Glucose Tolerance

Somewhere between the 24^th and 28^th week of your pregnancy, your obstetrician is going to have you take a glucose tolerance test to check for gestational diabetes. There isn’t much that needs to be done to prepare for the test, however, you will have to fast for 8-12 hours before the test is administered. Many women schedule the glucose tolerance test first thing in the morning to prevent having to fast during the day. You will not have to alter any of your eating habits during the weeks leading up to the test.

On the day of the test, you will have your blood drawn. This will give the physician a baseline reading. Then you will have 5 minutes to consume a glucose solution, which will contain about 95 grams of sugar. Your blood will be drawn 2 hours after you drink the solution to measure your body’s reaction to the glucose. If your blood sugar levels are elevated you will have to repeat the test with a blood draw at one, two and three hour intervals.

If you are at risk of, or diagnosed with gestational diabetes you will have to carefully monitor your glucose levels and your diet throughout the rest of your pregnancy.

Gestational Diabetes and the Importance of Effective Glucose Management During Pregnancy

By now, hopefully most Americans know that diabetes can develop in otherwise-healthy individuals over time, brought on by high sugar intake and weight gain. In some instances, the diagnosis can come out of nowhere; however, in most cases, it’s a gradual process.

People who consume high quantities of sugar, fatty foods, and rarely exercise need to be aware of the risk and improve their lifestyle before the symptoms of diabetes start to appear.

The same, unfortunately, cannot be said for gestational diabetes. Gestational diabetes, quite literally comes out of nowhere; women who previously exhibited no symptoms of diabetes start to exhibit high glucose levels during pregnancy. And unlike Type 1 or Type 2 diabetes, there are few symptoms for gestational diabetes.

This ailment afflicts roughly 3-10 percent of pregnancies, leading some medical experts to conclude it’s a natural occurrence. But that’s of little consolation to mothers who have it: babies born to mothers with the disease tend to be abnormally large, have low blood sugars, and jaundice. Fortunately, gestational diabetes can be treated by effectively managing one’s blood sugar levels.

Therefore, if you are pregnant, it is critical to talk to your doctor about this and to closely watch your diet.

The Ideal Gestational Diabetes Diet

If your doctor has diagnosed you with gestational diabetes, paying attention to your diet is very important during this critical phase in your life. Managing diabetes while pregnant is not easy, and you need to follow a few dietary rules.

While you take your diabetes medication prescribed by a physician, you should also pay attention to the foods you eat. Your goal is to keep a steady glucose level throughout your body. Therefore, stay away from simple carbohydrates like sugar and white flour. Have regular meals with enough carbohydrates to keep your glucose levels stable. Vegetables, fruits, and whole grains are the best foods to eat to get enough healthy carbs.

Drink plenty of water throughout the day. Pure water without any sugar is best for the developing baby and your own body. Coffee that contains caffeine is not good for someone with gestational diabetes. You may want to drink extra milk to get your calcium. If you don’t like milk, leafy green vegetables or supplements will supply you with enough of the vitamin.

If you need sugar in your food, use an artificial sweetener like agave nectar or stevia. These are natural alternatives that shouldn’t raise your glucose levels. Diabetes management while pregnant is something that you cannot brush off, because it can negatively affect your baby and raise your risk for Type 2 diabetes in the future.

Risk Factors of Gestational Diabetes

Pregnancy brings about many obvious changes to a woman’s physical appearance but there are also many potential changes that are not so obvious, such as gestational diabetes.

If you did not previously have diabetes before becoming pregnant you may not be aware that you have gestational diabetes, since it rarely causes any symptoms. But there are some risk factors that your doctor will be looking for. And the more informed you are about these risks, the more vigilant you can be in monitoring yourself throughout your pregnancy.

The risk for gestational diabetes rises if you are overweight before becoming pregnant. If you are carrying 20% more weight than what you should be, you could be at risk.

Several ethnic groups tend to develop gestational diabetes more often than others, if you are Hispanic, Native American, Asian or Black, these tend to be groups, which are at higher risk.

After taking the glucose tolerance test and finding that your levels are high but not high enough to be diabetic, does put you in a higher risk category than someone whose test came back in the normal range.

If you had gestational diabetes during a previous pregnancy, if you have too much amniotic fluid, if your baby weighed over 9 pounds or if you gave birth to a stillborn baby, your OB will definitely be more concerned and will monitor you even closer throughout your pregnancy.

These are certainly only risk factors but knowing where you stand in terms of the risk, will allow you to be carefully monitored and if you do develop gestational diabetes your doctor will be on top of your care.  It is important to remember that many women who do not have any known risk factors can still develop gestational diabetes.

How to Deal With Diabetes while Being Pregnant

There is nothing to worry about if you have diabetes and you are pregnant. You will actually have better chances of having a healthy baby then those who do not have diabetes due to your already super healthy diet. Nevertheless there are some certain precautions that you should take.

The most important thing while having diabetes and being pregnant is to have a stable and normal level at all times. This may be a little more challenging since you have a little baby growing inside of you who may not be aware with you challenges with diabetes. This is important to know because miscarriages are more frequent in the first three months as the baby is growing at a rapid rate and your body is changing due to hormones. If you can manage your glucose level then you should be in the clear.

You should also be prepared to switch over to insulin shots if you are using hypoglycemic medication or are only using a healthy diet and exercise to control your diabetes. The insulin shots are the best method to keeping you and your baby safe.  Your diet will obviously have to change considering that you are not only eating for one so you will have to change your diet to fit the needs of you and your baby. You will most likely be taking in about 300 extra calories per day. The most important thing to do while having diabetes and being pregnant is control. If you can control your body’s glucose level and blood pressure then you will have a low risk of miscarriage and a healthy and happy baby.

What is Gestational Diabetes?

A pregnant woman is unable to maintain normal fasting blood sugar levels and also blood sugar levels after glucose challenge test. Interestingly blood sugar levels comes to normal levels after the baby was born. So it is short lived condition. It generally developed in second half of pregnancy.

Risk Factors:

* Obesity

* Positive family history of diabetes

* Unexplained still birth

* Polyhydromnios (excess amniotic fluid)

Reason Of Gestational Diabetes:

Normally insulin secreted by the pancreas controls blood sugar by pushing the excess glucose in to cells. But in pregnancy placenta produces hormones (human placental lactogen, placental insulinase, cortisol, progesterone) that counteract the actions of insulin. They increase blood glucose and make tissue resistant to insulin action. Once baby was born and placenta was delivered, these hormones action wanes out with in few days and blood glucose comes to normal.

Diagnose Gestational Diabetes:

Screening for gestational diabetes is routinely done on all pregnant woman as a part of regular checkups. If the pregnant woman has risk factors, early testing is required.

First screening test will be done : by 1 hour – 50 gram – oral glucose tolerance test. If the pregnant woman has blood glucose less than 140 mg/dl, it is considered normal. If the values are more than that then pregnant woman needs another test to confirm the diagnosis : 3 hour – 100 gram – oral glucose tolerance test.For this test patient need to be on overnight fasting. And three glucose values are obtained after the test. So total four values – one fasting and three after intake of glucose. If any two of four values are abnormal, then it is diagnostic of gestational diabetes.

Complications:

For the baby -

* Low blood sugar because of persistent insulin in baby’s blood

* Large babies due to excess growth result to excess insulin

* Low calcium levels in baby

* Jaundice due to liver immaturity

* Respiratory problems due to delayed lung maturation

For the mother -

* Big babies and difficult delivery

* Loss of blood after delivery due to uterine agony

Management Of Gestation Diabetes:

It is necessary to do home glucose monitoring at least four times a day. Also in some patients insulin therapy is required where they have to be given an extra dose of insulin. Diet of pregnant woman should be rich in whole grains, vegetables, low fats and nutritious. Regular exercise under the doctors guidance is a must like moderate aerobic exercises, walking, cycling are advised.

Women with overt diabetes have increased risk of fetal anomalies. These can be reduced by maintaining normal blood glucose levels starting three months prior to discontinuing the oral contraceptives or planning to conceive. Also Folic acid supplementation should started three months prior to conception.

[tags]diabetes, diabetic, diabetic pregnancy, gestational diabetes[/tags]