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It seems like you have a laundry list of questions and concerns during pregnancy. You are already avoiding certain foods, medicines, and hot tubs while simultaneously trying not to fall down an internet rabbit hole of everything that could go wrong. Right as your initial fears are quieting down and you are hitting your pregnancy stride, your obstetrician informs you it's time to schedule your gestational diabetes screening. You may be confused and even startled that something is wrong. Do not fret! Every pregnant woman is screened for gestation diabetes. Even then, only 10% of pregnancies in the United States are affected by gestational diabetes. Your best method of defense is arming yourself with knowledge. Let's explore what gestational diabetes is and what you can expect during this process.
What is Gestational Diabetes?
Gestational diabetes is similar to type-II diabetes in that it affects how our bodies process and use glucose. However, this is a unique condition that develops midway through a woman's pregnancy.
Fluctuating hormones are a hallmark of pregnancy. However, the change in hormones can throw off our body's production and insulin resistance level, a hormone used to process sugar. We experience high blood sugar levels without adequately working insulin levels, which can be dangerous for you and your baby. Often, women do not notice any symptoms of gestational diabetes, although you may see increased thirst and urination frequency.
Who is at Risk?
Gestational diabetes strictly affects pregnant women. Medical professionals and researchers have struggled to put their fingers on the actual cause of gestational diabetes. However, a few factors can place certain women at higher risk of developing this condition than others. An article in the World Journal of Diabetes cites that gestational diabetes is more prevalent in Black, Hispanic, Asian American, and Indigenous populations. You may be at a greater risk of developing gestational diabetes if you:
· Are overweight or obese before pregnancy
· Lead a sedentary lifestyle
· Have a history of gestational diabetes or prediabetes
· Live with Polycystic Ovarian Syndrome (PCOS)
· Have family members with diabetes
What are the Risks?
People often write off gestational diabetes as innocuous since it can be temporary or managed without medicine. While it may have a more uplifting prognosis than other conditions, it is still meant to be taken seriously. Even if gestational diabetes is diagnosed and managed, high blood sugar can still have devastating consequences for you and your baby. Experts at the Mayo Clinic warn that prolonged elevated blood sugar levels can lead to:
· Increased risk of emergency Cesarian-section
· Higher birth weights
· Elevated risk of injury to mother and baby during delivery
· Preterm birth
· Difficulty breathing
· Low blood sugar levels, or hypoglycemia, in babies
· Seizures
· Your baby developing weight problems and type-2 diabetes later in life
· Preeclampsia
· Elevated risk of the mother experiencing type-2 diabetes
How Do Doctors Test for Gestational Diabetes?
Your medical team will schedule your gestational diabetes screen sometime between your 24th and 28th weeks of pregnancy. If you have a history of gestational diabetes, a family history of diabetes, or are overweight; you may be tested earlier in your pregnancy.
The first screen is called the glucose challenge test. You will be asked to drink a sugary glucose solution in your doctor's office. After an hour, they will draw blood for testing. Your results will determine your next steps. These are the general benchmarks for your blood glucose readings:
· Below 140 mg/dL is normal
· Above 140 mg/dL requires further testing
· 190 mg/dL indicates gestational diabetes
If it is determined that you need further testing, your doctor will schedule another appointment for you to return for your glucose tolerance test. Once again, you will drink a sugary glucose solution. However, this time, your blood will be drawn every hour for three hours. If two out of three of these new readings come back high, you will be diagnosed with gestational diabetes.
What is the Treatment Plan?
Women who are diagnosed with gestational diabetes do not need to panic! Your care team will help guide you through a treatment plan to help manage your blood sugar levels and get you through the coming weeks.
First, your medical provider will urge you to maintain a healthy, balanced diet. It is crucial that you only eat refined carbs and sweet treats in moderation. Instead, opt for a fiber-packed, low-calorie diet that consists of nutrient-rich lean proteins, fruits, vegetables, and whole grains.
Next, you should pencil in thirty minutes of light exercise each day. Exercise lowers blood sugar and can alleviate pregnancy ailments such as cramps, back pain, and insomnia. Do not worry – we are not sending you to boot camp! You can go for walks around your block or find prenatal yoga tutorials on YouTube, as long as you are moving.
You will be asked to monitor your blood sugar levels to ensure they stay within a healthy range. Most commonly, you will check your levels in the morning and after meals. The American Diabetes Association recommends you aim for the following blood sugar levels:
· 95 mg/dL before a meal
· 140 mg/dL after a meal
· 120 mg/dL two hours after a meal
Many cases of gestational diabetes do not require medicine for management. Only between 10-20% of women experiencing gestational diabetes require insulin injections. If your blood sugar levels are still high even after diligent dieting and exercise, your provider may prescribe you an oral medication.
Additionally, your doctor will want to closely monitor your baby through the end of your pregnancy due to the elevated risks for both of you. You will have more frequent ultrasounds and check-ups as you near your due date. Suppose you do not naturally go into labor before or on your due date. In that case, your obstetrician may consider inducing you because the likelihood of complications rapidly rises the longer you carry beyond your due date.
Gestational diabetes is usually a temporary condition. Some women experience their blood sugar levels returning to normal levels on their own shortly after delivery. Even so, your doctor will want you to get another blood test six-to-twelve weeks after delivery to test you for diabetes.
Some programs on the market promote awareness about living a diabetes-free life, like the Diabetes freedom program. Please check with your doctor before starting any such program. A healthy diet is a key to good health.
Diabetic or not, but a regular medical check-up essential, nutrition, exercise, and meditation are all important to keep you in check when pregnant.