What You Need to Know about Gestational Diabetes

WHAT IS GESTATIONAL DIABETES?

Gestational diabetes is a type of diabetes that develops during pregnancy and usually disappears after giving birth1,2. It occurs in one in seven pregnancies worldwide3. It can occur at any stage, but seems to be more common in the second half of pregnancy2. The cause of gestational diabetes is thought to be the placenta, which connects your baby to your blood supply and produces high levels of hormones which impair the action of insulin1. This causes blood sugar levels to rise and can affect your pregnancy and your baby’s health. Gestational diabetes usually disappears soon after delivery1,2. In some instances, however, it does continue after pregnancy and progresses to type 2 diabetes4.

WHAT FACTORS PUT YOU AT AN INCREASED RISK?

All women run the risk of developing gestational diabetes, but women with the below risk factors are at a greater risk1,2:

  • Family or personal health history: If you have prediabetes; have had gestational diabetes in a previous pregnancy or if a close family member – such as a parent or sibling – has type 2 diabetes, you are at a higher risk.
  • Over the age of 25 years: If you are over the age of 25, you are at a higher risk.
  • Obesity: If you are significantly overweight, with a body mass index (BMI) of 30 or higher, you are at a higher risk. To calculate your BMI, divide your weight in kg by your height in meters, squared. I.e. BMI = weight (kg) ÷ (height)2
  • High birth weight baby: If you have delivered a baby, weighing more than 4.1 kg, you are at a higher risk.
  • Family origins: Women who are South Asian, Chinese, African-Caribbean or Middle Eastern appear to at a higher risk.

ARE THERE SYMPTOMS TO LOOK OUT FOR?

Gestational diabetes doesn’t usually cause any severe symptoms. Normally, it is diagnosed when your blood sugar level is tested while screening for gestational diabetes1,2. Symptoms of high blood sugar include increased thirst, a dry mouth, increase urination and tiredness2. But these symptoms are experienced by many pregnant women and they don’t always indicate gestational diabetes.

HOW DOES IT AFFECT YOUR PREGNANCY?

Most women who have gestational diabetes deliver healthy babies, however management is important. If it is not carefully monitored, it can lead to uncontrolled blood sugar levels and cause problems for you and your baby. Some of the complications for you include1,2:

  • High blood pressure and preeclampsia: Preeclampsia is high blood pressure in women who have previously not experienced high blood pressure before3. It can lead to complications in pregnancy, if left untreated.
  • Increased risk of developing diabetes: You’re more likely to get gestational diabetes again, during a future pregnancy and to develop type 2 diabetes as you get older.

Some of these complications for your baby include1,2:

  • Excessive birth weight: This leads to difficulties during the delivery and increases the likelihood of requiring an induced labour or a caesarean section. It occurs as the extra glucose in your bloodstream crosses the placenta, which triggers your baby’s pancreas to make extra insulin. Insulin is a fat-storing hormone, so extra insulin causes your baby to store more fat and become larger.
  • Early, preterm birth: This refers to giving birth before the 37th week of pregnancy.
  • Respiratory distress syndrome: Babies who are born early often experience respiratory distress, but even babies who are not born early may experience respiratory distress syndrome.
  • Polyhydramnios: Too much amniotic fluid, which is the fluid that surrounds the baby in the womb, can cause premature labour or problems at delivery1.
  • Low blood sugar or hypoglycaemia after birth: This is as a result of the baby’s own increased insulin production.
  • Increased risk of type 2 diabetes and obesity later in life.
  • Loss of your baby: In very severe cases, this can result in a baby’s death either before or shortly after birth.

HOW CAN IT BE MANAGED?

Now before you start to panic, gestational diabetes can easily be controlled through lifestyle choices such as:

  • Following a healthy and balanced diet: Focusing on including a variety of foods such as whole grain / high fibre / low GI carbohydrates, while avoiding refined carbohydrates and added sugars such in foods like white bread, pasta, sweets, biscuits, cakes and chocolate. Choose lean plant and animal proteins and healthy fats like olive oil, avocados, nuts, seeds and omega-3 rich fish. Make sure you are getting enough folic acid, calcium, iron and omega-3. Include plenty of water, vegetables and a moderate intake of fruits. Eat regular meals and practise portion control.
  • Regular exercise under the guidance of a health care team: Exercise is beneficial in the management of blood sugar levels as it stimulates your body to move glucose into your cells, where it is used for energy. It also increases your cells’ sensitivity to insulin, making your body use the insulin more effectively and resulting in less insulin production. It can also help to relieve common discomfort associated with pregnancy such as muscle cramping, back pain, swelling and constipation. Being fit also helps to prepare you for labour and delivery.
  • Medication: If diet and exercise aren’t enough, your doctor may prescribe medication to help manage your gestational diabetes.
  • Controlling blood sugar levels: Self-monitoring of your blood sugar levels at least four times a day.
  • Close monitoring of your baby: You will also most likely be monitored by your doctor more closely, especially during your last three months of pregnancy.

Remember everyone is an individual, so consult with a registered dietician who can help you figure out a plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget. After you have had your baby, it is still as important to follow a healthy diet and balanced lifestyle as you want to prevent the onset of type 2 diabetes. It is often daunting and confusing choosing the correct foods. Look out of the Diabetes Association of South Africa (DSA) and Low GI (GIFSA – GI Foundation of South Africa) logos on food products. These logos indicate what foods have been critically analysed and identified as suitable to eat regularly. At FUTURELIFE® we have a range of products that are suitable during pregnancy, we also have products ideal for those living with diabetes as well as gestational diabetes. The most suitable products for you would be:

  • FUTURELIFE® Smart Food™
  • FUTURELIFE® HIGH PROTEIN Smart Food™
  • FUTURELIFE® ZERO Smart Food™
  • FUTURELIFE® High Protein LITE SmartBar
  • FUTURELIFE® Smart Drink™FUTURELIFE® Smart Fibre™ 2in1

IN SUMMARY

Gestational diabetes develops during pregnancy and affects one in seven births worldwide. It is often asymptomatic but can show symptoms common to hyperglycaemia. It can affect anyone but certain factors – such as being over 25 or having a history of diabetes, a BMI of over 30, a baby with a high birth weight baby or a certain ethnicity – increase your risk of developing it. It causes a rise in blood sugar levels, which can result in serious complications for mom and baby. Gestational diabetes can easily be managed by following a healthy, balanced diet that controls blood sugar levels, including regular exercise, medication (if necessary), regular testing of blood sugar levels as well as close monitoring of your baby by a health care professional. Remember that following a healthy diet and having a balanced lifestyle is as important after birth, as you want to prevent the onset of type 2 diabetes. Choose foods that carry the Low GI or DSA logo. Consult with a dietician who will help you figure out a personalised plan to better manage your diabetes.

REFERENCES:

  1. Mayo Clinic. Gestational diabetes. Available at: http://www.mayoclinic.org/diseases-conditions/gestational-diabetes/home/ovc-20317173 (Accessed 14th August 2017)
  2. NHS. Gestational diabetes. Available at:  http://www.nhs.uk/Conditions/gestational-diabetes/Pages/Introduction.aspx (Accessed 14th August 2017)
  3. International Diabetes Federation. IDF Diabetes Altas: 7th edition. Available at: http://www.diabetesatlas.org/ (Accessed 14th August 2017)
  4. WebMD. Preeclampsia and Eclampsia. Available at: http://www.webmd.com/baby/guide/preeclampsia-eclampsia#1 (Accessed 14th August 2017)