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How to Manage Gestational Diabetes

Gestational diabetes is something that a lot of people have never heard of, but it can be something very dangerous if not treated and taken seriously. It can be a challenge to manage gestational diabetes, but before you can manage it, you need to know what gestational diabetes is.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that is only present in pregnancy. It develops during pregnancy and usually goes away shortly after the baby is born. Having gestational diabetes increases your risk of developing it in future pregnancies and later in life. Gestational diabetes affects between 2 and 10 percent of pregnant women making it one of the most common medical conditions during pregnancy.

When you eat food that contains carbohydrates your body breaks these down to make glucose. Your pancreas makes a hormone called insulin. The glucose enters your bloodstream, and with the help of insulin, your cells and your body use the glucose for energy.

During pregnancy there are a lot of hormonal changes that happen. Some of these hormonal changes affect how your cells react to insulin, making them less responsive to insulin. This isn’t a problem for most pregnant moms-to-be, when their body needs additional insulin, their pancreas makes more insulin. In some cases though, the pancreas cannot keep up with the insulin demand, causing blood glucose levels to rise, resulting in gestational diabetes.

How do I know if I have Gestational Diabetes?

Gestational diabetes usually does not have any outward signs, but every pregnant woman is screened for it with a glucose-screening test between 24 and 28 weeks.

You may have heard other moms talk about the glucose-screening test. They usually talk about the overly sweet drink they had to drink, which most moms think is disgusting. The drink contains 50 grams of glucose, which you have to drink in about 5 minutes. You cannot drink a lot of water after it and if you have horrible morning sickness and end up throwing it up, you will have to take the test again. An hour after you finish the drink you will have blood drawn to test your glucose levels. This will help the doctor determine if your pancreas is having difficulty keeping up with the increased demand for insulin. Having a positive result with the glucose-screening test does not mean that you have gestational diabetes. In fact, only about one-third of women who have a positive glucose-screening test end up having gestational diabetes.

If you have a positive glucose-screening test you will have to have a glucose tolerance test (GTT). The glucose tolerance test is a bit more in depth. You will be instructed to not eat the day of the test, so you will want to schedule the test early in the morning if possible. When you arrive for the test, you will have blood drawn to get a baseline reading, or initial reading of your blood glucose. You will have a similar drink to the first one, and you will have your blood drawn 3 more time, once every hour. If one of the readings is abnormal you will have to come in for another test; if two or more of the readings are abnormal, you will be diagnosed with gestational diabetes.

For more information on these tests, check out BabyCenter.

If you are considered high risk for gestational diabetes you may be tested earlier. You may be at higher risk for gestational diabetes if you are obese, if you had gestational diabetes in a previous pregnancy, you have sugar in your urine, or you have a family history of diabetes. You may also be screened earlier if you have ever had a large baby (over 8 pounds 13 ounces), you are over 35, you have had an unexplained stillbirth, you had a baby with a birth defect, or you have high blood pressure.

Also, if you have diabetes prior to becoming pregnant you will not need to be screened, instead you will work with your OB and your endocrinologist to manage your diabetes.

Managing Gestational Diabetes

I have gestational diabetes, now what?

Having gestational diabetes will cause you to make many changes to your daily life, all of which are very easily done. It is important that you work with your doctor to maintain your blood glucose levels in the designated range. The goal is to keep your blood glucose levels in a range comparable to those of women without gestational diabetes.

  • You will have to keep track of your glucose levels. Keeping track of your blood glucose levels will help your doctor determine if the treatment plan you are currently following is working. You may have to adjust the plan several times before you find something that consistently works.
  • Eating balanced meals, multiple times per day. It is recommended that you eat several small frequent meals to help keep your blood glucose levels stable during the day. You also have to eat balanced meals, with fruits and vegetables. You will also learn how to limit carbohydrates, but not eliminate them completely.
  • Exercise regularly. Exercise can help your body use insulin better and help lower your blood sugar level. You should try to get at least 30 minutes per day. You should talk to your doctor before starting an exercise routine, but exercise can be perfectly safe during pregnancy.
  • Take medications if needed. You may have to take medication to manage your gestational diabetes, either oral medication, or insulin via injection. You have to make sure you are taking your medication as ordered.
  • Keep all your doctor appointments. You will have more doctor appointments to monitor the growth of your baby, your blood glucose levels, and your weight. It is important that you keep all these appointments so any complications can be discovered early. You may also have to have additional testing towards the end of your pregnancy to check on the well-being of your baby.
  • Monitor your baby’s movements. It is important with any pregnancy to make sure your baby is moving throughout the day, but if you have gestational diabetes your doctor may want you to monitor your baby’s movements more closely. You may be asked to do kick counts, which is where you sit or lay and count how many times your baby moves in a set time frame. If your baby is moving significantly less, or not at all, you need to see your doctor right away.

How will having gestational diabetes affect my pregnancy and my baby?

During pregnancy, ever mother is worried more about her baby than anything else. Having gestational diabetes does not mean that you cannot go on to have a completely healthy baby. The best way to ensure you have a healthy baby, though, is to everything mentioned above to manage your gestational diabetes.

If your blood glucose levels are too high, then your baby will have too much glucose in it’s blood, causing your baby’s pancreas to produce more insulin. This can cause your baby to gain weight, increasing your chances of a cesarean delivery.

After birth, your baby may have low blood glucose levels due to your baby’s pancreas producing more insulin. This is more likely if you had high blood glucose levels during pregnancy, and especially if your blood glucose was high during labor. The best way to help with this is to feed your baby right after birth. The medical team will test your baby’s blood glucose levels at birth and any time they think your baby is exhibiting signs of low blood glucose.

There are other risks as well, such as increased risk stillbirth, increased risk for preeclampsia and others. (For more information, see BabyCenter.

Having gestational diabetes is a challenge, but there is no reason you cannot have a perfectly healthy baby if you take care of yourself and manage your blood glucose.

Did you have gestational diabetes? How did you manage it? Did it have any effect on your pregnancy or your baby?

Thanks for reading, Cassie

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