By: Dr. Fawzi Saoud
DHR Health Maternal Foetal Medicine
• What is Gestational Diabetes (GD)?
A condition that develops for the first time during pregnancy, in which too much sugar stays in the blood instead of being used for energy. Women with GD need special care both during and after pregnancy.
• What causes GD?
Normally, the body produces a hormone called insulin that keeps blood sugar levels in the normal range. During pregnancy, higher levels of pregnancy hormones can interfere with insulin. But in some women, the body cannot make enough insulin during pregnancy, and blood sugar levels go up. This leads to GD.
• Who is at risk for GD?
It can occur in women who have no risk factors, but it is more likely in women who: are overweight or obese, who have PCOS (Polycystic Ovary Syndrome), are physically inactive, had GD in a previous pregnancy, had a very large baby (9 pounds or more) in a previous pregnancy, have high blood pressure, or have a history of heart disease.
• How can GD affect your baby?
Babies born to women with GD may have problems with breathing and jaundice. These babies may have low blood sugar at birth. Large babies are more likely to experience birth trauma, including damage to their shoulders, during vaginal delivery. Large babies may need special care in a neonatal intensive care unit (NICU). There also is a higher risk of stillbirth with GD.
• How can GD affect you and your pregnancy?
When a woman has GD, her body passes more sugar to her foetus than it needs. With too much sugar, her foetus can gain a lot of weight. A large foetus (weighing 9 pounds or more) can lead to complications for the woman, including labour difficulties, caesarean delivery, heavy bleeding after delivery and severe tears.
• When will you be tested for GD?
All pregnant women should be screened for GD. Your Ob-gyn will ask about your medical history to determine whether you have risk factors for GD. If you have risk factors, your blood sugar will be tested early in pregnancy. If you do not have risk factors or your testing does not show you have GD early in pregnancy, your blood sugar will be measured between 24 weeks and 28 weeks of pregnancy.
• Should you change your diet if you have GD?
When women have GD, making healthy food choices is even more important to keep blood sugar levels from getting too high. If you have GD, you should eat regular meals throughout the day. You may need to eat small snacks as well, especially at night. Eating regularly helps avoid dips and spikes in your blood sugar level. Often, three meals and two to three snacks per day are recommended.
Also, it is important to gain a healthy amount of weight during pregnancy. For a woman with GD, too much weight gained or weight gained too quickly can make it harder to keep blood sugar levels under control.
• What about exercise?
Exercise helps keep blood sugar levels in the normal range. In general, 30 minutes of moderate-intensity aerobic exercise at least 5 days a week is recommended. Walking is a great exercise for all pregnant women. In addition to weekly aerobic exercise, it’s a good idea to add a walk for 10–15 minutes after each meal. This can lead to better blood sugar control.
• Will medications be needed?
For some women, medications may be needed to manage GD. These medications can come in the form of pills by mouth or injections such as insulin.
• How will GD affect your delivery?
Most women with controlled GD can complete a full-term pregnancy. But if there are complications with your health or your foetus’s health, labour may be induced (started by drugs or other means) before the due date. Although most women with GD can have a vaginal birth, they are more likely to have a caesarean delivery than women without GD.
• What are future health concerns for you and your child?
GD greatly increases the risk of developing diabetes in your next pregnancy and in the future when you are no longer pregnant. One third of women who had GD will have diabetes or a milder form of elevated blood sugar soon after giving birth. Between 15% and 70% of women with GD will develop diabetes later in life.
Children of women who had GD may be at risk of becoming overweight or obese during childhood. These children also have a higher risk of developing diabetes. Be sure to tell your baby’s doctor that you had GD so your baby can be monitored.
https://www.themonitor.com/2020/11/23/gestational-diabetes-affect-pregnancy/
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