Gestational or Pregnancy Diabetes: What You Need To Know

By Dr Andrew Orr

Gestational diabetes is diabetes that occurs during pregnancy only. It is definitely on the increase, most likely due to our high carbohydrate diet and lack of proteins.

Gestational Diabetes Symptoms

Gestational diabetes usually has no obvious symptoms. If symptoms do occur, they can include:

• Unusual thirst
• Excessive urination
• Tiredness
• Thrush (yeast infections)

Diabetes in Pregnancy

During pregnancy, the placenta produces hormones that help the baby grow and develop. These hormones also decrease the action of the mother’s insulin. This is called insulin resistance. Because of this insulin resistance, the need for insulin in pregnancy is two or three times higher than normal. Insulin resistance can also be hereditary and if there is a family history of diabetes, you have higher chance of having insulin resistance by default. Women with PCOS and those doing assisted reproduction (IVF, IUI, ICSI etc) also have higher risk of developing gestational diabetes.

Consequently, during pregnancy, the mother’s body needs to produce higher amounts of insulin to keep her blood glucose levels within the normal range. If her body is unable to produce more insulin to meet her needs, gestational diabetes develops. After the baby is born, the mother’s blood glucose levels usually return to normal.

Unfortunately many women think they can eat whatever they like during pregnancy and this also puts a greater load on insulin and insulin sensitivity, resulting in them being at increased risk of gestational diabetes. Gestational diabetes is very much a preventable disease (see BellyBelly’s article here about recent research that uncovered how Gestational Diabetes could be reduced up to 83%), and strict diet needs to be adhered to for optimum health of mother and child.

Management Of Gestational Diabetes

• Diet – You need to follow a strict, low GI diet. The best diet to follow is a grain-free diet. This way you are cutting out the inflammatory foods that spike your blood sugars and then spike your insulin. Basically you should be having 5-7 small meals per day. You need to have 2 serves of nuts per day, 2 tablespoons of healthy oils per day (coconut, olive oil etc), only one serve of starchy carbs per day (basmati rice, potatoes etc – no wheat grains at all), every meal or snack should have some form of protein in it (meats, fish, avocado, cheese, nuts etc), 5 serves of veggies per day (including salads), 2 pieces of low GI fruit per day (berries, strawberries, apples etc), 8 glasses of water per day and some form of electrolyte daily.
• Physical activity – such as walking, yoga or pilates to keep fit. It will help you to prepare for the birth of your baby and will help to control your blood glucose levels. Check with your health care professional before starting a new or particularly strenuous exercise regimen.
• Monitoring your blood glucose levels – this is essential. It gives a guide as to whether the changes you have made to your lifestyle are effective or whether further treatment is required. A diabetes nurse educator can teach you how and when to measure your blood glucose levels and discuss the recommended blood glucose levels to aim for. Your health care professional or diabetes educator can help you link in with the National Diabetes Services Scheme (NDSS) for cheaper blood glucose strips. Regular contact with your health care practitioner, diabetes educator, or doctor is recommended.
• Take a good multivitamin, some omega 3 oils, a probiotic and an insulin regulating formulation to help with staying healthy, providing adequate nutrients to the baby and help in preventing gestational diabetes. Acupuncture is also great in the prevention on gestational diabetes.
• Insulin injections – may be needed to help keep your glucose level in the normal range. In Australia, blood glucose lowering tablets are generally not used in pregnancy. Insulin is safe to take during pregnancy and does not cross the placenta from the mother to the baby.
• Education – including information and support from your diabetes educator or doctor, regarding the action of insulin, insulin injection technique, insulin storage, signs and symptoms of hypoglycaemia (low blood glucose levels) and its treatment, as well as safe blood glucose levels for driving.

After The Birth

After their baby is born, most women will no longer need insulin injections, as gestational diabetes usually disappears. Breastfeeding is encouraged.

Blood glucose levels are measured before breakfast and two hours after meals to make sure that these are within the normal range. An OGTT is done six to eight weeks after the baby is born to make sure that the mother no longer has diabetes.

Following the birth, it is important that your baby’s blood glucose levels are measured to make sure that their blood glucose is not too low. If it is, this can be treated by feeding your baby breastmilk, or formula if necessary.

A baby whose mother had gestational diabetes will not be born with diabetes. However, they may be at risk of developing type 2 diabetes later in life.

Things to remember:

• Gestational diabetes is diabetes that occurs during pregnancy.
• When the pregnancy is over, the diabetes usually disappears.
• Women who develop gestational diabetes have an increased risk of developing type 2 diabetes.
• A healthy lifestyle with a grain free diet, is important for both mother and baby to reduce their risk of diabetes in the future.
• In future pregnancies, an OGTT will be performed early in the pregnancy to make check that your blood glucose levels are in the normal range. If this test is normal, then a repeat OGTT will be done, usually between 22 and 28 weeks gestation.

Prevention is the best way to deal with gestational diabetes and type 2 diabetes. Before you conceive, it’s ideal to start preparing for pregnancy with good foods, good supplements, exercise and a healthy lifestyle. These healthy eating and lifestyle changes should continue into the pregnancy as well, for optimal health and the best outcomes for mother and baby.

Source: bellybelly.com.au