Gestational Diabetes During Pregnancy

Gestational diabetes Mellitus (GDM) during pregnancy is different from normal forms of diabetes in that it is temporary; other forms last for a lifetime. Other than sugar showing consistently in your urine test, GDM exhibits no other signs and symptoms. Common features include:

• Gestational diabetes Mellitus (GDM) shows up only during pregnancy in the 2nd and 3rd trimesters and disappears after baby's birth.

• During pregnancy the demand for insulin increases 2 to 3 times more than before pregnancy.

• If there is insufficient insulin or if insulin is not working properly, glucose accumulation occurs and is expelled from your system through your kidneys into the urine.

• If you are careful about your diet and exercise habits, diabetes can be controlled.

How Gestational diabetes Mellitus (GDM) happens

• Glucose from the foods that you eat is absorbed into your bloodstream, muscles and tissues under the supervision of insulin.

• Insulin is produced by your pancreas

• Glucose is derived from simple carbohydrates, which is in sugar form found in jam, cakes and sugar to name a few;

• Complex carbohydrates, which is in starch form found in bread, potato and rice etc converts into glucose in your body.

• Some of the hormones produced by the placenta have a blocking effect and prevents insulin from doing its work.

• Because of this insulin-blocking hormone your pancreas is compelled to produce more insulin in response to the increased demand.

• In most women this demand is met but if for some reason insufficient insulin is produced than GDM is the result

• WHO has defined GDM as either diabetes or impaired glucose tolerance

Who gets Gestational diabetes Mellitus (GDM)

You are at risk if you:
• Are overweight or obese

• Have a family history of type-2 diabetes

• Had a large baby previously

• Had an unexplained stillbirth

• Had a baby with a birth defect

• Have high BP

• Urine test shows sugar at every antenatal check

Keeping Gestational diabetes Mellitus (GDM) under control

• Keep a close watch over your glucose levels using home glucose meter or strips

• Moderate exercise such as aerobics, walking or swimming improves your ability to process sugar and keep your blood sugar in check. You would need to check with your caregiver if you should exercise before you start on any program

• A controlled diet with blood sugar lowering tablets (hypoglycemic) is one option

• If insulin shots are mandatory then go along with the recommended dose; rest assured they are safe for your baby

• Eat well balanced meals to keep your glucose at the right level. You would probably need guidance in the start from a dietician on the dos and don'ts of eating based on your personal statistics and lifestyle as well as a calorie chart to meet your needs

• Diabetic women usually have to undergo extra scans at weeks 28, 32 and 36 to check baby's growth and may have them more often if there is cause for concern

Postnatal check on your blood sugar is important as the tendency for developing type2 diabetes in later life is possible. Good dietary habits and exercise will go a long way in helping you deal with this problem.

The dangers of Gestational diabetes Mellitus (GDM)

• Your odds of developing preeclampsia is higher

• Chances of delivering a 'large-for-date baby' is high: your baby may weigh above 4kg and have an overgrowth of fatty tissue in his upper body making delivery difficult

• Increased likelihood of a C-section

• Increased risk of developing type-2 diabetes later in life

• Your baby may have low blood sugar (hypoglycemia), be at risk for jaundice, overproduce red blood cells and have low blood calcium. All these conditions are treatable.

• Some babies experience respiratory problems

• If your blood sugar goes really out of whack, baby's heart function may be at stake

• Increased risk for stillbirth

Smart food decisions

1. Eat in variety - well balanced meals and snacks

2. Eat in moderation - don't binge, snack in between instead

3. Don't skip meals - be consistent in your timing and in the quantity

4. Breakfast is a MUST - glucose levels are most odd in the mornings. Boost protein and limit your carbs

5. Up your high fiber foods; cut your sugars - foods that break down slower get absorbed slower unlike quick sugar fixes. Eat more complex carbs over simple carbs e.g. choose wholemeal bread over cake

6. Avoid drinks and foods containing caffeine

The Tests..

Ensure that mid-stream urine sample was given for testing during your antenatal checks. If sugar is found in your urine repeatedly, further test(s) will be required.

Challenge Test (GCT)

You are required to drink a glucose fluid drink

The glucose level in your blood is tested an hour later

Some women feel nauseas during this test

The test is carried out between weeks 24-28

If glucose level is found to be on the high side you are required to come back for the GTT

Glucose Tolerance Test (GTT)

This is a follow up test to GCT

You will be required to fast overnight

Your sugar levels are tested to measure your 'fasting blood glucose level'

You are made to drink a glucose drink

Some women find GTT nauseating

Your sugar levels are tested again after 2 hours