Gestational Diabetes: The Basics of This Not So Sweet ConditionJennifer Beam
Gestational Diabetes is a complication that occurs in approximately 4% of pregnancies and exemplifies yet another reason to seek and receive quality prenatal care, but it is still considered a very manageable condition. While testing, diagnosis, and treatment is somewhat disputed among medical professionals, gestational diabetes can result in various complications with delivery and if untreated may compromise the health of both mother and baby. For these reasons, the vast majority of obstetricians send their patients for a glucose screening test midway through pregnancy.
What is Gestational Diabetes?
A diabetic condition that occurs at approximately 20 to 24 weeks, gestational diabetes results in women whose pancreas does not produce enough insulin to regulate their blood sugar. The reason a previously non-diabetic woman may experience diabetes during pregnancy is due to the insulin blocking hormones that are produced by the placenta. After delivery of the placenta, the condition essentially goes away. In fact, most women's blood sugar returns to normal almost immediately after giving birth. However, research has indicated that gestational diabetes may be a precursor for developing the condition later in life. Approximately one half of women who develop gestational diabetes develop the condition permanently within about 15 years.
The Glucose Screening Test
Somewhere around 22 weeks of pregnancy, your obstetrician will order a glucose-screening test. You will likely be asked to refrain from eating for one to two hours prior to your scheduled test time when you will be given a sugary, sickly sweet, liquid to drink. If you're lucky, you may be offered a variety of flavors from cola to orange, but be prepared, it won't be a thirst-quenching treat. Some women experience nausea to a level of discomfort, but severe nausea is rare. The test itself is performed by drawing blood and testing the blood sugar level. If your blood sugar level is 120 or higher, a similar, but more in depth, glucose fasting test will likely be required to actually diagnose gestational diabetes. Don't panic if your initial glucose screening results in a blood sugar level higher than 120 since it is not an automatic indicator that you are or will be developing gestational diabetes, simply that further testing is required to confirm the condition. A good percentage of women test below 120 even with a higher than normal blood sugar level after the first test.
How is it Treated?
Once gestational diabetes is diagnosed, your blood sugar will need to be monitored throughout the remainder of your pregnancy. In many cases, a modified diet with limited intakes of sugar and complex carbohydrates is all that will be necessary to control the condition. This may seem difficult if you happen to be one of those women who crave chocolate, ice cream, butterscotch and the like, but well worth the self-restraint. If diet alone is not enough, it may be necessary to take insulin injections. Moderate and safe exercises may also be recommended. Your health care provider should be comfortable with treating gestational diabetes and will advise you on treatment and control.
What About Baby?
The most common effects of gestational diabetes are larger than normal babies, jaundice and fetal distress. For these reasons, a woman diagnosed with diabetes during pregnancy may be required to obtain more than one ultrasound and multiple stress tests. Ultrasounds can help to determine the growth rate of the baby and can thus prevent a complicated delivery. While the risk of cesarean does increase, preventing complications from attempting to deliver a baby too large to fit through the birth canal is priority. In some cases, it may be necessary to induce labor. Fetal stress tests are also more common and frequent under these conditions.
It is important to remember that this is a controllable condition and that participating in the screening is the first preventative measure you can take to avoid any further complications. While it's true that if gestational diabetes occurs in one pregnancy, it's likely to reoccur in subsequent ones, most women go on to have a moderately normal pregnancy and healthy children. Screening for and discussion of gestational diabetes with a qualified health care provider will ease any uncertainties you may have.
As a resource to learn more about gestational diabetes visit http://www.nichd.nih.gov/publications/pubs/gest1.htm#2.
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