One of the worst things about being pregnant is getting gestational diabetes. I was only informed of it last saturday, 6 November 2010. A traumatising discovery I must say. Since then I’ve been stopping myself from eating the baked goods that I so love. What’s more, I love to bake so I’m making use of any gathering to serve up my “creations” which are nothing to write home about.
Anyway, as you may have gathered by now, I love doing research (fact finding research, not experiments in the lab research) and have gathered up the following information:
What causes gestational disbetes
Got to start this section with what is gestational diabetes. Shall not be overly technical here, suffices to say that its a condition where a pregnant lady has an abnormally high level of sugar in her blood.
Essentially all food gets broken down into glucose (the simplest sugar) or glucose and something else (forgot my high school biology). Obviously if you consume glucose, it doesn’t need to be broken down anymore and immediately gets released into the bloodstream for use. At the same time, the pancreas produces insulin which converts sugar into glycogen to be stored in the liver and in muscles. Pregnancy hormones can make one’s cells less responsive to insulin. This should normally not be a problem and the pancreas will then just proceed to produce more insulin. However, the problem comes in when the pancreas cannot keep up with increased insulin demand.
This condition occurs more common in non-white women and usually develops in the second trimester.
According to the American Diabetics Association, the following are indicators of high risk:
2) have had gestational diabetes in previous pregnancies
3) sugar in urine
4) strong family history of diabetes
Which brings me to the question: why me??? The only thing I had was sugar in urine but I had thought that was because I ate sugary cereal immediately before the appointment.
Heath implications for mummy
For most women, gestational diabetes goes away after birth. But it does mean that one is at higher risk of getting gestational diabetes for future pregnancies and later in life.
Women with gestational diabetes are also at increased risk for developing preeclampsia (disgnoised by high blood pressure and protein in the urine), particularly those who are obese before pregnancy or whose blood sugar levels are not well controlled.
If baby gets too big, delivery can also result in vaginal damage and or need for a large episiotomy.
Health implications for baby
If sugar levels are not controlled, baby’s pancreas will need to produce extra insulin to process the excess sugar. If the baby’s pancreas cannot keep up, baby will put on extra weight, especially in the upper body. Obviously, this will lead to a difficult birth and possibly a dangerous situation where the baby’s head can go through the birth canal but the shoulders get stuck. This may lead to fractured bones, damaged nerves or (worst of all) brain damage from lack of oxygen in the baby.
Moreover, excessive fat stores may also result in continued weight problems for the child.
Related to the need to produce excess insulin to process mummy’s excess sugar is the possibility of the baby being hypoglycemic shortly after birth, as it is still producing excessive amounts of insulin.
Baby also have tendancy to develop breathing problems and lungs of the babies with diabetic mums tend to mature slower. This risk increases if the diabetes is not well controlled and if baby is delivered early.
If your blood sugar control is especially poor, your baby is at risk for polycythemia (an increase in the number of red cells in the blood) and hypocalcemia (low calcium in the blood), and your baby’s heart function could be affected as well.
For some reason which I haven’t figured out, there appears to be a link between gestational diabetes and increased risk of jaundice as well.
Some studies have found a link between severe gestational diabetes and an increased risk of stillbirth in the last two months of pregnancy.
How to control gestational diabetes
1) eat a well planned diet, limiting intake of simple sugars and refined starch. Some go to the extent of consulting a nutritionist but that may not be necessary. Just being sensible about it should be good enough, or at least, that’s what Singaporeans seem to do most of the time.
Just as an aside, I personally will not recommend going on no-carb diets (atkins diet) though. For one, these tend to be high in saturated fat, which leads to heart problems and obesity. Moreover, I read a book written by proponents of the Atkins diet and still found it to be dangerous as it describes the body going into ketosis, which to my mind is toxic.
2) exercise. This is difficult to do when pregnant of course, but half an hour of walking or swimming each day helps.
Insulin injection/pills will be the next step if diet and exercise is not sufficient.