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Gestational Diabetes

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Diabetes that develops during pregnancy is known as gestational diabetes.  It occurs because the body cannot produce enough insulin (an important hormone in controlling blood glucose) to meet its extra needs in pregnancy.

  This results in high blood glucose levels.  Gestational diabetes usually starts in the middle or towards the end of pregnancy.

Risk factors for developing gestational diabetes:

  • Polycystic Ovary Syndrome
  • A previous diagnosis of gestational diabetes or prediabetes, impaired glucose tolerance, or impaired fasting glycaemia
  • A family history revealing a first-degree relative with type 2 diabetes
  • Maternal age - a woman's risk factor increases as she gets older (especially for women over 35 years of age).
  • Being overweight, obese or severely obese increases the risk
  • Previous poor obstetric history

How Is Gestational Diabetes Diagnosed?

High risk women should be screened for gestational diabetes as early as possible during their pregnancies.  All other women will be screened between the 24th and 28th week of pregnancy.  An oral glucose tolerance test is used to screen for gestational diabetes.  This test involves quickly drinking a sweetened liquid, which contains 50g of sugar.  The body absorbs this sugar rapidly, causing blood sugar levels to rise within 30-60 minutes.  A blood sample will be taken from a vein in the arm 1 hour after drinking the solution.  The blood test measures how the sugar solution was metabolized by the body.  A blood sugar level greater than or equal to 140mg/dL is recognized as abnormal.  If the results are abnormal based on the oral glucose tolerance test, another test will be given after fasting for several hours.  In women at high risk of developing gestational diabetes, a normal screening test result is followed up with another screening test at 24-28 weeks for confirmation of the diagnosis.

Possible complications: 

If gestational diabetes is not managed properly, it could cause a range of serious complications for both mother and baby, including:

v     Baby being large for its gestational age i.e. weighing more than 4kg (macrosomia)

  • This increases the need for induced labour or a caesarean birth, and may lead to birth problems such as shoulder dystocia.

v     Premature birth: Baby being born before week 27 of the pregnancy leading to complications such as newborn jaundice or respiratory distress syndrome.

v     Baby having health problems shortly after birth that require hospital care such as low blood sugar

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How Is Gestational Diabetes Managed? 
  • Monitoring blood sugar levels four times per day: before breakfast and 2 hours after meals.
  • Controlling high blood pressure
  • Try to avoid sugar and any food or drink containing large quantities of sugar for instance sweets, chocolate, sweet fizzy drinks, squashes, biscuits, cakes and puddings.
  • Use diet or no added sugar alternatives e.g. diet yoghurts, sugar free jelly, milk puddings made with no sugar. 
  • Use sweeteners in powder, tablet or liquid form as alternative to sugar in drinks, cereal or puddings.
  • Eat normal, or smaller, portions of starchy carbohydrate foods at each meal for example bread, potatoes, rice, pasta or breakfast cereal. Granary or multigrain bread, pitta bread, basmati rice, porridge and wholegrain cereals such as muesli, beans, peas and lentils all release their sugar slowly so are good at helping control the blood sugar because they have a lower GI (Glycaemic Index), but a large portion will increase the blood sugar after meals.
  • Fruit contains vitamins and fibre, making a nutritious snack.  However, too much fruit or natural fruit juice (even if it is unsweetened) can affect your blood sugar levels.  Try and limit yourself to 4 portions of fruit throughout the day.  Ideally the fruit should be spread throughout the day and the fruit juice taken with a meal.
  •  Eat plenty of vegetables: all types, fresh, frozen and tinned.
  • Eat regularly i.e. breakfast, lunch and evening meal and in-between snacks including fresh fruit, a plain biscuit, oatcakes or diet yoghurt.
  • Try not to eat a lot of fat particularly saturated animal fats. Choose skimmed or semi-skimmed milk, to give plenty of calcium for your baby’s bones and teeth.
  • Limit table salt.
  • Follow the general health rules which apply to all pregnant women for example avoid liver, raw eggs, blue cheeses etc.
  • Exercise can lower the blood sugar levels thus regular exercise during pregnancy is recommended to at least three times a week. Regardless of gestational diabetes, every pregnant woman should consult with her health care provider before beginning an exercise program to give her personal exercise guidelines.

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