meals at regular intervals is recommended to avoid a rise in blood sugar levels. Apart from diet planning, careful monitoring of sugar levels is essential. You can use a home blood sugar monitoring device to check your blood sugar at least four times daily or as advised by your physician.
In addition, physical activity is important to maintain normal blood glucose levels. Swimming and walking are good exercises, and you can do them with the approval of your doctor. If the mother has any complications, then only upper body exercises are advised by the doctor that can be performed sitting on the chair. Aerobics in the water is also a good exercise that is relaxing and fun.
Apart from diet planning and physical exercise, some women with gestational diabetes will need to take insulin shots or oral medications, depending on the test results. Insulin is not harmful to the baby and is given under a doctor’s supervision.
Complications of untreated gestational diabetes
Untreated gestational diabetes leads to complications for the mother as well as the baby. In mothers, it may lead to a condition called preeclampsia, where there is excess protein lost in the urine and high blood pressure that occurs in the 20th week of pregnancy. Due to excess sugar in the urine, mothers with gestational diabetes have a higher chance of getting urinary tract infections than mothers with normal pregnancies. Mothers with a history of gestational diabetes may develop it again during their second pregnancy or develop diabetes in later years.
During pregnancy, the mother with gestational diabetes has more sugar in her blood, which crosses the placenta and reaches the baby. The baby’s pancreas then starts producing more insulin to counter the glucose, resulting in overgrowth of the baby. This condition is called macrosomia. Delivery of such large babies may need a caesarean section.
After birth, babies may develop low blood sugar, which may result in seizures. Careful monitoring and intravenous glucose are administered by the doctor under such circumstances. The infant’s blood sugar levels are carefully monitored by conducting blood sugar tests. If the infant is diagnosed with low blood sugar, then sugar water or glucose is administered to the baby intravenously or through a tube into the infant’s vein. Untreated gestational diabetes may result in the birth of a baby with breathing problems that continue until the lungs become stronger. In later life, the baby has a high risk of developing diabetes and obesity. The baby may also develop problems with walking and balancing. There can be disorders like hyperactivity or inattentiveness.
If bilirubin (the yellowish pigment found in bile produced by the liver) level is found to be high, then it is treated with light therapy. In this treatment, the baby is placed under a blue-green spectrum of light that changes the structure of bilirubin molecules, which are then easily excreted in the baby’s urine and stool. Plastic shield filters are used to protect the baby against any harmful rays. The baby is also given eye patches for eye protection during the therapy. The baby wears a diaper only during the treatment.
Your bundle of joy!
By following the doctor’s advice and taking all the necessary precautions, you can get over gestational diabetes. Awareness regarding gestational diabetes removes all fears and apprehensions regarding the safety of your baby. The health and safety of your ‘bundle of joy’ is in your hands!
