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The Not-So-Sweet Side of Pregnancy

Swollen feet, low back pain and stretch marks are just some of the effects of pregnancy, but gestational diabetes, a form of diabetes that occurs only during pregnancy, is a far more serious condition.

What’s gestational diabetes?

During pregnancy, the placenta produces hormones that increase insulin resistance resulting in increased blood glucose or blood sugar. In some pregnant women, the pancreas can’t make enough insulin to handle the increase in blood sugar which can result in gestational diabetes.

Who’s at risk?

According to Douglas Clarke, D.O., endocrinologist with Meritus Endocrinology Specialists, gestational diabetes is becoming more commonplace. “Women are having babies later in life and increased age is a risk factor,” says Dr. Clarke. He also notes that women are at a greater risk of gestational diabetes if they are overweight before becoming pregnant. Some ethnic groups including African Americans, Hispanic Americans, Native Americans, Pacific Islanders, and South/East Asians also have a higher risk of developing gestational diabetes, as well as individuals with a family history of diabetes.

Signs, diagnosis and treatment

Gestational diabetes may not cause symptoms, but warning signs like blurred vision, frequent urination, increased thirst, increased infections and fatigue may occur when blood sugar levels are very high.

To identify gestational diabetes, an oral glucose tolerance test is performed between the 24-28th weeks of pregnancy. If test results exceed the target threshold, most women can manage gestational diabetes with moderate exercise and a healthy diet of protein, vegetables and fresh fruit; and by limiting starchy or sugary foods such as breads, cereal, juice and pasta.

Ongoing daily monitoring of blood sugar levels will indicate whether the gestational diabetes is under control. When diet and exercise don’t manage the condition, obstetricians may recommend oral medication or insulin therapy or refer patients to an endocrinologist.

Coupled with medical therapy, women can participate in nutrition counseling, led by a registered dietitian with Meritus Diabetes Education, to learn how to eat healthy foods, plan meals and count carbohydrates to control blood sugar.

Prevention

Adopting a few healthy habits before becoming pregnant can reduce the risk of developing gestational diabetes. “It’s all about eating nutritious foods, exercising and maintaining a reasonable weight,” says Dr. Clarke. Staying active is a key ingredient in slowing the progression to prediabetes and preventing gestational diabetes because exercise improves blood sugar control.

With regular monitoring of mother and baby, gestational diabetes can be managed. But poorly controlled blood sugar can result in a high-birth weight baby and the need for a planned or emergency Cesarean section or worse, harm to the baby while traveling through the birth canal. After birth, the baby can have respiratory issues and hypoglycemia or low blood sugar. Babies born to mothers with gestational diabetes may also be at higher risk for obesity and prediabetes later in life.

Outlook

Women with gestational diabetes are at increased risk for developing type 2 diabetes and they’re 40 percent more likely to have gestational diabetes during a second pregnancy. Following prevention strategies can halt and reverse the progression to diabetes. “It’s not an inevitable evolution in one direction,” says Dr. Clarke.

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