So the question is, 'Can you have a healthy baby though you have gestational diabetes?'
The answer is yes. You can have a healthy baby with suitable treatment.
Let's understand about gestational diabetes and its diagnosis in detail.
What Causes It?
Hormones could be the cause. During pregnancy, placenta/umbilical cord produces special hormones that cause insulin insensitivity. Insulin insensitivity occurs when your body produces enough insulin but is unable to utilize it properly. Your pancreas usually makes enough insulin to make up for it. But in case if it does not, it will raise your BSL (Blood Sugar Level). This leads to gestational diabetes. The mother may need upto three times more insulin.
Who Are At Risk?
Can you get gestational diabetes? Following are the high-risk groups:
- Overweight: Being overweight at the time of conception. Pregnant women with a BMI (Body Mass Index) of 26+ are more likely to be affected by gestational diabetes.
- History of gestational diabetes: If you had gestational diabetes in your previous pregnancy.
- Family history: If diabetes runs in your family. Genetic factors are one of the major causes of almost all types of diabetes.
- Racial: If you are an African-American, Asian, Native American or Hispanic. These races are more prone to gestational diabetes than others. Studies show that 3% to 7% of conceived women in these areas are at a high risk of getting gestational diabetes.
- High BP: High blood pressure during pregnancy can be a cause of gestational diabetes.
9.2% of pregnancies result in gestational diabetes.
Gestational diabetes usually manifest during 24th to 28th week of your pregnancy. That is during the final phase of the second trimester period of pregnancy.
You may not carry a risk of gestational diabetes if you fall under the following criteria:
- Age: Less than 25 years
- Weight: Normal weight, a BMI/ Body Mass Index of 18.5 to 24.9 is normal. BMI values are based on your height and weight.
- No family history: Parents/ siblings do not have diabetes.
- No history of gestational diabetes
- Not a member of high-risk racial groups: Hispanic American, African American, Pacific Islander, Native American, Asian American, etc.
- Not suffering from high BP
If you fall in the high risk category, your doctor may want to perform an OGTT (Oral Glucose Tolerance Test) in your first prenatal (first appointment with your doctor upon confirming your pregnancy) visit itself. The OGTT test measures how the glucose is being used by the body and is also used in diagnosing gestational as well as type 2 diabetes. According to the estimate of American Diabetes Association, 9.2% of the pregnancies result in gestational diabetes.
OGTT for Diagnosing Gestational Diabetes:
- You are given a glucose solution that contains 50 grams of glucose.
- Your blood is drawn after an hour to check the BSL.
- If it is below 140mg/dl, it is considered normal. This proves that you do not have gestational diabetes.
But, if the value is above 140mg/dl, you will be asked to repeat the test.
For the repeat test,
- You will be asked to come in the morning after a fasting period of at least 8 hours.
- First, your fasting blood sample is drawn.
- Next, a glucose solution of 100 grams is given.
- This is followed by drawing a sample every 30 minutes for 3 hours. Hence a total of 7 samples are taken.
Test results are as below:
Below 95 mg/dl
At the end of 1 hour
At the end of 2 hours
Below 155 mg/dl
At the end of 3 hours
Below 140 mg/dl
This is how the test is interpreted:
- If all the above values fall within the normal range, you do not have gestational diabetes.
- If any one of the above values is higher, your doctor may ask you to modify your diet.
- If any two of the above values is higher, your doctor will confirm that you have gestational diabetes.
You need to start the treatment quickly to protect yourself and your baby.
Appropriate treatment is necessary because excess glucose will pass through the placenta allowing the baby's body to produce more insulin. Such babies tend to weigh more and carry a risk of damage to their shoulders during birth. Secondly, such babies are also at a higher risk of being obese in their childhood and having type 2 diabetics in their adulthood.
A healthy diet rich with fruits, vegetables, nuts and whole grains while counting calories is advised for patients with gestational diabetes. Grains and starch supply carbohydrates to the body which is necessary to keep the blood sugar level in a stable condition. Small frequent meals should balance the nutrition and calories in pregnant women suffering from gestational diabetes.
You will be asked to stay active and get into a routine of regular exercise. But during pregnancy, you should not strain yourself excessively. Listen to your body. If you cannot exercise at one go, split it after each meal. Brisk walking, prenatal yoga and indoor cycling on stationary bikes are preferred during pregnancy period.
3. Daily glucose monitoring:
If you are diagnosed with gestational diabetes, you will be asked to monitor your glucose levels quite often.
Targets for the mother will be:
Pre-meal glucose of less than 95 mg/dl
1 hour after food glucose: 140 mg/dl
2 hours after food glucose of 120 mg/dl
Insulin and Metformin (oral medicine in the form of tablets) are used in treating gestational diabetes. Insulin is preferred more as Metformin might cause weight loss issues in pregnant women.
After childbirth, your focus should be on losing weight, regular exercise and healthy diet to prevent type 2 diabetes in later life.
Cases of diabetes are perpetually increasing and it needs to be put in check. Today, the children are being affected limiting their avenues. We need proper check-ups and also proper awareness as to how and why a person might be affected by diabetes.