Pregnancy is a life-changing experience filled with growth and important decisions for both you and your baby. Among the many changes that a woman's body goes through during this time, some women develop a temporary condition known as gestational diabetes mellitus (GDM), a type of diabetes that appears during pregnancy. Though hearing the word "diabetes" can be a bit scary, the good news is that gestational diabetes is treatable, and with the right care, you can easily have a healthy pregnancy.
What is gestational diabetes?
Gestational diabetes is a condition in which blood glucose (sugar) levels rise above normal during pregnancy, typically in the second or third trimester. Compared to type 1 or type 2 diabetes, gestational diabetes:
- Only develops during pregnancy.
- Typically goes away after childbirth.
Note: However, it does require monitoring and treatment during pregnancy to avoid complications for both you and your baby.
Why does it happen?
During pregnancy, your body naturally goes through hormonal changes to support your developing baby. The placenta produces several hormones, including human placental lactogen, which interfere with the action of insulin (the hormone responsible for moving sugar from your blood into your cells for energy).
This condition, known as insulin resistance, is somewhat normal during pregnancy. However, if the resistance becomes too strong or your pancreas is unable to produce enough insulin to compensate, your blood sugar levels rise, resulting in gestational diabetes.
Is it similar to other types of diabetes?
Gestational diabetes and type 2 diabetes share similarities, particularly in terms of insulin resistance. However, it's not the same:
- It is usually only temporary and goes away after the birth.
- It is directly associated with pregnancy-related hormonal changes.
Unlike type 1 diabetes, which is autoimmune, GDM is not caused by the body's attack on insulin-producing cells. Even though most women's GDM resolves after delivery, it does increase the risk of developing type 2 diabetes later in life, with approximately half of women worldwide developing it within 5-10 years.
Does it need to be monitored?
Absolutely, yes. Monitoring gestational diabetes is important for preventing pregnancy complications. High blood sugar levels can affect both you and your baby. Possible complications include:
- Preeclampsia (high blood pressure while pregnant)
- Macrosomia (a large baby, which increases the risk of C-section and birth injuries)
- Premature delivery
- Neonatal hypoglycemia (your baby having low blood sugar after birth)
- Increased risk of obesity and type 2 diabetes in your baby’s adult life.
Are additional tests required?
Yes, because often gestational diabetes has no visible symptoms, which makes testing critical. Routine screening is typically performed between 24 and 28 weeks of pregnancy, and it includes:
- Glycemic Challenge Test (GCT):
- You drink a sugary solution and have your blood sugar tested an hour later.
- If the results are high, your healthcare provider might order a glucose tolerance test.
- Glucose tolerance test (GTT):
- This test includes fasting overnight
- Drinking a glucose drink
- And having your blood sugar checked at regular intervals over several hours.
If you have a higher risk (e.g., a history of GDM, are overweight, or have PCOS), your healthcare provider may test you earlier in pregnancy. If your blood sugar levels rise during early pregnancy, they will test for whether you already have type 2 diabetes. Once diagnosed, you will be taught how to monitor your blood glucose levels at home, typically with a glucometer.
What blood sugar levels do I need to maintain?
Target levels may differ slightly depending on your pregnancy, but general recommendations for women with gestational diabetes include:
- Fasting glucose: Less than 95 mg/dL
A level below 95 mg/dL indicates that your body is properly managing glucose in a fasting state.
- One hour after meals: <140 mg/dL
A level under 140 mg/dL indicates that your body is processing the glucose from the meal effectively.
- Two hours after meals: <120 mg/dL
A level below 120 mg/dL indicates that your body has effectively used insulin to process the glucose from the meal, and your blood sugar is returning to normal levels.
Regular monitoring, usually four times per day (fasting and after meals), allows you and your healthcare provider to keep glucose levels under control.
Should I change my diet too?
Yes, diet is one of the most effective ways to manage gestational diabetes. A well-balanced diet focuses on:
- Controlled carbohydrates: Spread them out throughout the day and combine with protein and fibre.
- Healthy fats: avocados, nuts, seeds, olive oil.
- Plenty of vegetables and some fruits (low-glycemic options like apples, pears, and berries).
- Lean proteins: Such as eggs, poultry, legumes, tofu, fish (be cautious of mercury-rich fish).
- Whole grains: Select complex carbs such as oats, quinoa, and whole wheat.
Can exercise help?
Yes, regular but moderate exercise lowers blood sugar levels and improves insulin sensitivity. Activities that are safe to do while pregnant include:
- Walking
- Prenatal Yoga
- Swimming
- Stationary cycling
Aim for 30 minutes per day, at least five days a week, after consulting with your healthcare provider. Even short walks after a meal can help lower blood sugar levels.
What about after birth?
Blood sugar levels typically return to normal after delivery. However, keep in mind that:
- Your baby's blood sugar will be monitored at birth.
- Breastfeeding is strongly encouraged because it helps both you and your baby regulate blood sugar levels and lowers the risk of future diabetes.
- You'll need to follow up with testing, especially if you plan for future pregnancies.
Gestational diabetes isn't your fault. It does not imply that you have failed your body or your baby. Rather, it is a sign that your body requires a little extra support at this time. With early detection and thoughtful lifestyle changes, you can confidently manage this condition. Remember, the ultimate goal is the same: a healthy, thriving baby and a healthy, supportive you.
