Wellness Wednesday: Gestational diabetes in pregnancy | Lifestyle

Gestational diabetes mellitus is a form of diabetes that appears only during pregnancy. According to the Center for Disease Control and Prevention, approximately 6-9% of pregnant women develop gestational diabetes, with a whopping 30% spike over the last couple years, affecting 1 in 6 live births globally.

The highest rate occurs in our own backyard, with non-Hispanic Asian women leading the curve.

According to the National Library of Medicine, a diagnosis of gestational diabetes can lead to several unwanted adverse outcomes in both the mother and the child. A pregnant gestational diabetes woman is at an increased risk of pre-eclampsia or eclampsia, Cesarean section, preterm delivery, medication-induced delivery, longer hospital stay after delivery and macrosomia births, resulting in a larger and heavier baby.

Before you get pregnant, knowing your family history of diabetes is significant. This information is the tool that equips you with the road to prevention.

Gestational diabetes is usually diagnosed between week 24 to week 28 of pregnancy, but it can develop earlier. Down the road, non-managed, uncontrolled gestational diabetes can lead to future type 2 diabetes and cardiovascular disease.

The signs

• You are overweight. Having a BMI of 30 or more going into pregnancy is one of the most common risk factors for gestational diabetes.
• You are older. Doctors have noted that women over the age of 30 years old have a higher risk of developing gestational diabetes, with that risk increasing as you get older.
• You have a family history. If diabetes runs in the family, especially in any of your first-degree relatives, you may be more at risk of gestational diabetes.
• You have a personal history of gestational diabetes. If you have had gestational diabetes during previous pregnancies, research suggests a higher likelihood to get diagnosed gestational diabetes again in subsequent pregnancies.
• You received a pre-diabetes diagnosis. If your blood sugar levels were slightly elevated before pregnancy such as hemoglobin A1c more than 5.7% or high fasting glucose levels can predispose you to a higher risk of gestational diabetes.
• You have been put on bed rest. Some research has shown that because bed rest restricts activity levels, it’s more likely to lead to additional pregnancy weight gain and, consequently, gestational diabetes.
• You have a medical condition associated with the development of diabetes. This could include metabolic syndrome, polycystic ovary syndrome, hypertension or cardiovascular disease.
• You’re pregnant with multiples; twins, triplets, etc. Carrying more than one baby may increase your risk for gestational diabetes.

Symptoms

• Unusual excessive thirst.
• Frequent urination in large amounts (commonly early pregnancy has light increases of urination).
• Extreme bouts of fatigue (commonly, early pregnancy has intermittent episodes of tiredness).
• Sugar in urine. Between 24-28 weeks of pregnancy, your doctor will give you a glucose screening test, where you’ll drink a sugary liquid beverage and have your blood drawn an hour later. If your bloodwork picks up high sugar levels, your doctor will order you to do a three-hour glucose tolerance test to determine whether you have gestational diabetes mellitus. This tool is used to check for sugar in your urine, however, only one positive screening test doesn’t necessarily mean you will be diagnosed with GDM.

Prevention

• Exercise. It is recommended that women with gestational diabetes should stay active with walking, aerobic and resistance exercise at a moderate intensity, a minimum of three times a week for 30-60 minutes each time. Core tip: Exercise has been proven to be beneficial in improving pregnancy outcomes because it allows the body to burn glucose.
• Dietary changes. It is recommended that women with gestational diabetes eat a mix of fresh or frozen fruits and vegetables, healthy protein and complex carbs. Recommendations include whole grains, legumes, nuts, seeds, tofu, fish, lean red meat, poultry, chicken and low-fat dairy.
• Gain weight gradually. You may have heard that a pregnant woman should normally gain 25-35 pounds; however, this recommendation is for woman whose body mass index is within the normal weight range before pregnancy. In women trying to prevent or lessen symptoms of gestational diabetes, consult with your doctor as there are a host of factors aside from pre-pregnancy BMI that contribute to how much weight gain is acceptable.

Healthy pregnancy tips

• Measure out and eat smaller portion sizes.
• Avoid packaged foods — junk foods, candies and snacks.
• Avoid processed meats, eat more lean protein, meats, poultry, fish and tofu.
• Increase fiber intake by eating plenty of fruits, vegetables and whole grains.

Recommendations

There is no way to cheat the system. Treating gestational diabetes appropriately and implementing lifestyle changes is important for a healthy mom and a healthy baby.

Gestational diabetes can be considered a high-risk pregnancy — your risk of high blood pressure and preeclampsia can threaten both mommy life and baby life.

Women with gestational diabetes will also need follow-up appointments with their OB/GYN six to 12 weeks after delivery to test for diabetes mellitus type 2.

Long-term, the mother should get annual check-ups from their primary care physician, as the risk for developing type 2 diabetes is high.