By Cynthia D. Smith, PharmD
Being diagnosed with gestational diabetes mellitus (GDM or GD for short) can be a scary prognosis whether you’re a first time mom or experiencing the joys of motherhood once more.
It can be especially alarming if you’ve had none of the usual signs or symptoms of diabetes such as weight loss or blurred vision. And if you did have symptoms like tiredness, frequent urination or increased hunger, you may have attributed those to your pregnancy.
But sometime between the 24th and 28th week, a test may have revealed that you have diabetes. Now what? What should you do? What are your options? And what is the best way for you to protect your health and your baby’s health?
This article will answer those questions and cover some background knowledge to help you gain the confidence you need for a safe delivery and beyond. Let’s get started!
HERE ARE 10 THINGS YOU MUST DO:
#1: Understand the Basics
You’ve talked to your doctor, dietitian and other healthcare providers, but there’s so much new information to absorb and so much to learn that you don’t know what to do next or where to begin.
Well, the first step is to understand the basics of the disease. Knowledge is power and understanding the general concept will put you in control and help you gain confidence. It will give you a starting point so that you’ll be able to know what questions to ask.
Simply put, the food we eat breaks down into sugar. This sugar, also called glucose, is an important and necessary fuel that our bodies use as a source of energy.
Before our bodies can use it, however, glucose needs to leave the bloodstream and enter our muscle and fat cells.
Glucose enters the cells with the help of insulin, a hormone that our bodies produce. Insulin unlocks the cells, allowing glucose or sugar to go inside. If our bodies don’t make enough insulin or if the insulin we have is not working properly, then too much sugar remains outside the cells and in the blood where it begins to accumulate.
If you have diabetes, it means that you have too much sugar circulating in your blood. There are different types of diabetes: Type 1, Type 2, and Gestational Diabetes. Let’s focus on gestational diabetes.
When diabetes occurs during pregnancy, it’s called gestational diabetes. Usually this is temporary and will go away after the baby is born.
No one knows exactly what causes gestational diabetes, but most likely the hormones produced during pregnancy interfere with insulin production allowing too much sugar to accumulate in the blood.
This can lead to complications that may be harmful to you and your baby.
This illustration, sponsored by the American Diabetes Association, helps explain gestational diabetes.
#2: Be Aware of Possible Complications
Most women with gestational diabetes have uneventful pregnancies. But being aware of the possible complications helps you appreciate why it’s important to keep your blood sugar under control.
Possible complications for you… could include high blood pressure and the risk of needing a c-section delivery if the baby is large.
According to a study published in the Journal of the American Medical Association, women who have gestational diabetes have a higher risk of postpartum depression.
As with anyone with diabetes, hyperglycemia (high blood sugar) can also be damaging to your organs, especially your blood vessels, heart, kidney, nerves and eyes.
Possible complications for the baby…
The baby may need an infusion of glucose after delivery if his or her blood sugar is low. The baby could be born weighing over 9 pounds which may increase the need for a cesarean birth. (Babies store extra blood sugar as fat, which can make them larger than normal.)
A baby born early may have organs that are not fully mature. If the liver is not fully mature, this could cause jaundice (referring to the yellowish color of the skin and whites of the eyes). Babies with lungs not fully mature, may require oxygen.
For both mother and baby, there is the risk of developing type 2 diabetes later in life.
Learning the skills necessary to keep your blood sugar under control will help you now and in the future to avoid the complications diabetes can cause.
Visiting your doctor is the first step to gaining control of your condition.
Many people have diabetes and don’t even realize it. So it’s especially important that expectant mothers go in for regular medical checkups. Your doctor will be able to fully evaluate you, do any necessary testing and prescribe medications, including prenatal vitamins.
Keep regular visits so that your doctor can monitor your condition and weight gain and also monitor the baby’s fetal movements and growth.
You may need to make changes to — When, What and How Much You Eat.
And if you’re inactive, you will need to add exercise to your daily or weekly routines to help regulate your blood sugar.
Your doctor and other health professionals will work with you to develop a treatment plan especially for you.
Making changes now may help prevent diabetes in your future and help you have a healthy pregnancy.
So visit your doctor and follow his or her advice.
Family physicians, pediatricians, obstetricians, midwives, nurses, dietitians, pharmacists. There are many professionals in the medical arena who are willing to help you and guide you and answer any questions you may have.
They’re on your team. But the most important person on the team….is you!
#4 : Take Control — You are the captain of your team
You may have a team of professionals working for you, but remember that you are the captain of the team. Your team may include a doctor trained to care for people with diabetes, obstetrician who handles high-risk pregnancies, pediatrician, midwife, registered dietitian, or diabetes educator.
A treatment plan will be developed just for you, but you will be the one in charge of–
- Eating a balanced diet
- Planning ahead
- Being prepared
- Testing regularly
- Exercising
- Relaxing
It’s up to you to get it done!
#5: Eat a Healthy, Balanced Diet
What you eat during pregnancy nourishes you and the baby and helps support the baby’s growth and development.
Genes and DNA play an important role in the baby’s overall health, and they can be influenced by a healthy diet and good nutrition. While a poor diet can predispose a baby to diabetes, heart disease and even high cholesterol.
Eat a good balance of proteins, carbohydrates and good fats. Include healthy protein. Choose high-fiber foods such as whole grains, vegetables and fruits. Limit sugar and concentrated sweets. Avoid added fats.
One of the most important parts of your gestational diabetes treatment is following a meal plan. Having a plan will help you stay on track and help you make healthy choices.
Start your day with a good breakfast and eat frequently throughout the day. You’ll feel better and have more energy.
The specialists on your team will help you create a personalized meal plan.
#6: Plan Ahead for Mealtime
You have enough to worry about.
Besides taking care of you and your growing baby, you have dozens of other things to deal with during your busy day.
Having a meal plan will give you one less thing to worry about.
It will keep you on the straight and narrow road to good nutrition. And it’ll take the guesswork and chaos out of grocery shopping, meal prep or dining out.
#7: Be Prepared for Special Occasions and Emergencies
Many things happen that we can’t control. They happen whether we’re ready or not.
But being prepared can help you fend off the added anxiety of stress-filled events.
No matter what’s happening around you, you still need to take care of yourself and your growing baby. Whether that involves meal planning or being sure to have enough medication and supplies on hand.
Holidays mean shortened hours for doctors’ offices and pharmacies. So plan ahead.
Start at least a week in advance of special occasions. You may have medications that need refills. You don’t want to run out!
Enjoy your special time with friends and family while keeping your diabetes management on track.
Hypoglycemic Emergencies
Be prepared for instances of low blood sugar or hypoglycemia.
Your blood sugar can dip low for many reasons. Medication, exercise, skipping meals, to name a few.
Confusion, shakiness, sweating, hunger, fatigue – are all signs of hypoglycemia. These signs can come on quickly.
The best way to know if you have low blood sugar is to test. Blood sugar 70 mg/dL or less may signal low blood sugar but your doctor or dietitian may give you a different, individual target level. You should know what that level is.
However, according to the American Diabetes Association, if you are unable to test, you should go ahead and treat your low blood sugar.
Not treating hypoglycemia could lead to severe headaches, coma or death.
Treat with 15-20 grams of simple carbohydrates — ½ cup of juice or regular soda (not diet), glucose tablets, or hard candy.
Be prepared. Don’t let special events catch you off guard. And if you experience symptoms of low blood sugar, know what to reach for.
#8: Test Regularly
Keeping your blood sugar in the proper range can help you avoid complications. So know your numbers. And the only way to do that is to test regularly.
As you learn more about your body and how it reacts to certain foods, medication, exercise, etc., you may need to make adjustments.
The goal of therapy is to achieve blood sugar readings similar to pregnant women who do not have diabetes. These women have after meal levels that range from 70-120 mg/dL.
Know your numbers so that you are better able to make changes to your diet if needed. Write down or save your readings. Take them with you on your doctor visits.
Invest in a glucose monitor. Starter kits range from $10 to $50 and may be covered by your health insurance.
#9: Exercise
Exercise is important for you and your baby. It can help lower blood sugar, control weight gain, and relieve stress.
Of course, first consult with your health care provider, especially if you weren’t physically active before your pregnancy.
At least 30 minutes of moderate-intensity physical activity is recommended at least five days a week.
But how much exercise you need depends on how active you were before you became pregnant. Also you may have other health-related concerns to consider.
Some good prenatal activities are walking, swimming and yoga. Remember to drink lots of water before, during and after your activity.
#10: Be Positive / Relax
The Good News? Your gestational diabetes will probably go away soon after delivery. Another reason to remain positive.
Making diet and lifestyle changes now, can have a big impact on the rest of your life and help prevent development of type 2 diabetes.
Latest research points out that women with GD who successfully treat their diabetes have outcomes equal to women without gestational diabetes.
You’re in Control
Yes, there are things you can’t control. But good nutrition that allows you to keep your blood sugar in a healthy range will go a long way toward your success.
Have you been diagnosed with gestational diabetes? What things are you concerned about? What questions do you have?
Please share your thoughts and ideas.
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