Why Screening and Treatment for Gestational Diabetes is Important

Can gestational diabetes affect the development and growth of the baby?

Gestational diabetes is a type of diabetes only develops during pregnancy, and most of the time, gestational diabetes is diagnosed during the last stage of pregnancy. If someone is diagnosed with diabetes during the earlier stages of pregnancy, then it is possible for that person to have had diabetes before she was pregnant.

Treating gestational diabetes is very important in order to help both the mother and the baby stay healthy. Both the baby and the mother can be protected by taking immediate steps to control blood glucose levels, but this can only happen if it is properly screened first.

What are the causes of gestational diabetes?

Gestational diabetes occurs when the body cannot make enough insulin during pregnancy. Insulin is a hormone that is produced in the pancreas, an organ allocated behind the stomach. Insulin helps the body use glucose for energy and helps control blood glucose levels.

During pregnancy, the body produces more hormones and goes through other changes, such as weight gain. These changes cause the body's cells to use insulin less effectively, a condition called insulin resistance, which would ultimately increases the body's need for insulin. If the pancreas cannot produce enough insulin, it is a sign of gestational diabetes.

All pregnant women have some insulin resistance during the last stage of pregnancy, however, some women have insulin resistance even before they get pregnant, usually because they were overweight. These women begin pregnancy with a greater need for insulin and are more likely to develop gestational diabetes while pregnant.

An interesting story

Sarah Ricca is a 33-year-old woman who works at the Morton Plant Hospital in Clearwater as a delivery surgical technician. She was very surprised when she found out she had gestational diabetes last year, even when it was her second pregnancy. Taking into account that during her first pregnancy her blood sugar screening showed that she was just about to have gestational diabetes, however, her doctor did not consider treatment necessary.

The truth is that diagnosing gestational disease is a very challenging task since it does not produce any noticeable symptoms. It requires to be tested, and the evaluation consists of drinking a sugary solution with blood being scanned constantly after drinking it.

During pregnancy the mother’s body produces way more insulin in order to normalize blood sugar levels. But there is always a certain amount of women that do not produce enough insulin to keep the level of insulin within the range. However, if this is not treated properly gestational diabetes can potentially harm the baby because of the increase in the levels of blood sugar. It is recommendable to go through screening between 24 and 28 weeks of pregnancy in order to determine the possibility of suffering from gestational diabetes.

Statistics say that 7 to 10 % of pregnant women can develop gestational diabetes from the fifth month and on. The reason behind this condition has not been found yet. Sarah has stated to feel guilty about the situation because the doctor asked her to get a scan during her 3rd month of pregnancy, but Sarah thought it would be the same as with her first son. But, 3 years later with a screening test done for Abigail, her daughter, clarified that treatment from earlier stages could have been beneficial.

Once it was found that Sarah had gestational diabetes, the doctor recommended her to follow a strict diet which had her cooking all her meals at home, keeping a controlled level of carbohydrate consumption. Sadly, it was too late for Sarah and Abigail, so medications needed to be prescribed in order to assure Abigail’s correct development and growth.

Treating gestational diabetes

Treating gestational diabetes is the wisest decision in order to avoid the baby being affected by high levels of blood sugar. There are risks for the mother to develop type 2 diabetes if gestational diabetes is not treated in the first place, and it is also possible for the baby to grow too large, making delivery way more difficult. Other problems that can be related to untreated gestational diabetes are obesity in childhood and breathing problems.

But, “how can gestational diabetes be treated?” well in most cases it is treated as type 1 diabetes would be treated, making changes to dietary habits and controlling carbohydrates consumption. In most cases, patients suffering from gestational diabetes are remitted to a registered dietitian for the elaboration of a feeding plan that allows keeping blood sugar within normal levels. For this purpose, most diets combine proteins and carbs in smaller amounts.

Grace Lau, a registered dietitian who is also a diabetes educator at St. Joseph’s Hospital’s Diabetes Self Management Center based in Tampa, says that the most recommendable option is to eat three small meals and three small snacks throughout the day, distributing carbohydrates equally during said meals. Distribution plays an essential part in controlling diabetes since consuming the entire amount of carbohydrates all at once can be harmful.

Common myths and beliefs regarding dietary habits for diabetes

Many women believe that having gestational diabetes means having to eliminate carbohydrates and starches (potatoes, rice and bread) from their diet in order to control their blood sugar levels, even embracing a gluten-free diet. This is a misunderstanding that needs to be clarified, since the consumption of carbohydrates is allowed but needs to be controlled and well-distributed throughout the day.

Reducing carbohydrates during pregnancy, however, is not recommended since they are essential for the brain development of the baby as well as growth. Keeping the consumption of carbs to 180 grams per day and distributing said consumption throughout the day is more than enough.

Regarding extra recommendations that can be given in order to keep pregnant women’s blood sugar level controlled, exercises such as swimming, walking and doing other types of aerobic activities after meals can help lower blood sugar levels as well. However, this should always be consulted with a doctor.

Results of timely treatment

Once Abigail was born she went through tests that are not typically done to new-borns, and having her blood sugar level tested was the first step. Seeing that it was low, they fed Abigail and gave supplemental donor breast milk. In less than 24 hours, her blood sugar levels were within the normal range.

By the time of this article, she is a healthy 8-month-old baby.

Regarding Sarah, her diabetes disappeared a couple of months after delivery as it usually does in most women. Nevertheless, 1 out of every 10 women develop this as a lifelong condition.

There are some other cases where women are predisposed to suffer from diabetes and pregnancy only triggers its appearance. Also, the hormonal changes that take place during pregnancy may give a hint of a woman suffering from diabetes while they have suffered from it for a long time, but did not have any kind of problems and therefore, did not have it checked before. The general suggestion is to have mothers checked about 6 to 12 weeks after giving birth.

Regarding the possibility of developing the condition later in their lives, the American College of Obstetricians and Gynecologists states that most people that go through gestational disease are very likely to develop it during their lifetime, so it is recommended to keep checking their blood sugar levels constantly and to keep healthier dietary habits with a right distribution of carbohydrates consumed.