Gestational Diabetes

Gestational Diabetes

What is Gestational Diabetes?

A type of diabetes that develops or is first recognized during pregnancy which usually resolves after the baby is born. Diabetes is the name given to a group of conditions where the concentration of glucose or sugar in the blood is higher.

This glucose comes from the carbohydrates food which we eat and they include bread, cereals, potato, pasta, rice, fruit and certain dairy products. The glucose level in the blood is regulated by insulin hormone which is produced by the pancreas. Insulin supplies glucose from the blood into the cells where it can be utilized by the body for energy. Diabetes develops when the body is not producing enough insulin, or the insulin not functioning properly.

What are the causes Gestational Diabetes?

During pregnancy, the placenta plays a key role in hormones synthesizer which helps in maintaining growth and development of a baby. Some of these hormones block the functioning of the mother’s insulin so-called insulin resistance. In order to maintain the normal blood glucose level mothers are required to produce 2 to 3 times the more amount of insulin due to this insulin resistance. Gestational diabetes develops when insulin becomes more resistant or when the pancreas is unable to synthesize more insulin. As the baby is born, insulin requirements falls, glucose levels return to normal and this syndrome usually disappears.

How to identify the risk of Gestational Diabetes?

There are few screening guidelines available for gestational diabetes. All pregnant women are screened for gestational diabetes at 24th -28th week of pregnancy.

  • Had a baby born weighing over 8 to 9 pounds?
  • Had a previous pregnancy with gestational diabetes.
  • Are overweight or obese?
  • Have a family history of diabetes.
  • Are more than 25 years old.
  • Are being treated for HIV.

How is gestational diabetes diagnosed?

The oral Glucose Tolerance Test is mainly used to diagnose how the body is responding to a glucose load. This test is carried out in two steps. In the first step fasting (8-12 hours) blood sample is collected from the patient. The second blood sample is collected after one and two hours later.

How is gestational diabetes treated?

The management of gestational diabetes is a team effort, involving the woman with gestational diabetes, her partner, and her doctor accredited practising dietitian (APD), credentialled diabetes educator and midwife.

There are three basic components to effectively manage gestational diabetes.

  1. Eating pattern

The most important part of management relates to healthy eating habits. Women with
gestational diabetes are encouraged to:

  • Eat small amounts often. It is important to satisfy the hunger and maintain a healthy weight gain throughout pregnancy.
  • Include some carbohydrate in every meal and snack. It is important to distribute
    carbohydrates evenly in all meals.

Including foods that provide nutrients for the mother eg: foods which include calcium, folic acid, iron, etc. Low in fat, particularly saturated fat, and high in fiber, moderate in carbohydrates such as grains, cereals, fruit, pasta, and rice, varied and enjoyable.

  1. Physical activity

Physical activity helps to reduce insulin resistance and is an effective way to lower blood glucose levels. Physical activity, such as brisk walking, helps to keep fit and also prepares for the baby birth.

Always consult the doctor or midwife before starting any form of physical activity or planned exercise or any pregnancy-related complications like discomfort after physical activity or experiencing any pain.

  1. Regular monitoring blood glucose levels
  • Regular self-monitoring of blood glucose levels is essential for assessing progress and adjusting management as necessary.
  • A diabetes educator will guide how to self-monitor blood glucose and record the results, and other necessary precautions if the blood glucose levels are above the recommended target range.
  • Insulin injections are also prescribed to return blood glucose levels to the target range.

Practise This Question

Identify the set of substances which are not used in the preparation of nutrient culture medium.