Gestational Diabetes Explained
June 4, 2008 by Tom
I have covered diabetes in a number of my previous articles. However, these articles were written when this blog was just starting out and after re-reading a lot of these early articles I am cringing at how much information I missed out. The main thing I noticed is that although these articles contain a lot of good information I did not actually explain what diabetes is. A general definition of diabetes is a condition where blood glucose/sugar levels (the body’s primary source of energy) are high because the body is not producing enough insulin (the hormone which helps your body to break down sugar/glucose) or the insulin in the body is not working properly. However, there are various types of diabetes and this broad definition is not really enough. In my next few articles I will be explaining gestational diabetes, pre-diabetes, type 1 diabetes and type 2 diabetes. This article is going to cover gestational diabetes.
Gestational diabetes (also known as gestational diabetes mellitus or the abbreviated GDM) is when pregnant women with no previous record of diabetes start to suffer from elevated blood glucose levels during pregnancy. It usually develops during the second half of pregnancy and disappears after the baby is born. In other words GDM is a type of diabetes which develops during pregnancy and only lasts temporarily.
Although no specific cause has been identified it is generally accepted that GDM is brought on by the changes that your body goes through during the second and third trimester of pregnancy. During this time the placenta produces hormones that resist insulin to ensure that the growing baby is getting enough glucose. As a result a pregnant woman’s insulin needs usually increase by two or three times the normal rate. GDM develops when your body cannot produce enough additional insulin to meet this demand.
According to Diabetes.co.uk 5% of pregnant women suffer from GDM. It is not known why certain women suffer from GDM and others do not. However, according to BUPA you are more at risk if you:
- Have a family history of GDM.
- Have previously given birth to a large baby (over 4.5kg/9lb).
- Have previously had a stillbirth.
- Are overweight or obese.
- Have polycystic ovary syndrome (PCOS) (a complex condition affecting the ovaries).
Your doctor should perform tests during your pregnancy to see if you are suffering from GDM. Generally, your doctor will perform an oral glucose tolerance test (OGTT) between the twenty fourth and twenty eighth week of your pregnancy. You are usually required to fast for eight hours before an OGTT but when screening for GDM no fasting is required. However, the doctor may recommend that you take the test first thing in the morning before you have eaten anything. To begin the test your doctor will administer glucose orally (usually via a sugary drink) and then take blood samples at different intervals to see how your body breaks down the glucose over time. If you are worried that this test is being performed too late, there is no need to panic. Testing earlier than this is often of little value because the hormonal changes discussed above will not have taken place.
As discussed in previous articles, the symptoms of diabetes (including gestational diabetes) are generally hard to identify. However, people with hyperglycaemia (high blood sugar levels) often exhibit the following symptoms:
- Increased Thirst Levels.
- Increased Hunger Levels.
- Increased need to Urinate.
- Nausea or Vomiting.
- Blurred Vision.
- Increased Tiredness.
GDM is not an immediate risk to your health. However, this does not mean it can be taken lightly. If it is not properly managed GDM can lead to; pre-eclampsia (a form of high blood pressure which is induced by pregnancy), premature labour and macrosomia (a new born baby with an excessive birth weight) which increases the complications surrounding giving birth. Poorly managed GDM also increases your risk of contracting GDM during future pregnancies and increases the likelihood of getting type 2 diabetes later in life.
Luckily GDM can usually be managed with a healthy diet and regular exercise. Very few women require additional insulin to manage GDM. Your doctor will be able to help you formulate an eating plan but a general recommendation is to eat lots of starchy foods (wholemeal bread, pasta, potatoes) and consume at least 5 portions of fruit and vegetables daily. You are also be advised to participate in regular, moderate intensity exercise for at least 30 minutes per day. Suggestions include; walking, cycling or swimming.
If your blood sugar stays high even after making these positive lifestyle changes your doctor may prescribe daily insulin injections to help you manage your glucose levels. If this is the case your doctor will be able to fully advise you on how and when to administer these injections.
Finding out that you have GDM may be a shock to you initially. However, remember that in most cases it is not your fault (it is caused by hormonal changes), it is temporary and it can be properly managed by making sensible changes to your diet and increasing the amount of daily exercise you perform.
Whilst every intention has been made to make this article accurate and informative it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. If you have any concerns regarding GDM or diabetes you should seek the advice of your doctor immediately.
Sources:
Blood Glucose/Sugar Information (Wikipedia)
Gestational Diabetes Facts (Diabetes.co.uk)
Gestational Diabetes Facts (BUPA)
Insulin Information (Wikipedia)
Macrosomia (Emedicine)
Polycystic Ovary Syndrome Information (Net Doctor)
Pre-Ecalmpsia Information (Preeclampsia.org)
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If you are still concerned about gestational diabetes after reading this article you may want to also read Overcoming Gestational Diabetes by Diane Ball, a writer who specialises in materials for parents and parents to be. In this detailed ebook Diane discloses the results of her 6 months research into gestational diabetes and explains how it develops, the complications it can cause and how it can be effectively managed.
Coming from an RN, this article was rock solid. I’m glad you touched on the why’s and the what’s. Most mom-to-be’s all suffer from GD, but only the hanful actually exhibit the symptoms and can suffer from the effects.
I also congratulate on mentioning other concomitant medical conditions as well as being diligent in taking care of yourself, ESPECIALLY as a mom-to-be.
I am so glad that I never had this during either of my pregnancies but my sister in-law did and she was miserable. I never knew how much there was to it! great post!
Two of my friends had this problem when they were pregnant and they were “older” first time moms. Does being an “older” first time mom makes a difference? I am actually terrified that I might have this problem when I try to get pregnant in a couple of years (that will put me well into my 30s).
One of them had to attend this nutrition class where they were telling the moms to stop eating the white stuff. Half the class was either Asian or Indian, and they were telling these women to stop eating rice! My friend was almost in tears when she was telling me this. Being Asian myself, I cannot imagine not eating rice for more than a few days.
Great post Tom! I stumbled it.
Thanks Strong One. I put a lot of research into this article and tried to cover all the key bases so I’m glad to have your approval.
Thankyou for your comment Heidi. It’s quite a new topic to me too. I only researched and wrote the article after deciding that the diabetes section of my blog needed fleshing out a bit more. Sorry to hear about your sister-in-law but at least she only had to put up with it for a few months.
Thanks Asithi. I’ve done a little research for you. Unfortunately, according to this article an older maternal age (over 30) is one of the factors that increases the risk of you getting gestational diabetes. It’s something I missed in my initial research for the article and it’s probably not what you want to hear. However, please remember that just because age is a risk factor it does not mean that you will definitely get GDM.
As for the rice issue, what about brown rice? You’d have to check this with your doctor but since it’s a wholegrain food and contains lots of fibre I think it would be suitable to eat IF you do get GDM when pregnant. I’ve recently made the switch to brown rice myself and although it does take longer to cook than white rice I find that it has a better texture and flavour than brown rice.
I thought that would be the case. But the best option for me would be to get my pre-pregnancy weight at close to normal as possible beforehand and take folic acid.
I don’t know about the brown rice. My mom does a 75% white rice/25% brown rice mix (she eats rice for two meals a day). I have it every other day. Longer than that, I will start to crave it. And the funny thing is, when growing up, I hated eating rice all the time. I wanted American food. Thanks Tom.