How Do You Manage Gestational Diabetes
If you are diagnosed with gestational diabetes it is important that you are supported and know what to do to manage it. Health professionals such as your doctor, a dietitian, a diabetes nurse educator or sometimes a diabetes specialist will help you understand what to do and will support you.
Family also can be a great support. It is important that your family understands about gestational diabetes and how it is managed.
Management of gestational diabetes aims to keep blood glucose levels in the recommended range during pregnancy. This can prevent problems during birth and also helps reduce the babys risk of being overweight in childhood and developing type 2 diabetes later in life.
Management of gestational diabetes involves:
- monitoring blood glucose levels
Some women may need insulin injections to help manage their gestational diabetes.
Gestational Diabetes And Your Baby
Gestational diabetes can affect your developing baby in a couple of ways:
- High birth weight Exposure to higher sugar levels from the maternal bloodstream can result in a larger baby and a high birth weight. The baby’s pancreas produces extra insulin in response to the higher glucose, which results in the baby storing extra fat and growing larger. A larger baby can make delivery more complicated for both mother and baby.
- Low blood sugar If your blood sugar has been elevated during the pregnancy, your baby may have low blood sugar, called hypoglycemia, shortly after birth. The extra insulin that your baby produces when your blood sugar is high continues to bring your baby’s blood sugar down for a short time after birth. Without the continued supply of sugar from maternal blood, your baby’s blood sugar level may fall too low.This is temporary, though, and the nurses and doctors caring for your newborn will monitor your baby carefully and treat any episodes of low blood sugar that may occur.
Is It Safe For Me To Exercise While I’m Pregnant
Your doctor will help you choose an exercise that is safe for you and your baby. To be cautious, you should follow some simple guidelines when you exercise. For example, don’t exercise too hard or get too hot while you’re exercising. Depending on your age, your pulse shouldn’t go higher than 140 to 160 beats per minute during exercise. If you get dizzy or have back pain or other pain while exercising, stop right away and call your doctor. If you have contractions , vaginal bleeding or if your water breaks, call your doctor right away.
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What Should I Do After My Blood Sugars Return To Normal Postpartum
- Continue to test your blood sugar! Test 2 hours after your largest meal a couple times per week. This is important data that will give you a heads up if your blood sugar starts trending up or you are just not tolerating the carbohydrate content in a particular meal.
- Limit processed carbs. Just because your blood sugars come down doesn’t mean you should eat all the junk. Generally avoid processed carbohydrate foods it will result in better blood sugar control long term.
- Focus on eating a nutrient rich whole foods diet. This is simple and will benefit your health on many levels. Those who eat a whole foods diet generally do not develop diabetes, simple as that.
- Move you body. Working out improves insulin sensitivity. If gestational diabetes indicates some level of insulin sensitivity you will want to do what you can to improve your response to insulin. Doing something as gentle as walking post-meal you can reduce your blood sugar without relying on insulin. This is a great tool and should be utilized!
- Get your A1c tested annually. Even if you are young getting your A1c tested each year is important. Those who miss these annual appointments sometimes miss the pre-diabetes diagnosis and jump straight to diabetes. Prediabetes is scary but it is still early enough to make changes to prevent a chronic disease. Prevention is key.
What strategies did you use to control blood sugar during and after pregnancy? Leave your comments below.
Your Healthcare Team Will Take Extra Steps To Make Sure You And Your Baby Get Off To A Healthy Start
This will include checking your babys blood sugar levels about 2 to 4 hours after birth. This is not a test for diabetes, it’s to make sure your babys blood sugar is not too low.
You might be worried that because you have diabetes, your baby will too. Its natural to worry but rest assured, its very rare for a baby to develop diabetes. Having Type 1 or Type 2 diabetes does not increase your babys risk.
But having a close relative with diabetes does increase someones risk of developing diabetes later in life. Type 1 diabetes cannot be prevented but there are lots of things people can do to reduce their risk of Type 2 diabetes.
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Management Of Igt After Pregnancy
How should the clinician manage the woman with prior GDM and IGT identified after pregnancy? Certainly weight loss or weight maintenance medical nutrition therapy and 3060 min exercise daily at least 5 days per week should be applied . The 2-h 75-g GTT should be repeated at some interval, since it can revert to normal or abnormal spontaneously. For women with persisting IGT after a good effort of medical nutrition therapy and planned physical activity, clinical trials support the clinician adding pharmacotherapy . Acarbose delays carbohydrate absorption and helps with postprandial glucose control, but side effects limit usage . Metformin decreases hepatic glucose production and lipid oxidation, improves peripheral tissue insulin sensitivity and helps with weight loss . Thiazolidinediones as peroxisome proliferatoractivated receptor- agonists increase insulin sensitivity and may improve lipid balance and cardiovascular and renal function . Metformin and glitazones may help take the load off the overworked pancreatic -cells . As noted above, it is important to identify and control type 2 diabetes before a subsequent pregnancy. This may justify continued follow-up in the gynecological setting of women with the potential to become pregnant, or close collaboration with other physicians.
How Does Gestational Diabetes Develop
Your body makes insulin to help keep your blood glucose at the right level. Your blood glucose levels become higher if your body doesnt make enough insulin or if your insulin does not work as well as it should.
During pregnancy, hormones are made by the placenta to help the baby develop and grow. These hormones, however, stop the mothers insulin from working properly. This is called insulin resistance. As the pregnancy develops and the baby grows bigger, the mothers body has to make more insulin to keep her blood glucose at the optimal level.
Later in pregnancy the amount of insulin needed to keep blood glucose levels optimal is two to three times higher than usual. If the mother is unable to produce enough insulin to meet this demand then her blood glucose levels rise and gestational diabetes develops.
The babys response to the higher glucose levels is to make more insulin. This can lead to the baby becoming larger than usual and cause problems during and after birth.
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Tips For Women With Gestational Diabetes
I’ve Had My Baby What Now
But, in some cases, pregnancy uncovers existing diabetes, so some women will need to carry on with their treatment.
After having gestational diabetes, youre at an increased risk of developing it in future pregnancies, so you should be offered testing for diabetes when planning future pregnancies. Youre also more likely to develop type 2 diabetes in later life.
“Two months after the birth, the nurse told me my HbA1c was so good I neednt worry about what I ate, but warned me I might get diabetes in later life. I smiled, thinking she meant when I was much older, maybe 80. I believe having more knowledge about type 2 diabetes would have stopped me developing the condition.” Watch Zena’s story
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Who Is At Risk Of Gestational Diabetes
Between three and eight per cent of pregnant women develop gestational diabetes. It is usually detected around weeks 24 to 28 of pregnancy, although it can develop earlier. Being diagnosed with gestational diabetes can be both unexpected and upsetting.
Certain women are at increased risk of developing gestational diabetes. This includes women who:
- are over 40 years of age
- have a family history of type 2 diabetes
- are overweight or obese
- thrush .
How Gestational Diabetes Can Affect You
As mentioned above, gestational diabetes often comes with no symptoms, so you probably wont know that you have it until the doctor diagnoses it. However, gestational diabetes can still have an effect on you.
Gestational diabetes can increase your risk of high blood pressure while youre pregnant. Also, you may have a larger baby, which can make delivery difficult or require a C-section.
Gestational diabetes can also put you more at risk for developing type 2 diabetes later in life.
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Emotional Support After Pregnancy
Some women can feel down, anxious or tearful after giving birth. Your health visitor and GP should talk with you about how youre feeling after the birth.
If your feelings last longer than two weeks or start later, you could have postnatal depression. Symptoms may include feeling sad or low for long periods of time, tiredness, not sleeping well and feeling like cant take care of your baby.If you think you have postnatal depression, talk to your doctor, midwife or care team straight away. They will be able to arrange care and support for you. The earlier its diagnosed and treated, the quicker youll recover.
How Is Gestational Diabetes Treated
If you have GDM, your prenatal care provider wants to see you more often at prenatal care checkups so she can monitor you and your baby closely to help prevent problems. At each checkup, you get tests to make sure you and your baby are doing well. Tests include a nonstress test and a biophysical profile. The nonstress test checks your babys heart rate. The biophysical profile is a nonstress test with an ultrasound. An ultrasound uses sound waves and a computer screen to show a picture of your baby in the womb.
Your provider also may ask you to do kick counts . This is way for you to keep track of how often your baby moves in the womb. Here are two ways to do kick counts:
If you have GDM, your provider tells you how often to check your blood sugar, what your levels should be and how to manage them during pregnancy. Blood sugar is affected by pregnancy, what you eat and drink, how much physical activity you get. You may need to eat differently and be more active. You also may need to take insulin shots or other medicines.
Heres what you can do to help manage gestational diabetes:
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What Does It Mean To Have Gestational Diabetes
- 13 June, 2020
- 7 min read
One of the most commonly asked questions in pregnancy is What does it mean to have Gestational Diabetes?.
Most mums-to-be are aware of the condition, but are not too familiar with the causes, symptoms and effects of gestational diabetes, so we thought to coincide with National Diabetes Week wed take a look at this in our blog.
Here are answers to some of the questions you may be asking around what it means to have gestational diabetes.
What is Gestational Diabetes?
Gestational diabetes affects 1.5 out of 10 pregnant women and is high blood sugar that develops during pregnancy which usually disappears after giving birth. It happens when your body cannot produce enough insulin, a hormone that helps to control blood sugar levels, to meet your extra needs during pregnancy.
Whilst gestational diabetes is more common during the second and third trimester, it can occur at any stage of pregnancy. If detected early and managed well the risks to you or your baby are low, however gestational diabetes can cause problems, so its best to understand if you are at risk and how to look out for those tell-tale signs that you may have the condition.
How do I know if I am at risk?
Gestational Diabetes can affect any pregnant woman however some people are more at risk than others. Heres what you should look out for:
If any of these apply to you, you should be offered screening for gestational diabetes early on in your pregnancy
What causes Gestational Diabetes?
Screening For Gestational Diabetes
During your first antenatal appointment at around week 8 to 12 of your pregnancy, your midwife or doctor will ask you some questions to determine whether you’re at an increased risk of gestational diabetes.
If you have 1 or more risk factors for gestational diabetes you should be offered a screening test.
The screening test is called an oral glucose tolerance test , which takes about 2 hours.
It involves having a blood test in the morning, when you have not had any food or drink for 8 to 10 hours . You’re then given a glucose drink.
After resting for 2 hours, another blood sample is taken to see how your body is dealing with the glucose.
The OGTT is done when you’re between 24 and 28 weeks pregnant. If you’ve had gestational diabetes before, you’ll be offered an OGTT earlier in your pregnancy, soon after your booking appointment, then another OGTT at 24 to 28 weeks if the first test is normal.
Find out more about an OGTT.
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Whos At Risk Of Gestational Diabetes
Any woman can develop gestational diabetes during pregnancy, but youre at an increased risk if:
- your body mass index is above 30 use the healthy weight calculator to work out your BMI
- you previously had a baby who weighed 4.5kg or more at birth
- you had gestational diabetes in a previous pregnancy
- 1 of your parents or siblings has diabetes
- you are of south Asian, Black, African-Caribbean or Middle Eastern origin
If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy.
Keeping Worry In Perspective
While gestational diabetes is a cause for concern, the good news is that you and your health care teamyour doctor, obstetrician, nurse educator and dietitianwork together to lower your high blood glucose levels. And with this help, you can turn your concern into a healthy pregnancy for you and a healthy start for your baby.
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Testing Baby For Hypoglycaemia Following Birth With Gestational Diabetes
In the majority of hospitals, newborns born to diabetic mothers are routinely monitored for hypoglycaemia.
Each hospital is different as to how they monitor the blood sugar levels, but the procedure is the same.
A midwife or nurse will heel prick the baby to obtain enough blood to be tested on a blood glucose test monitor, the same as we use to monitor our own blood sugar levels throughout the pregnancy.
You may find watching this distressing as sometimes baby may become distressed, screaming and crying once they have been pricked with the lancet.
You may notice that your babys foot looks blue or purple in colour following the testing too. As much as this may seem terrible for your baby to go through, it is very important that levels are checked to make sure they are not suffering hypoglycaemia.
The amount of tests taken can vary and the times taken, but your hospital will have a policy which they will follow.
The most commonly used test times are 3 tests, 3 hours apart either before or after feeding which must all be above a certain target. Once again, different targets are used for this. NICE recommends a target of > 2.0mmol/l
Some hospitals may have longer testing times such as 3 hourly for 24 hours and we have seen some of our mothers in our Facebook support group inform us that they do not test babies for hypoglycaemia in their hospital, or because they were diet controlled the baby will not be tested.
Does Gestational Diabetes Go Away After Delivery
As the name implies, gestational diabetes is a condition that affects pregnant women. But you might be wondering how long it lasts does it go away towards the end of pregnancy, or do things take a little longer?
For most women, gestational diabetes does go away after delivery. It might not happen immediately, which is why healthcare providers monitor women who have had gestational diabetes. Theyll give them periodical blood tests for 1 to 2 months after delivery, to ensure that things have returned to normal. For many women, however, the condition disappears right after delivery.
Does GDM ever last past the first month?
Its very uncommon, but sometimes gestational diabetes lasts past the first month. This happens to about 2-3% of all women who experience gestational diabetes. In these cases, the condition is diagnosed as type 2 diabetes. Sometimes a healthy diet and exercise can prevent the onset of type 2 diabetes, but either way, its important for women to continue to get their blood glucose tested periodically to watch for any changes.
Can gestational diabetes come back?
Women who have had gestational diabetes are more likely to develop the condition again in future pregnancies. However, getting regular exercise and eating a balanced diet can significantly reduce the chances of developing diabetes in future years. If you are able to maintain a healthy weight, you have a much lower chance of developing gestational diabetes.