You have been enjoying a very healthy pregnancy. Everything seems to be going smoothly and without any hiccups. Then, out of nowhere, your blood tests come back showing that you have gestational diabetes. But how can that be?
This can be frightening news to hear, especially if you are absolutely sure that you were not diabetic before your pregnancy. So what does this mean? And will your little one be okay?
What is gestational diabetes?
According to information released by the Health Society of South Africa, gestational diabetes is a type of diabetes that occurs during pregnancy, hence the name. When you are pregnant, your body undergoes several changes. Some of these changes may cause you to have too much blood sugar, which in turn causes gestational diabetes.
Before you start to panic, it is important to understand that, although you have gestational diabetes, this does not mean that you are sick or that your baby will be born with diabetes. It just means that you will need to take special care and look after yourself to ensure a healthy pregnancy.
Are you at risk?
According to information released by the Health Society of South Africa, women are more at risk of developing gestational diabetes if they:
- Are overweight
- Have a family history of diabetes
- Have had a baby who weighed more than 4 kilograms at birth
- Have had a baby who died before birth
- Have had gestational diabetes in the past
How gestational diabetes develops
Without bombarding you with too many facts and subjecting you to an advanced biology lesson — it is important that you have a basic understanding of how gestational diabetes develops. This will go hand-in-hand with caring for the condition.
As the Health Society of South Africa explains, your body gets energy from sugar in your blood, just as a car gets energy from petrol. Your blood sugar also goes to your baby. If your blood sugar level are too high, this can cause problems for your baby and for you. That’s why you need to control your blood sugar.
Your body turns the food you eat into sugar (glucose). This sugar goes into your bloodstream. Your body then turns this blood sugar into energy — with the help of a hormone called insulin. Your blood sugar then goes to your baby through the placenta (special tissue that connects the mother and the baby). Your baby uses this sugar to grow. But the placenta also makes hormones that can disrupt the way your body uses insulin. This creates “insulin resistance”. If your body can’t use insulin properly, your blood sugar level become too high. Then too much blood sugar goes to your baby.
If your blood sugar stays too high, both you and your baby can have problems. If you control your blood sugar, the risks to you and your baby remain the same as can be expected during a normal pregnancy.
Is my baby at risk?
If you don’t control your blood sugar, your baby is more likely to have certain problems. These, as listed by the Health Society of South Africa, include:
Your baby growing large: If your blood sugar stays too high, your baby may be too large to come through your vagina without injuring the baby’s arms and shoulders.
Your baby’s organs not being fully developed before birth: If your blood sugar stays too high, your baby might have to be born early. This may mean that your baby’s lungs have not developed properly at this stage. This is called respiratory distress syndrome (RDS). Your baby’s liver may also not be fully developed. This can result in your baby displaying a yellow colouring on his skin known as jaundice.
Your baby’s blood sugar being low after birth: If your blood sugar is too high, your baby makes extra insulin. The baby still makes extra insulin right after birth. Then he or she may have to be treated for low blood sugar.
Your baby being stillborn: This if very rare, but your baby could die before birth if your blood sugar stays high for too long.
Risks to you
If you don’t control your blood sugar, you are more likely to also develop certain problems. These, as listed by the Health Society of South Africa, include:
High blood pressure: High blood sugar makes you more likely to have high blood pressure during your pregnancy (preeclampsia). This is a danger to your health. And it could mean that your baby will have to be delivered early.
More infections: High blood sugar makes you more likely to have bladder, kidney and vaginal infections.
Being uncomfortable or having shortness of breath: High blood sugar can cause too much fluid around the baby (polyhydramnios). This will result in your abdomen getting enlarged and pushing on your lungs. This may also lead to premature labour .
A harder delivery or longer recovery: If your blood sugar stays too high, your baby may grow too large. Then the baby may have to be delivered by making a cut (incision) in your abdomen and uterus. Delivery by caesarean section (C-section) is one of the most common consequences of gestational diabetes.
Special care for you and your baby
The good news is that your health care provider will be a wealth of information during this time, helping you and teaching you on what you can do. However, according to the Health Society of South Africa, there are various things that you can also do to ensure that you and your baby are receiving the right care.
The main way to control your blood sugar is by eating right. In fact, most women can keep their blood sugar within a normal range by diet alone. To do this, you need to eat regular meals and snacks. You need to avoid foods that are high in sugar, and you need to gain the right amount of weight.
To keep your blood sugar within a normal range, it’s best to eat small amounts every 2 to 4 hours. If you eat less often, you’re likely to eat too much at once. This will make your blood sugar rise too high. So spread your meals and snacks evenly throughout the day. And keep the amount of food you eat the same each day.
Eat a small breakfast
You always need to eat breakfast. But keep your breakfast small. That’s because your blood sugar rises the most in the morning. Eat a protein and a starch diet. Do not eat fruit, fruit juice or cold cereal. These foods raise your blood sugar too high in the morning. You may also be told not to have milk at breakfast.
Always eat before you go to bed. You need a bedtime snack so you don’t go too long without food. Doing so can cause problems. Eat three meals and three snacks a day. Try to space your meals and snacks out evenly throughout the day, starting with breakfast and ending with a bedtime snack. If you do miss a meal or snack, don’t have more food next time you eat. This will raise your blood sugar too high.
Avoid high-sugar foods
Eating foods that are high in sugar (simple carbohydrates) raises your blood sugar the most. You know that candy and desserts are high in sugar. But so are lots of other foods, such as baked beans and spaghetti sauce. Follow these tips:
Read the ingredients on the food label: Avoid foods that list any of these kinds of sugar in the first four ingredients: Sugar, honey, molasses, corn syrup, dextrose, fructose, glucose, corn sweetener.
Low fat doesn’t mean no sugar: Low-fat desserts, ice creams, frozen yoghurts, salad dressings and packaged foods can be high in sugar. Read the labels.
Beware of sauces: Barbecue sauce, teriyaki sauce, hoisin sauce, tomatoe sauce, chutney and most other condiments have added sugar. Read the labels.
Avoid alcohol: Wine, beer, hard liquor and liqueurs are high in sugar. Alcohol also raises your baby’s risk of having problems after birth.
Avoid saccharin: This sugar substitute can cross the placenta.
The right food choices
You need to eat plenty of starch, protein and vegetables, and some milk, fruit and fat each day. Your health care provider will help you make a meal plan that works for you. Your meal plan will tell you what to eat, how many servings to have, and how much in a serving. Remember: Following your meal plan is the key to controlling your blood sugar and keeping you and your baby healthy.
Exercise can help you keep your blood sugar within a normal range. That’s because your body uses more blood sugar when you exercise. Your health care provider may want you to exercise every day. Together you can decide on the best kind of exercise for you, and the best times for you to exercise.
What happens to diabetes after pregnancy?
The good news is that most cases of diabetes that occurred during pregnancy may disappear after delivery. According to the World Diabetes Foundation, the insulin requirements will fall immediately after birth. It is then important to change over to the treatment as advised by your doctor.
In cases where insulin was started only during pregnancy, chances are that it may be stopped altogether post pregnancy. However, women who develop gestational diabetes have a higher risk of developing permanent diabetes. About 25-30% of women with gestational diabetes develop diabetes within 10 years after the birth of their child. Even so, diabetes can be managed if you follow your treatment rigerously.