Gestational diabetes is the high blood sugar level that occurs during pregnancy. It usually shows no clear and non-life-threatening symptoms in pregnant women, but gestational diabetes causes the mother to give birth to a larger baby. This may increase the likelihood of problems in labor. The disease also causes an increased risk of high blood pressure in pregnancy.
How to deal with gestational diabetes?
A healthy diet can control blood sugar so you do not need to take medication. Doctors, nurses, and dieticians will create a diet for you. Your health care provider may advise you to keep a record of what you eat. Do not drink alcohol while pregnant.
Exercising can keep blood sugar under control. Walking is the easiest exercise. Try walking 1-2.5 km, three or more times per week. Swimming or other low impact sports are also good to do. Ask your doctor what kind of exercise and how often it is done best for you.
Drugs can control gestational diabetes. However, most women with gestational diabetes do not need drugs. When changing your diet does not control blood sugar levels, you may need either drinking drugs or insulin therapy (injections)
Check your blood sugar
You can see how you are doing by checking your blood sugar level at home. Your doctor may ask you to check your blood sugar once or more in a day.
The most common way to check blood sugar is to stab a finger to take a drop of blood. Then the blood drops will be placed on a monitor (test machine). If the monitor gives you too high or too low a number, you have to stabilize your blood sugar.
The doctor will keep your blood sugar level under control. Make sure you know how your blood sugar level should be.
Visits and tests for you and your baby
Your health care provider will keep an eye on you and your baby during pregnancy. These include:
- Visits to doctors every week
- The ultrasound shows the size of your baby
- A non-invasive test that shows whether your baby is healthy or not
What to do after childbirth
- Women with gestational diabetes should be closely monitored after delivery. They should also continue the examination at the next doctor’s visit for signs of diabetes.
- High blood sugar levels often return to normal after delivery. However, many women with gestational diabetes will eventually develop diabetes within 5 to 10 years after delivery. The risk is greater in obese women.
When to contact a doctor
Contact your health care provider for any of the following diabetes related issues:
- Your baby looks less mobile in the stomach
- Blurry vision
- More thirsty than usual
- Nausea and vomiting
How To Treat Gestational Diabetes
Some women with gestational diabetes can control their blood sugar levels by changing their diet and exercising regularly. In addition you can do some therapeutic treatment.
Check your blood sugar level
The most important part of treating gestational diabetes is checking blood sugar levels regularly. Pregnant women with gestational diabetes should also check their blood sugar levels regularly.
Blood glucose levels are usually measured from the number of millimoles of glucose present in a liter of blood. Milimol is the measurement that determines the amount of glucose in your blood. Measurements are expressed by millimoles per liter, or mmol / l.
Your individual mmol / l target will be set for you by your doctor. Here’s what might include your mmol target:
- Fasting blood glucose (after you have not eaten for about 8 hours – usually first thing in the morning)
- Postprandial blood glucose (1 or 2 hours after you eat)
The doctor will explain when and how often you need to measure your blood glucose levels. You may need to test your fasting blood glucose and normal blood sugar after meals during your pregnancy. If your diabetes is being treated with insulin, you may have to frequently test your blood glucose before bedtime at night.
Once you know that you have gestational diabetes, you should limit the amount of carbohydrates you eat as a way to control blood sugar. Especially for those who are overweight or obese, the reduction should be done significantly.
Eat as usual
Do not skip meals, and always balance your food menu that includes low glycemic carbohydrates (GI) so you can absorb carbohydrates more slowly, which helps keep your blood sugar levels steady between meals.
You can choose between pasta, oatmeal or regular rice; bread with rough wheat, and rye; or tubers such as potatoes, cassava, and sweet potatoes. High varieties of starchy starchy fiber will also help your digestive system and prevent constipation.
Food glycemic index
The glycemic index is a measure of how much a food effect in raising blood sugar levels. Foods with a high glycemic index are foods that are quickly digested and absorbed so that blood sugar levels will rise rapidly significantly. Foods with a low glycemic index experience slower digestion and absorption so that the elevated levels of glucose and insulin in the blood will occur slowly. Do not be too stiff and obsessed with Glycemic Index standards. Keep running a balanced diet that you like.
Eat lots of vegetables and fruit
You are also advised to eat high fiber foods. Fresh fruits and vegetables are very important in this context. You should consume at least 5 servings of fresh fruits and vegetables daily. However, you only need to eat 1 serving of fruit per meal and no more than 3 servings a day. Better avoid consumption of fruit juice. Try to combine beans like red beans, peanuts, beans, red beans, and green beans.
Limit consumption of sugar and sweet foods
You do not need to avoid sugar. Sugar can you mix in different types of food and cake, but you must be careful in mixing sugar into your menu. Drink sugar-free drinks, or fruit juices, instead of sweet drinks that can reduce the amount of sugar in your diet.
You may also be advised to choose lean protein like fish. Eat 2 servings of fish a week, one of them must be oily fish, like sardines or mackerel. There are some fish that should not be eaten too much, like tuna.
It is better to eat balanced with polyunsaturated fats and monounsaturated fats. Some types of unsaturated fats can keep your immune system healthy and can also reduce cholesterol levels.
Foods that contain unsaturated fats are:
- Nuts and seeds
- Jam made from sunflower, olives, and vegetable oil
If your body mass index is more than 27 before you become pregnant, you may be advised to reduce the number of calories in your diet. You can use a healthy weight calculator to calculate your body mass index – but remember to measure your weight before becoming pregnant.
Your doctor, midwife or diabetes doctor will suggest how many calories you should eat in a day, and the safest way to reduce calories from your diet.
Physical or exercise activity can lower your blood glucose levels, so regular exercise can be an effective way to treat gestational diabetes. Your doctor, midwife or diabetes doctor can advise on the safest way to exercise during pregnancy.
If your body mass index is over 27 before you become pregnant, you may be advised to take moderate exercise for at least 150 minutes (2 hours and 30 minutes) in a week.
This can be an activity that makes you a little out of breath and increases your heart rate, such as biking or walking fast.
Gestational Diabetes Treatments
If diet and exercise do not effectively control your gestational diabetes after 1-2 weeks, you may be given prescription drugs. The time may vary depending on your glucose level.
There are several types of drugs available, and the choice will depend on:
- What will most effectively control your blood glucose
- What is most likely for you
Possible drugs include:
- Metformin in tablet form
These drugs will be discontinued immediately after the birth of your baby.
When is insulin prescribed for gestational diabetes?. If your body does not respond to insulin, you may need insulin injections to make sure your body has enough insulin to lower your blood glucose levels.
Insulin must be given by injection, so you will be told how:
- How and when to inject itself
- How to store insulin and remove your needle properly
- The signs and symptoms of low blood sugar
- Driving and regulation with insulin
Insulin exists in several different forms. Here’s a recipe your doctor may give you:
- Fast-acting insulin analogues – usually injected before or after meals; can work quickly, but not last long
- Basal insulin – usually injected at bedtime or waking
Here’s how to safely use insulin during pregnancy. However, you will need to monitor your blood glucose carefully. If you are using insulin, you will need to check:
- Fasting blood glucose (after you have not eaten for about 8 hours – usually so first thing in the morning)
- Blood glucose at 1 or 2 hours after each meal
- Blood glucose at other times (for example, if you feel unwell or have a period of hypoglycemia – low blood glucose)
When is insulin needed for gestational diabetes? If your blood glucose falls too low, you may be exposed to hypoglycemia.
In some cases, you may be prescribed a hypoglycemic medication called metformin instead of insulin. This is a medicine taken to lower blood sugar levels.
Metformin can cause side effects, including:
- Nausea (stomach pain)
- Stomach cramps and diarrhea (watery bowel movements)
For a complete list of side effects, see the patient’s leaflet information in your medicine box.
Monitoring the baby in the womb
If you have gestational diabetes, unborn babies may have the risk of complications, such as larger sizes. Therefore, you may be offered additional antenatal appointments so that the baby can be supervised during pregnancy. Encounters with your doctor may be offered include:
- Ultrasound about 18-20 weeks of your pregnancy, to check your baby’s heart and see signs of abnormality (if your gestational diabetes is diagnosed as your pregnancy is advanced, you may not be required to have an ultrasound)
- Ultrasound at weeks 28, 32, 36 and regular checkups from week 38 of pregnancy to monitor your baby’s growth and see the amount of amniotic fluid that surrounds your baby in the womb.