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Gestational Diabetes Facts
Diabetes Support Site Website
http://diabetessupportsite.com/
What is Gestational Diabetes?
Pregnant women who
have never had
diabetes before but
who have high blood
glucose (sugar) levels
during pregnancy are
said to have
gestational diabetes.
According to a 2014
analysis by the Centers
for Disease Control
and Prevention, the
prevalence of
gestational diabetes is
as high as 9.2%.
We don’t know whatcauses gestational
diabetes, but we havesome clues. The placentasupports the baby as itgrows. Hormones fromthe placenta help the
baby develop. But thesehormones also block theaction of the mother’sinsulin in her body. Thisproblem is called insulin
resistance. Insulinresistance makes it hardfor the mother’s body touse insulin. She may
need up to three times asmuch insulin.
Gestational diabetes
starts when your body
is not able to make and
use all the insulin it
needs for pregnancy.
Without enough insulin,
glucose cannot leave
the blood and be
changed to energy.
Glucose builds up in
the blood to high
levels. This is called
hyperglycemia.
Gestational Diabetes Explained
It usually appears late
in the second trimester
and resolves after
childbirth. Most women
are screened for it
between 26 and 28
weeks of pregnancy.
Women with
gestational diabetes
are either unable to
produce enough insulin
or unable to use insulin
effectively.
Managing the conditioninvolves regular exerciseand healthy eating. Some
women also requiremedication, such asinsulin injections.
Women with gestationaldiabetes have anincreased risk ofdeveloping type 2diabetes and/or
cardiovascular diseaselater in life – 17 per centof women with gestationaldiabetes develop type 2diabetes within 10 yearsand 50 per cent develop it
within 30 years.
Risk factors for Gestational Diabetes Age greater than 25.
Women older than age 25 are
more likely to develop
gestational diabetes.
Family or personal health
history.
Your risk of developing
gestational diabetes increases
if you have prediabetes —
slightly elevated blood sugar
that may be a precursor to
type 2 diabetes — or if a close
family member, such as a
parent or sibling, has type 2
diabetes. You’re also more
likely to develop gestational
diabetes if you had it during a
previous pregnancy, if you
delivered a baby who weighed
more than 9 pounds (4.1
kilograms), or if you had an
unexplained stillbirth.
Excess weight.
You’re more likely to
develop gestational
diabetes if you’re
significantly overweight
with a body mass index
(BMI) of 30 or higher.
Nonwhite race.
For reasons that aren’t
clear, women who are
black, Hispanic,
American Indian or
Asian are more likely to
develop gestational
diabetes.
How Will Gestational Diabetes Affect My Baby?Because your baby maybe larger than normal, heor she is at higher risk forsome complications.
Remember, these are justpossible complications.Your baby might havenone of them. They
include:
Injuries during deliverybecause of the baby’s
sizeThe greatest impact ofgestational diabetes ondelivery is related to fetalsize. When gestationaldiabetes is undiagnosedor poorly managed during
pregnancy the fetusresponds to the high
maternal glucose levelsby secreting insulin.
These high levels of
fetal insulin result in
excessive fetal growth.
At term these infant
may weigh in the range
of 9 to 12 pounds.
These macrosomic
infants are more likely
to become wedged in
the birth canal, to
cause laterations of the
maternal perineal
tissue, to sustain birth
injuries and to
necessitate a
cesaream delivery.
Low blood sugar and mineral
levels at birth
Low blood glucose
(hypoglycemia): Right after
the baby is born, the blood
glucose level may drop very
low (hypoglycemia) because
they have so much insulin in
their bodies.
The extra glucose in your
body actually stimulates the
baby’s body to make more
insulin, so when the baby is
out the womb, the extra
insulin can cause problems.
Hypoglycemia in babies is
easily treated by giving the
baby a glucose solution to
quickly raise the blood
glucose level.
Feeding the baby should also
raise the blood glucose level.
Jaundice, a treatable condition that makes the skin yellowish
Most parents panic when they
hear their baby has jaundice
as they think it’s the same
ailment which affects adults.
Jaundice in healthy infants,
unlike in adults, is not due to
problems in the liver.
Jaundice develops in a
healthy baby when her blood
contains an excess of bilirubin
– a chemical produced during
the normal breakdown of old
red blood cells.
Newborns tend to have higher
levels because they have
extra oxygencarrying red
blood cells and their young
livers can’t metabolise the
excess bilirubin.
As the baby’s bilirubinlevel rises above normal,the yellowness spreadsdownwards from the headto the neck, to the chest,and in severe cases, tothe toes. Unless it’s a
serious case, your baby’sjaundice will usually notcause any damage.
In severe but rare casesof jaundice caused by
liver disease or maternalblood incompatibility,newborns may sufferdamage to the nervous
system.
How common is jaundice in
newborns?
60 per cent of fullterm infants
develop jaundice on the second or
third day after birth. It usually
peaks by around the fifth or sixth
day and then starts to decrease. In
most babies it disappears after one
week, though some babies may
take about a fortnight to recover
completely.
80 per cent of premature babies
develop it between the fifth and
seventh days after delivery. It
usually disappears within a month
of birth.
Some studies suggest that
mothers with gestational diabetes
may have a higher risk of giving
birth to babies with jaundice.
Some studies also suggest that the
male child is more likely to have
jaundice than a female.
Babies of mothers with blood
group O have a higher chance of
developing jaundice
How can Jaundice in my baby be treated?If your baby looks jaundiced,
your doctor may suggest tests
to measure the bilirubin level in
her blood. If your baby was
born at term and is otherwise
healthy, most doctors will not
begin treatment, unless the
bilirubin level is over 16
milligrams per decilitre of blood
but it also depends on the age
of the baby.
Since the early 1970s, jaundice
has been treated with
phototherapy, a process in
which infants are exposed to
fluorescenttype lights which
break down excess bilirubin.
The baby usually lies naked
under the lights for a day or
two, with his/ her eyes covered
by a protective mask.
If the level of bilirubin doesn’t
require phototherapy, you can
still help your baby by taking
her out into the sunlight in the
early morning or late
afternoon. Take care not to
expose your baby for too long
since her delicate skin is
prone to sunburns.
In the rare case of bloodtype
incompatibility where the
bilirubin level can rise to
dangerously high levels, your
baby may need a blood
transfusion. The Rh blood test
you have when you are
pregnant should alert you in
advance about any
incompatibility with your baby,
and you will be given antiD
injections to avoid this
problem.
Pre-term birthIf your baby is born early– also called ‘premature’or ‘preterm’ – he/she may
need special care.
The definition of a‘premature’ or ‘preterm’baby is one that is bornbefore 37 weeks. Thereare different levels ofprematurity and these
carry their own risks. Verypremature babies, bornbefore week 26, are atmost risk and are
sometimes known asmicro preemies. A babyborn at 37 weeks or moreis known as a ‘term’ baby.Generally the earlier yourbaby is born the higher
the risk of health problems
Development ProblemsResearchers have
noticed that children
whose mothers had
gestational diabetes
are at a higher risk for
developmental
problems, such as
language development
and motor skill
development.
Later in life, your baby
might have higher risks
of obesity and
diabetes. So help your
child live a healthy
lifestyle — it can lower
his/her chances of
developing obesity and
diabetes.
How Will Gestational Diabetes Affect Me?
Gestational diabetes increases the
chances of certain pregnancy
complications. Your doctor or
midwife will want to watch your
health and your baby’s health
closely for the rest of your
pregnancy.
Possible risks include:
Higher chance of needing a C
section
Gestational diabetes can
sometimes affect whether you are
able to deliver your baby vaginally
or by cesearean delivery.
Your healthcare provider, once you
have been diagnosed with
gestational diabetes, will follow you
closely, and monitor your baby. In
monitoring you and your baby
closely, your healthcare provider will
monitor the baby’s growth.
Babies born to mothers with
gestational diabetes are often
large for their gestational age —
meaning that they are bigger than
most babies at the same time in
their mother’s pregnancy. Large
babies, sometimes referred to as
macrosomic infants, are at risk for
not fitting through the mother’s
boney pelvis.
This may lead to a failure to dilate
in labor, or an ability to dilate in
labor to 10 centimeters, but an
innability to push the baby out
safely.
As your healthcare provider
measures your baby’s growth in
the last weeks of your pregnancy,
he/she will be able to determine
the safest route of delivery for you
and your baby.
MiscarriageWomen with pre-existing
diabetes have a higher riskof miscarrying. Those withtype 2 often need to adjusttheir medication early inpregnancy; many switch
from tablets to insulininjections.
Women with type 1 diabetesare risk having severe
‘hypos’ (episodes of lowblood glucose). Often, theusual warning signs, such
as feeling sweaty orshaking, change or
disappear duringpregnancy.
To avoid unexpected hypos,you should be careful not toskip meals. You should also
always carry foods toquickly treat hypos, such as
jelly beans, carbohydratesnacks and glucose tablets.
High blood pressure or PreeclampsiaLike gestational diabetes,
preeclampsia is a condition
that only appears during
pregnancy. Gestational
diabetes causes elevated
blood sugar levels and can
result in preeclampsia which
involves type of high blood
pressure.
Sometimes pregnancy
hormones can disrupt your
body’s ability to use insulin.
Insulin is the hormone that
converts blood sugar into
usable energy. When it can’t
perform effectively, blood
glucose (sugar) levels rise.
Insulin resistance can cause
high blood glucose levels and
can eventually lead to
gestational diabetes.
PreeclampsiaGestational diabetes is
a risk factor for
preeclampsia. Your
risk for gestational
diabetes is highest if
you already have
preeclampsia.
Preeclampsia results in
an escalation in blood
pressure, as well as
high levels of protein in
the urine or blood, as
well as swelling in the
face, feet and hands.
Preeclampsia is more
prevalent among
women with gestational
diabetes, and among
overweight women.
There are many factors that
can increase the risk for
preeclampsia.
Periodontal disease or urinary
tract infections may leave a
woman more vulnerable to
preeclampsia. If you have
been subject to chronic high
blood pressure, kidney
disease, lupus, migraines or
rheumatoid arthritis or other
chronic conditions you are at
high risk for preeclampsia.
Women at risk for
preeclampsia may have a
family history of
preeclampsia, or may have
had it in an earlier pregnancy.
Women pregnant for the first
time are at highest risk for
preeclampsia.
Preeclampsia must be carefully
monitored to prevent serious
complications such as seizures.
Once preeclampsia is on the
scene, the only way to end it is by
delivering the baby.
If the pregnancy is at less than
approximately 37 weeks, and if the
preeclampsia is mild, you may be
able to buy some time by resting in
bed at home. You can help things
by drinking more water and eating
less salt. Your doctor will want
frequent appointments with you to
monitor the situation.
At or beyond 37 weeks, your
doctor may recommend induction
of labor or a cesarean section.
Generally delivering the baby
begins the resolution of
preeclampsia. In most cases within
six weeks of delivering the baby
will see the disappearance of high
blood pressure, protein in the urine
and all other symptoms of
preeclampsia.
Pre-term birthMothers with preexisting or
gestational diabetes are more
likely to have a preterm (prior
to 37 weeks), or very preterm
(before 32 weeks) birth. On
average, oneinfive women
with type 1 or 2 diabetes and
almost oneinten mothers
with gestational diabetes give
birth at 3236 weeks. Women
with diabetes are more likely
to have an induced labour, an
instrumental birth (delivery
with forceps or ventouse) or a
caesarean section.
After birth, you will have a
higher risk of developing type
2 diabetes. Lifestyle changes
can lower the odds of that
happening. Just as you can
help your child, you can lower
your own risk of developing
obesity and diabetes.
How can I protect Myself and my Baby?Women with diabetes canhave healthy pregnanciesand babies. It is importantto try to establish healthyblood glucose levels
before pregnancy. If youhave an unplannedpregnancy, stabilisingyour blood glucose assoon as you find out
you’re pregnant is criticalbecause your baby’smajor organs developduring the first eightweeks. Paying carefulattention to nutrition andmaintaining generalfitness can help you
control your blood glucoselevels.
Before you conceive, or as soon as
possible afterwards, your doctor
will want to test you for diabetes
related complications. You may
undergo a physical exam to check
for nerve damage; you will be
asked to provide a urine sample so
your kidney function can be
assessed and your doctor will
recommend that you visit an
ophthalmologist to have your eyes
assessed.
During pregnancy, your diabetes
medication will need to be carefully
monitored. If you have type 2
diabetes and are taking tablets
prior to pregnancy, your doctor
may advise that you convert to
insulin in order to better control
your glucose levels. During labour
and delivery, your endocrinologist
will keep an eye on your levels.
They will adjust your insulin
dosage directly after your baby is
born to safeguard you against
hypoglycaemia.
If your baby is producing high levels ofinsulin during your pregnancy in responseto your high glucose levels, their bloodsugars could be low following birth.
If left untreated, this could lead toseizures. Your baby’s blood glucose levelswill be tested (by heel prick) every fourhours for the first 24 hours of their life. Iftheir glucose levels are very low, they may
need to have supplementary feeds.
Insulin does not pass into your breastmilk,so it is safe for mothers to breastfeed theirbabies. Breastfeeding within 30 to 60
minutes of birth can reduce the risk of yourbaby having low blood sugar. Regular
feeds (every three to four hours) can helpthem to maintain blood glucose levels.
Mothers with gestational diabetes are atrisk of developing type 2 diabetes later inlife. You will typically be offered an oralglucose tolerance test about 68 weeksafter giving birth. This test assesseswhether your blood glucose levels are
within the normal range. The test should berepeated every three years.
After delivery, youand your baby Will
need to bemonitored closely
(a)For the first few hours, your
blood sugar level may be tested
every hour. Usually blood sugar
levels quickly return to normal.
(b)Your baby’s blood sugar level
will also be watched. If your blood
sugar levels were high during
pregnancy, your baby’s body will
make extra insulin for several
hours after birth. This extra insulin
may cause your baby’s blood
sugar to drop too low
(hypoglycemia). If your baby’s
blood sugar level drops too low, he
or she may need extra sugar, such
as a sugar water drink or glucose
given intravenously.
(c)Your baby’s blood may also be
checked for low calcium, high
bilirubin, and extra red blood cells.
Most of the time, the blood sugar
levels of women who have
gestational diabetes return to
normal in a few hours or days after
delivery.
Most doctors willrecommend that you
breastfeed, if possible,for the health benefits foryou and your baby. Forexample, breastfeedingcan help keep your childat a healthy weight, whichmay reduce his or herchances of developingdiabetes. It provides
antibodies to strengthenyour baby’s immune
system. And it lowers yourbaby’s risk for many typesof infections. Also, it maylower your chances of
developing diabetes laterin life.
Preventing Gestational Diabetes
There are no guarantees when
it comes to preventing
gestational diabetes — but the
more healthy habits you can
adopt before pregnancy, the
better. If you’ve had
gestational diabetes, these
healthy choices may also
reduce your risk of having it in
future pregnancies or
developing type 2 diabetes
down the road.
Eat healthy foods.
Choose foods high in fiber and
low in fat and calories. Focus
on fruits, vegetables and whole
grains.
Strive for variety to help you
achieve your goals without
compromising taste or
nutrition. Watch portion sizes.
Keep active.
Exercising before and during pregnancycan help protect you from developing
gestational diabetes. Aim for 30 minutes ofmoderate activity on most days of the week.Take a brisk daily walk. Ride your bike.
Swim laps.
If you can’t fit a single 30minute workoutinto your day, several shorter sessions cando just as much good. Park in the distant lotwhen you run errands. Get off the bus onestop before you reach your destination.Every step you take increases your
chances of staying healthy.
3.Lose excess pounds before pregnancy.
Doctors don’t recommend weight lossduring pregnancy. But if you’re planning to
get pregnant, losing extra weightbeforehand may help you have a healthier
pregnancy.
Focus on permanent changes to youreating habits. Motivate yourself by
remembering the longterm benefits oflosing weight, such as a healthier heart,more energy and improved selfesteem.
E V E R Y T H I N G Y O U N E E D T O K N O WA B O U T D I A B E T E S
DIABETES SUPPORT SITE WEBSITE
http://diabetessupportsite.com/