What is Gestational Diabetes? Gestational diabetes, sometimes known as GD, occurs when a pregnant woman’s blood sugar rises dangerously high. The pancreas is responsible for producing insulin which controls blood sugar within a normal range, but during pregnancy, hormones produced by the placenta can in some cases render insufficient insulin, leading to gestational diabetes. It’s important that GD is recognized and treated quickly because of the health implications for both mother and baby.
Screening for Gestational Diabetes
The American Diabetes Association (ADA) suggests that all expectant women who don’t already have diabetes be tested for gestational diabetes between the 24th and 28th weeks of pregnancy. One of the more common ways to determine if a woman has GD is to submit to the oral glucose tolerance test (OGTT). You should schedule the test in the morning as you have to take it on an empty stomach. When you arrive at your doctor’s office or lab, you will be provided with a special solution drink containing 75 grams of sugar (glucose). A blood sample will be taken 1 and then 2 hours after you drink the solution to determine if your blood sugar is in fact considered high.
Does gestational diabetes affect the baby?
Women with GD who receive appropriate care usually go on to deliver healthy babies. However, if you have continuously high blood glucose levels all through pregnancy, the fetus will also have increased blood glucose levels. High blood glucose can result in a larger than normal fetus, possibly making the birth more problematical. The baby also faces the risk for having neonatal hypoglycemia (low blood glucose) right after birth. Further newborn health problems arising as a result of poorly treated gestational diabetes can include a superior risk of jaundice, a bigger risk for respiratory distress syndrome, and a higher chance of dying before or following birth. The baby may also face a higher risk of becoming overweight and developing type 2 diabetes later in life.
Diagnosed with Gestational Diabetes, Now What?
Gestational diabetes can often be controlled through dietary changes such as avoiding high-glycemic foods, sugar, simple carbohydrates, and by participating in moderate physical activity. However, between 10-20% of women will also need insulin injections and/or may need to take oral medication to help establish a stable glucose level. Since most diabetic tablets are not suitable for use during pregnancy, metformin may be used to help control the GD.
Glucose Levels and Eating for Two One
After you’re diagnosed with high glucose levels, there is no further truth than “eating for two”. Your cravings may be tempting you to eat twice as much, but your portions should be significantly reduced. Pregnant women with GD should eat six small meals throughout the day, about 2-3 hours between meals. I remember looking at my plate and thinking I couldn’t possibly be feeding myself and the baby. The simple psychological thought of food and having to control myself made me feel hungry. I mean, all I wanted was a Häagen-Dazs vanilla milk chocolate almond ice cream bar… From my personal perspective, the most dreaded part of having gestational diabetes was certainly not being able to eat when you want, what you want, and having to wait to take your blood glucose reading (four times a day). However, it gets easier after you figure out how to properly work your blood glucose monitoring device and what you can and can’t eat.
Your doctor will advise you on your ideal blood glucose levels and your individual target level during your pregnancy. Fasting: 5.3 mmol/litre 1 Hour After Meals: 7.8 mmol/litre 2 Hours After Meals: 6.4 mmol/litre. You should monitor your blood glucose the first thing when you wake up in the morning while you’re fasting (not exceeding 10 hours from your last meal the night before), and one or two hours (depending on what your doctor advised; for me, it was two hours) after each breakfast, lunch and dinner. These testing periods are important because they determine how efficiently your body’s hormones are regulating the metabolism and uptake of glucose. As a side benefit, knowing exactly what is triggering your glucose levels after each meal lets you make healthier choices.
Personally, my biggest fear before pregnancy was not gestational diabetes (as I wasn’t even aware of it, and considered myself rather healthy), but having to give up caffeine. The constant monitoring made me aware that I could have a “tall, skim, 130 degree, decaf, latte” in the morning and still be under my ideal numbers – and to me, that was life. I remember the barista once jokingly tell me, “no caffeine, no fattening milk, and no temperature”.
Because I also had iron deficiency during pregnancy, I lived on green vegetables – avocado, broccoli, peppers – and hard-boiled eggs. Any sort of pasta would make my glucose numbers sky rocket. I learned to replace pasta with about two spoonfuls of brown rice. My favorite snacks included half a banana, ten (I kid you not, I counted each one up to ten) goldfish, and a handful of popcorn. But the truth is, there are no superfoods. If you want to reduce your blood sugar, don’t eat sugary foods. Focus on meat, veggies and healthy fats. Get some rest. Exercise (walk, walk, walk) moderately and be outdoors.
The Positive Side of GD
While I found the initial GB diagnosis worrisome, and the process of establishing a healthier diet arduous and at times even frustrating, once I got the hang of it, I found both the diet and the blood sugar monitoring fairly easy after the first week. Gestational diabetes may actually have been a blessing in disguise. While I was able to manage my glucose levels entirely through diet, eating various meals throughout the day, having more portion control and an overall healthier diet – I was also able to control my weight. I lost only a couple kilograms all within safe ranges and once I delivered, the gestational diabetes just went away. At the very end of the day, I am in love with my baby and all the sacrifices are well worth it.
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