Pregnancy and diabetes: gestational diabetes

January 2017

Gestational diabetes, occurs during pregnancy usually in the second or third trimester and typically disappears after childbirth.

Gestational diabetes is increased glycemia, or sugar in the blood.

Approximately 1 in 400 pregnancies are complicated with diabetes.

An Oral Glucose Tolerance Test (OGGT) is performed to diagnose and confirm gestational diabetes.
  • Gestational diabetes is becoming increasingly more common in pregnancies, with possible complications to the mother and baby.
  • The risk of recurrence of developing gestational diabetes during a successive pregnancy is 66%.
  • The higher the blood sugar, the higher the risk of gestational diabetes.

Risk factors for developing gestational diabetes


For those women at risk it is important that they are regularly screened and monitored so any diabetes is detected early.
  • Family history of diabetes (first degree relative)
  • Overweight women: a woman with a BMI over 30.
  • Ethnic origin (South Asia, black Caribbean and Middle Eastern)
  • Older Woman: over 35 to 40
  • Unexplained stillbirth or neonatal death in a previous pregnancy.
  • Previous history of fetal macrosomia (measurements of the fetus superior to the head and abdominal curves) during a previous pregnancy.
  • Women originating from Asia, North Africa or the Caribbean.
  • During a previous pregnancy:
    • Gestational diabetes during a previous pregnancy
    • Delivery of babies over 4kg


Gestational diabetes, in the absence of any risk factors, consists in more than 50% of cases.

Associated problems for the baby when his mother suffers from gestational diabetes

  • Excessive weight gain
  • Fetal adiposity (increased body fat)
  • Increased risk of caesarean
  • Risk of hypoglycemia (low blood sugar)

Risk of developing diabetes following delivery

  • Diabetes disappears in 98% cases after childbirth.
  • The risk of developing permanent diabetes is 30% for type 2 and approximately 5% for type 1.
  • Tips to reduce the risk of developing diabetes on the longer term
    • Loose any excess weight - returning to a BMI of 25
    • Adopt a healthy balanced diet
    • Keep active doing regular physical activity
    • Monitor your blood sugars for approximately six months after the baby is born, and once a year thereafter.

Prevention of gestational diabetes: dietary advice




Eat a healthy balanced diet,at all stages of pregnancy and keep active with regular exercise.
  • Avoid sugary foods and drinks.
  • Eat up no more than 3 fruits per day because they contain sugar.
  • Limit drinks and foods containing artificial sweeteners as they are still high in calories and have a laxative effect.
  • Use fats in moderation

Dietary advice and treatment for gestational diabetes


Care may be shared between the hospital and GP and a treatment plan initiated to help achieve normal blood sugars. Treatment can be diet alone, a combination of diet and oral medication and sometimes Insulin when blood sugars are poorly controlled.

The goal of the treatment is to maintain normal blood sugar while managing to maintain a healthy diet for the mother and child.
  • Regular monitoring is essential particularly;
    • Blood sugar
    • The presence of sugar in the urine
    • Blood pressure.
  • Frequent hospital appointments will be necessary and a referral to see a specialist such as an endocrinolgist (a doctor who specialises in diabetes) may be necessary.


The diet:
  • Avoid cakes or sweets, juice, jam, sugar and derivatives
  • Eat complex carbohydrates such a wholemeal breads, pasta, rice, bran, oats etc, and eat plenty of fresh vegetable with each meal. High fiber foods can slow the absorption of sugar, hence reducing the glucose levels in the blood.
  • Focus on natural diary products rather than ones with added sugars.


Diet and or oral medication will be tried first which if your blood sugars do not normalise Insulin injections may be necessary..


For more information
http://www.diabetes.org.uk/
http://www.nice.org.uk/nicemedia/live/11946/41342/41342.pdf

Related


Diabète gestationnel - Causes et régime alimentaire
Diabète gestationnel - Causes et régime alimentaire
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Latest update on May 13, 2010 at 05:18 PM by Janey39.
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