If you are at high risk for diabetes, or show signs such as sugar in your urine, your caregiver will likely recommend a glucose-screen test at your first prenatal visit and again at 24 to 28 weeks if the first result is negative.
There aren’t really symptoms for gestational diabetes, but you are considered high risk for the condition if you have sugar in your urine, you are obese, have had gestational diabetes in a past pregnancy, and/or have a family history of diabetes.
Some practitioners may also screen patients who have previously given birth to a large baby, had a baby with a birth defect, you are more than 35 years old, or if you have high blood pressure.
If you are diagnosed with gestational diabetes, there are some things you can do to keep your glucose levels on track. These include:
- Eat a well-balanced diet, with meals and snacks planned in advance based on your height and weight
- Don’t skip meals and avoid sugary items such as candy, cakes and soda
- Maintain a moderate exercise level to help your body process glucose
- It may be necessary to take insulin
Parenting can be hard work and can be especially difficult for those whose children lead sedentary lifestyles. All too familiar a scenario today; a child or teenager coming home from school and subsequently spending hours on end in front of a computer, television, or playing video games. The parent suggests going outside or some other active recreation but has difficulty getting them off the couch.
So what can be done?
Fortunately, there are some helpful strategies out there to help parents get their children to become more active without resorting to threats and groundings. For example, it’s important to try and balance a child’s recreation time. That means not banning them from using computers or playing video games entirely, but instituting a type of trade-off, where an hour of exercise is rewarded with 30 minutes of video game time.
Also, remember that quality trumps quantity: fifteen minutes here, 50 jumping jacks there, are just as good as two hours of non-stop strenuous activity. Most importantly, make it a group effort. Children will be more likely to enjoy exercising if done in tandem with a parent.
Somewhere between the 24th and 28th 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.
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.
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.
The day you learn you are pregnant is the most magical day. Suddenly there is new life. You want to do everything you can to ensure your developing baby gets all his nutritional needs right from the beginning.
So, you do everything right: you eat the right foods, take your supplements, keep all doctor visits, exercise regularly, and keep your stress levels low. This is why it is even harder to hear that you have developed gestational diabetes during your pregnancy. Don’t feel daunted by this news. Many women, who develop this condition, do not continue to have diabetes mellitus after the baby is born. However, it is very important that during your pregnancy you continue to keep stress levels low, exercise and take your supplements. Your diet will probably need to change.
Keeping blood sugars low is a matter of being mindful about what foods you are eating. Foods high in fat and carbohydrates should no longer be consumed. Fruits, vegetables and complex carbohydrates with a high-fiber content can be consumed as they digest slowly and keep blood sugars at a consistent level. These include whole wheat breads, pasta and rice. Your diet should be high in protein including lean meats, fish, eggs, beans and peanut butter. Obviously foods high in sugar, such as desserts, pastries or soft drinks should be avoided at all times.
Skipping a meal is never a good idea since as a pregnant woman, you need lots of energy and your baby needs the nutrition. You also run the risk of lowering your blood sugar too much. You should plan on eating three meals per day with two snacks in between to help keep blood sugars under control. A pregnant women typically needs to consume about 300 more calories than she did when she was not pregnant. These calories need to include calcium, iron and plenty of vitamins and minerals.
It might be a good idea to consult a nutritionist on what foods are the best to maintain your blood sugar levels. Keep your doctor visits to have your blood glucose levels tested and to continue on the right path for the healthy development of your baby.
Anny H. Xiang, MD, of Kaiser Permanente Southern California in Pasadena, reviewed 140,000 cases occurring between 1995 and 2008 of pregnant women. While the prevalence of gestational diabetes were similar among African-American and white women, in the years following their pregnancies, blacks had a 9.2 times higher risk for developing full-fledged diabetes.
Other ethnic groups have a higher prevalence of gestational diabetes than African American women, though less risk for later diabetes. Hispanic women had the next highest incidence rate of later diabetes, with Asian/Pacific women having the lowest risk.
"Whether this difference is due to genetics, environment, lifestyle, or other differences among ethnic groups will require further investigation," they wrote.
They concluded that ethnicity should be considered in screening and counseling women who develop gestational diabetes, and particularly for blacks.
Women with gestational diabetes often control their blood glucose levels through diet and exercise and medications like insulin, if prescribed. Fetal complications such as macrosomia ("big baby syndrome") and jaundice are common in unresolved cases.
IDM or Infant of a Diabetic Mother refers to a baby who was born to a mother who had gestational diabetes: high glucose levels were found in her blood throughout her pregnancy. Gestational diabetes can present several issues for her newborn baby.
A baby born to a mother who has gestational diabetes is typically larger than babies born to women who do not have high blood sugar. These newborns may have periods of low blood sugar after birth, which means they will have to be closely monitored for signs including poor feeding and a weak cry. They will have to be tested until their blood sugar remains stable after normal feedings.
The baby may experience tremors after birth and there may be rapid breathing because the lungs are immature. They may also have larger kidneys and heart, which could lead to long-term complications such as heart failure.
If you have been diagnosed with gestational diabetes your doctor will refer you to a nutritionist who will help you keep your blood sugar under control and help to minimize any complications for your growing child. With better testing and more control over diabetes the number of children born with severe problems has decreased and the symptoms typically go away after a few weeks.
Why do some women get gestational diabetes? It is because some are at higher risk. Do you know your risk factors?
Knowledge is power. We have all heard this sentiment and nowhere is it more important than when considering your health and the health of your unborn baby. Knowing whether or not you are at risk for gestational diabetes puts you in the driver’s seat towards a healthy pregnancy and baby.
According to the National institute of Child Health and Human Development you could be at greater risk if:
- You have had gestational diabetes during a previous pregnancy
- You are overweight or obese (with a body mass index of over 30)
- You have a family history of diabetes or are in a high-risk ethnic group (African American, Hispanic, Native American)
- You are over 35
- You have given birth to a very large baby, a baby with a birth defect or have had a stillbirth
- You have high blood pressure
- You have had an abnormal glucose test in the past.
An obstetrician would also be concerned if you have gained a great deal of weight during your pregnancy. It is very important to be screened at around 24 weeks of your pregnancy as some women who have none of the risk factors can still develop gestational diabetes.
Keeping up with good nutrition is so important when you are pregnant. Your baby’s needs demand a diet rich in vitamins, protein and calcium, which will not only keep you healthy throughout your pregnancy but also your growing child. If you have been diagnosed withÂ gestational diabetes during pregnancy, you need to be even more vigilant about what goes into your body.
Not being able to sufficiently produce or use insulin, which is a hormone produced by the pancreas that allows the cells in your body to turn sugar into fuel or energy can have dire effects to you and your growing baby if not caught early and monitored. It needs to be controlled and the way to do this is through your diet. Sticking to a restricted diet is very important.
A registered dietitian will be able to recommend to you exactly you should be eating and what foods you need to avoid. She will begin by determining exactly how many calories you should be consuming per day. She will instruct you not only on how to create the correct portion sizes for each meal, she will also tell you how much protein, carbohydrates and fat you should be eating along with making sure you incorporate enough vitamins and minerals.
By eating a variety of healthy foods throughout the day you will be sure that you are getting the required calories. While you may need to cut back on the amount of carbohydrates you normally eat, it is important that you follow the directions of your dietician and do not skip a meal. Stay consistent with your diet and you will be able to manage your blood sugar.
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.
Though most people know only type 1 and type 2 diabetes, there are other minor variants of diabetes.
Type 1 diabetes :
* It’s genetic inheritance – Risk increases 20 – 50% if an identical twin is affected. More common with certain class II HLAs.
* Complete dependency on insulin treatment – Most of the patients need insulin in their daily life. The dose should be adjusted according to their demands, exercise and other stress factors.
* Young age onset – Around puberty.
* Autoimmune destruction of beta cells in pancreas (Body defense cells called lymphocytes destroy own body cells) – Lymphocytes of the patient are sensitized to his/her own beta cells destroying them.
* Development of ketoacidosis – Most serious complication of type 1 diabetes. As most patients depend on exogenous insulin for their blood sugar control, there should be fine balance between the demand and the supply. If there is more demand for insulin (like surgeries,exercise, pregnancy) and less supply (like missing insulin injections), they easily prone to high glucose levels and ketosis.
Type 2 diabetes :
* It’s genetic inheritance – 50 – 90% of risk if an identical twin is involved.
* Insulin resistance – Main pathology behind this type of diabetes. There are many genetic defects in insulin receptors that causes insulin resistance.
* Partial insulin deficiency – Still some insulin secretion will be preserved, atleast in most of the patients. Beta cell mass is reduced to 50% of normal at the time of diagnosis.
* Age over 40 years
* No autoimmunity – No role for autoimmunity as in type 1 diabetes.
* Development of Hyperosmolar nonketotic coma instead of ketoacidosis – This complication is common in type 2 than type 1. Due to hyperglycemia and impaired water intake in elderly diabetics.
* Insulin treatment sometimes – Usually oral antidiabetic drugs are given to control blood glucose. Some of these drugs enhances the insulin secretion from beta cells. Insulin is last resort if diet, exercise, oral drugs fail.
* Often obese – Central obesity appears to trigger the disease in persons who are genetically susceptible.
Maturity onset diabetes of the Young (MODY) :
* Primary defect is impaired glucose induced secretion of insulin.
* Age is usually less than 25 years.
* This is inherited by a mechanism called autosomal dominance.
* No autoimmunity (as in type 1)
* No insulin resistance (as in type 2)
* No obesity (as in type 2)
MODY is different category. It won’t lead to type 2 diabetes in old age.
Gestational diabetes :
Placenta in preganancy produces anti-insulin hormones that counteract the actions of insulin. So pregnant woman can not maintain normal glucose levels in blood exhibiting glucose tolerance. Fortunately, the condition disappears once the baby was delivered.
Risk factors are obesity, happens when more than 30 years of age, positive family history, unexplained still birth, polyhydromnios (excess amniotic fluid)
Other types of diabetes (secondary causes):
* Diabetes associated with insulin gene or insulin receptor genes.
* Pancreatic diseases like chronic pancreatitis, cystic fibrosis,hemochromatosis.
* Endocrine disorders like acromegaly, cushing’s syndrome, hyperthyroidsm.
* Exogenous administration of glucocorticoids.
[tags]gestational diabetes, mody, type 1 diabetes, type 2 diabetes, diabetes, diabetic[/tags]