Gestational diabetes, also known as type 2 diabetes, occurs in pregnancy when a woman’s blood sugar levels become high. Normally insulin, a hormone produced in the pancreas, helps glucose (sugar) to enter cells where it is used as fuel. Diabetes occurs when the pancreas is not producing enough insulin. It usually starts in the latter stages of pregnancy, and can be detected by measuring the amount of glucose in the blood.
Properly treated, a woman with gestational diabetes has every chance of a healthy pregnancy and normal birth. Left untreated, gestational diabetes can lead to serious problems.
Who Is At Risk Of Developing Gestational Diabetes?
Gestational diabetes may be caused by the action of the placenta during pregnancy. The placenta supports the growing baby, but also produces hormones that partly block the normal action of insulin. This makes it hard for the mother to use insulin, and excess sugar can build up in the blood. According to The American Diabetes Association the following groups of women are at higher risk of developing gestational diabetes:
- women with a history of diabetes
- women who are overweight (the more overweight the higher the risk)
- women in the following ethnic groups – Indo Asian, Afro-Caribbean, African, Arab Mediterranean or Hispanic
- older women
- women who have previously suffered from gestational diabetes
- women who have had unexplained stillbirths or neonatal deaths
- women who have had large babies
How Serious is Gestational Diabetes?
Poorly controlled gestational diabetes can harm the baby. The excess sugar circulating in the blood can cross the placenta. This causes the baby’s pancreas to make extra insulin to get rid of the sugar. The extra blood sugar and insulin cause the baby to make extra fat. This is known as macrosomia. It is twice as common in women with diabetes.
If the baby has high blood glucose, he or she may produce too much urine, and a condition known as polyhydramnios may occur. This is an uncomfortable condition in which too much amniotic fluid is retained around the baby. It may play a part in premature labour. Large babies are at higher risk of birth complications, particularly of damage to their shoulders.
If a baby is very big, there is a higher likelihood of a caesarean delivery. Babies may have breathing problems at birth, and low blood sugar levels. They are also more likely to suffer from jaundice. A small increased risk of unexpected intrauterine death can occur late in a diabetic pregnancy, even when blood sugar levels have been well controlled. The reasons for this are unknown but many consultants recommend that a woman delivers her baby early, at or around 38 weeks.
What To Do If You Are Diagnosed With Gestational Diabetes
It is entirely possible to have a healthy, happy pregnancy despite having gestational diabetes. The key issue is controlling blood sugar levels. This can be attempted through diet. A dietician will advise a pregnant woman to:
- Eat more starchy foods such as beans, vegetables, fruit, lentils, oats, wholemeal bread and pasta. This will slow down the rate of sugar absorption into the blood.
- Reduce sugary foods. Remember, this includes natural fruits and juices.
- Ead protein rich foods in moderation, such as milk, yoghurt, cheese, meat and eggs.
- Cut down on fat. Choose unsaturated fats rather than saturated.
- Eat little and often.
Some pregnant women will not be able to control blood sugar through diet, and will have to inject insulin into themselves. Whilst unpleasant, this is a short term measure until the birth of their baby.
Gestational diabetes is a pregnancy complication which must be taken seriously, but if all the proper advice is taken upon diagnosis , a healthy baby and a happy new mother will usually be the outcome. The advice given to pregnant women who have gestational diabetes is to stick to a healthy eating plan – a plan which should be followed after childbirth, since they are at higher risk of developing diabetes later in life. Along with a healthy diet women who have had gestational diabetes should stay as slim as possible and exercise frequently – basically common-sense advice for everyone.