Gestational Diabetes - What It Meansby Katlyn Joy | June 16, 2011 6:58 AM
According to the American Diabetes Association, gestational diabetes occurs in 4% of pregnancies. In the US, that means 135,000 women each year develop gestational diabetes. The disorder typically begins in the second trimester of pregnancy.
Gestational diabetes is only diagnosed in pregnant women who haven't had diabetes previously. Normally your body will digest carbohydrates you eat into glucose, which provides energy for your body. Your body must get the glucose from your blood into your cells. This requires your pancreas to manufacture a hormone called insulin. When you have diabetes, your body doesn't make enough insulin or it doesn't work properly. The result is a build-up of glucose, or sugar in your blood.
Most physicians test for gestational diabetes between the 24th and 28th weeks of pregnancy. There are two different types of tests for the condition. The glucose challenge test requires pregnant women to drink an extremely sweet thick drink then wait one hour for a blood test to be done to check the blood sugar levels. Generally you'll want a reading of below 140 milligrams per deciliter (mg/dL) or less than 7.2 to 7.8 millimoles per liter (mmol/L). If your reading is above this, it doesn't indicate you have gestational diabetes but rather that you are at risk. Your physician will have you take the second test if your test result is high on the glucose challenge test. This second test is glucose tolerance testing. For this procedure, you'll be required to fast overnight and usually go to the lab first thing in the morning. You'll drink an even sweeter solution this time and undergo a blood test an hour later, then again twice more in hour intervals. A diagnosis of gestational diabetes will be made if two of the three results are higher than acceptable levels.
Women who control their blood sugar can anticipate a healthy normal pregnancy. However, potential risks include giving birth to a larger than normal baby. This is called macrosomia, and typically requires a cesarean birth. Another possible complication is that the baby will be born with low blood sugar or hypoglycemia. Breastfeeding can offset this problem or the baby can be given an IV of glucose if necessary. Sometimes a baby may be born with Respiratory Distress Syndrome which will necessitate giving oxygen. Babies may also be born with jaundice, which is easily treated with bilirubin lights. Another risk is that the baby may have low mineral levels which may result in muscle twitching, for instance. The treatment for this is simply giving baby extra minerals.
Pregnant women who have gestational diabetes will be closely monitored during pregnancy particularly during the last trimester. Their blood sugar levels will be checked at doctor's visits, and some women may need to check glucose levels daily at home as well. Diabetes can be controlled by watching your diet, particularly your carbohydrate intake. Talking to a nutritionist may be helpful so you can learn what carbohydrates are good and which should be avoided. Whole grain foods are desirable while simple sugars and white flours should be kept out of the diet. Regular exercise is important for women with gestational diabetes, too. You will need to seek your physician's approval for an exercise program appropriate for you. You'll likely be advised to start slowly and gradually increase the amount of exercise and intensity. If lifestyle factors such as these fail to manage the condition adequately, then insulin will be required.
For mothers who have difficulty controlling their glucose levels, further testing may be done to insure that the baby is doing well. Physicians may perform a non-stress test which is simply fetal monitoring done by adhering a belt with electrodes to your abdomen and observing how baby's heart rate changes with movement. Or the doctor may do a Biophysical Profile or BPP, which is pretty much just a non-stress test combined with an ultrasound. The doctor will be checking baby's movements, heartbeat, breathing and muscle tone and also looking to see whether the amniotic fluid levels look right. Finally, mothers will be instructed to keep a kick count. This is a simple check in daily to make sure baby's activity level seems normal. Your doctor will have you observe for an hour or so how many times you feel the baby kick or move.
While the diabetes should disappear after giving birth, women are at increased risk for developing Type 2 diabetes if they had gestational diabetes. Six weeks postpartum another blood test will be done to see if the diabetes has remained or not. Watching the diet and staying active are important ways to prevent further diabetes problems. Breastfeeding can also help both the infant and the mother avoid diabetes.
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