Gestational Diabetes

Diabetes During Pregnancy

When you are pregnant, you can develop high blood sugar levels (so-called gestational diabetes), even if you have never had diabetes before.

Learn more about the Causes of Gestational Diabetes, the Effects on your Baby and on you as a mother, and how Gestational Diabetes can be treated.

Causes of Gestational Diabetes1

The exact cause of gestational diabetes is not yet known. One reason could be that the hormones released by the placenta, which help the baby grow, prevent the insulin from working properly in the mother’s body. This is called ‘insulin resistance’.

Gestational diabetes develops when the mother’s body cannot produce enough insulin for the extra needs during pregnancy.

Insulin is needed to make the sugar move from the blood into the cells, where the sugar is turned into energy. If there is not enough insulin, the levels of sugar in the blood become too high (so-called hyperglycaemia).

Pregnant woman
Healthy eating during pregnancy

Healthy eating during pregnancy5

Eating healthy is an important part of any pregnancy, and it’s particularly important for women with Gestational Diabetes. In general, principles of healthy eating should be followed: Avoid processed foods, since they contain empty calories. Instead, prefer vegetables and “natural” food. Watch your carbohydrate intake and test your blood sugar on a regular basis.

Carbohydrates have the most impact on your blood sugar!2

Carbohydrates are nutrients that provide most of the energy for your body. Therefore, they are very important when it comes to healthy eating! There are different types of carbohydrates, which influence your blood sugar levels in different ways (quickly or slowly). This means that you have to watch the type and the amount of carbohydrates you eat.

Are you curious about how much carbohydrate you eat?
Start counting the carbohydrates4 in your meals, drinks and snacks now! The nutrition label tells you how much carbohydrate food it contains. For food without labels, such as fresh produce, you can estimate the amount of carbohydrate they contain. If you record your carbohydrate intake and your blood sugar levels before and two hours after eating, your diabetes care team can see how your body reacts to different meals and plan your individual medication (if you need any) and your meal plan accordingly. Speak to your doctor about the best diet for you.

Count your carbohydrates4
Depending on how many of the different carbohydrate types you eat, your blood sugar level will rise quickly or slowly. Therefore, carbohydrate counting is a good way to manage your blood sugar levels.

Diet and exercise
An individual dietary plan and regular physical activities are always part of the therapy. Healthcare professionals generally recommend moderate-intensity exercise for at least 30 minutes a day, most days. This can include brisk walking, swimming, or prenatal yoga.3

Effects on you as the Mother

Blood sugar usually returns to normal levels after delivery. But if you’ve had it once, there is a two-in-three chance that it may reappear in future pregnancies.

Sometimes, the diagnosis of gestational diabetes reveals a pre-existing type 1 or type 2 diabetes. If the diabetes existed before pregnancy, it will not go away and the treatment will have to be continued after delivery of the baby.

Women who have had gestational diabetes are at risk of developing type 2 diabetes later in life3.

Mother with her child
Newborn

Effects on your Baby

Gestational diabetes usually diagnosed in the second half of pregnancy, while the baby is actively growing. Gestational diabetes must be treated in order to avoid negative consequences for you and the baby!

In gestational diabetes the high blood sugar levels are passed from the mother’s to the baby’s blood. If the mothers blood sugar are higher than normal, then the baby also receives more sugar than normal. Storing this extra energy causes your baby to grow bigger and may lead to a condition called Large-for-Gestational Age (LGA).

Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood sugar levels at birth and are also at higher risk for breathing problems. Babies born with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes4.

Treating Gestational Diabetes2

It is important to follow the recommendations of your Healthcare Professional and begin, upon his advice, the prescribed treatment as soon as possible. The goal is to keep blood sugar levels in a healthy range that is comparable to pregnant women without gestational diabetes.

An individual dietary plan and regular physical activities are always part of the therapy. Blood sugar checks and insulin injections may also be necessary. Successful control of gestational diabetes may help to reduce your risk of a caesarean section birth that may be necessary if your baby is too large2.

Pregnant couple doing yoga

Avoiding Hypoglycemia6

Type and duration of physical activities have different effects on blood sugar levels. Moderate exercises can lower blood sugar levels. Certain sugar-lowering medications, e.g. insulin, in combination with prolonged moderate exercising can cause hypoglycaemia (blood sugar levels go too low, which can become dangerous).

Speak to your doctor if you take any medication to lower your blood sugar levels. On the other hand, intensive exercise can raise blood sugar levels, since the body releases stored sugar to cope with high energy demands. To be sure, test your blood sugar levels before and after exercise.

Checking your Blood Sugar During Gestational Diabetes is Important7

To prevent the negative consequences of gestational diabetes, your blood sugar levels should be kept within a certain target range. Blood sugar monitoring is carried out with a blood sugar meter. You simply take a drop of blood by pricking a finger and the meter tells you how much sugar is in the blood at that time. Ask your doctor about your individual blood sugar target range.

How to best prepare for Blood Sugar Tests

Monitoring your blood sugar levels on a regular basis plays a fundamental role to take appropriate treatment decisions8. To get reliable results, some basic preparations should be considered when performing a blood sugar test:

  1. Since traces of sweat, moisture, etc. on the skind can influence measurements9, always wash your hands with soap and warm water, rinse and dry well
  2. Lancets are single-use products: Make sure to use a new lancet for every blood sugar test
  3. Follow the instructions according to the user guide of your blood sugar meter

These steps will help to obtain a clean blood sample.

For more information and personalised advice about Diabetes and Pregnancy, please contact your Healthcare Professional.

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Sources:

1. https://www.diabetes.org/diabetes/gestational-diabetes. Accessed August 2020.
2. https://www.diabetes.org/diabetes/gestational-diabetes/how-to-treat-gestational-diabetes. Accessed August 2020.
3. Noctor E, Dunne FP. Type 2 diabetes after gestational diabetes: The influence of changing diagnostic criteria. World J Diabetes. 2015 Mar 15;6(2):234-44. doi: 10.4239/wjd.v6.i2.234. PMID: 25789105; PMCID: PMC4360417.
4. https://www.diabetes.org/diabetes/gestational-diabetes/how-will-this-impact-my-baby. Accessed August 2020.
5. https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/gestational-diabetes. Accessed August 2020.
6. https://diabetes.org/health-wellness/fitness/blood-glucose-and-exercise. Accessed August 2020.
7. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes 2020 Diabetes Care 2020;43(Suppl. 1):S183– S192 | https://doi.org/10.2337/dc20-S014.
8. Immanuel J, Simmons D, Diabetes Care, 2018, Oct;41(10):20153-2058.
9. Barry H. Ginsberg. Journal of Diabetes Science and Technology. (Abstract Paragraph 1).

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