Diabetes develops when the body can't efficiently produce or use insulin made by the pancreas. Insulin is a hormone made by the pancreas that lets cells change glucose into fuel. When glucose accumulates in the blood in large amounts, it means that cells aren't getting the fuel they need. Gestational diabetes (GD) is a type of diabetes that can develop in a pregnant woman who did not necessarily have diabetes before becoming pregnant. This condition is caused by changes in a pregnant woman’s metabolism and hormone production where the body does not produce enough insulin to deal with the increased blood sugar of pregnancy. Symptoms of GD can include excessive thirst, more frequent urination, vaginal infections, and high blood pressure. GD almost always disappears once the baby is born and is usually not an indicator of the child developing diabetes later in life.
While a woman is generally safe from complications from gestational diabetes, there are some very big risks to the baby. If gestational diabetes goes undiagnosed, there is a greater risk of stillbirth. Other complications can include a condition called macrosomia, where the baby is born weighing 9 ¾ pounds or more. Excessively large babies can make delivery more difficult for both mother and child and as a result, birth injuries are more common in these babies. Other problems include hypoglycemia in the baby shortly after birth. The risk of gestational diabetes is higher in women who are over 30 years old, have a family history of diabetes, are obese, and those who have previously had a macrosomic baby.
Diagnosis and Management of Gestational Diabetes
Screening for gestational diabetes has become routine in prenatal care and usually takes place between 24 and 28 weeks of pregnancy. About 1-2 percent of pregnant women develop GD. Screening is done by drinking a glucose solution, waiting an hour, then having blood drawn and glucose levels checked. About 15 percent of pregnant women who are given a glucose screening test will have abnormal levels of blood glucose, which could suggest gestational diabetes. The next level of screening is called a glucose tolerance test. This test involves fasting overnight, drinking another higher concentrated glucose solution, then getting blood drawn periodically over the next three hours to check glucose levels again. This is the test used to diagnose gestational diabetes.
The main goal for pregnant women with gestational diabetes is to avoid problems during delivery because of an oversized infant. This can be successful with a carefully controlled diet (medical nutrition therapy), exercise, and monitoring of blood glucose levels. If a woman’s glucose levels remain too high, daily insulin injections may be required to lower it. Insulin does not cross the placenta and is safe for the baby.
The Role of Medical Nutritional Therapy in Gestational Diabetes
Good nutrition is important during pregnancy in women who have developed GD....