Find out how to manage gestational diabetes and reduce your risk of developing the condition by following expert advice from consultant dietitian Sarah Keogh.
Gestational Diabetes, also known as pregnancy diabetes, is diabetes that only appears during pregnancy. Gestational diabetes affects about 12% of pregnant women in Ireland and means that many women have to follow a special diet or use insulin while they are pregnant.
Diabetes needs to be carefully managed during pregnancy as it can lead to problems both for mum and baby if it is not looked after. We look at why blood glucose levels are important, some of the problems they can cause and what you can do to avoid gestational diabetes and how you can manage it if it does turn up for you.
Why is gestational diabetes so common?
We hear a lot more about pregnancy diabetes these days because in 2010 the HSE changed the criteria for screening pregnant women. They started to check more women for diabetes and once this happened, the numbers of women found to have gestational diabetes doubled. Screening for gestational diabetes takes place between 26 and 28 weeks.
You will be screened if you are obese (a BMI greater than 30), aged over 40, had diabetes in a previous pregnancy or have polycystic ovary syndrome. As obesity becomes a bigger problem in Ireland, the numbers of women with gestational diabetes has also increased.
What is gestational diabetes?
Diabetes is diagnosed when someone has too much glucose (sometimes called ‘blood sugar’) in their blood. Our bodies make a hormone called insulin. Insulin’s job is to help to keep blood glucose at healthy levels. During pregnancy, insulin has to work harder to control blood glucose levels. For most women this is not a problem, but for some women, the insulin can’t cope and blood glucose levels go up.
Why do high blood glucose levels matter?
High blood glucose levels during pregnancy can cause problems both for mum and for baby. Women with gestational diabetes are more likely to have high blood pressure during pregnancy, they are also more likely to have a premature baby or to have a Caesarean-section.
Glucose in your blood also passes through the placenta and reaches your baby. With gestational diabetes, this means that babies can get too much sugar and this causes them to grow more than they should. Women with gestational diabetes that is not treated can have babies that are much bigger and this can cause problems when it comes to giving birth.
Babies whose mothers had untreated gestational diabetes are also more likely to need special care after they were born, to be born with very low blood glucose levels and to have more obesity and diabetes in later life. However, if you look after your diabetes, these problems are much, much less likely.
Why do some women develop gestational diabetes?
There are certain things that make it more likely that you will get gestational diabetes and the biggest factor is weight. Being older, having a family history of type 2 diabetes or having PCOS will also increase your chances.
How can I manage gestational diabetes?
Diet is the main treatment for gestational diabetes. Even if you eventually need to use insulin, you will still need to look after what you eat. It is important that you see a qualified dietitian who can help you to manage your diabetes. Ideally, you need to see a dietitian within seven days of being diagnosed so that you can get blood glucose levels under control straightaway.
The key things to do are:
- Cut out unnecessary sugar. This means that you cut out sugary foods like soft drinks, sweets, biscuits, chocolate etc. However, you don’t need to cut out healthy foods that have a little sugar like fruit or yoghurt.
- Eat smaller portions of carb foods like bread, rice, pasta and potatoes. Although these foods do not have any sugar, the body makes blood glucose from them. Do not cut them out – it is not good to have a low blood sugar either! Your dietitian will be able to work out the correct portion sizes for your weight and pregnancy.
- Follow a low glycaemic index diet. Low GI foods cause a smaller rise in blood glucose when you eat them compared to high GI foods. Following low GI advice has also been shown to reduce the overall amount of weight you gain during pregnancy.
- Eat a sensible amount of protein foods. This helps to make sure your baby is getting everything he needs but also helps to control blood glucose levels.
- Exercise. Walking, swimming or doing any exercise that is safe and comfortable for you will help your insulin to work a lot better. This means that your blood glucose levels will be healthier and it is one way to help avoid going on to insulin.
Will I need insulin?
For some women, diet alone is not enough to get blood glucose to the right level and you may need to take insulin. Your doctor will advise you on when and how much to take and your dietitian will help you to adjust your food as needed.
Gestational diabetes and Type 2 Diabetes
Women who have gestational diabetes are much more likely to develop Type 2 diabetes later on. This is why it is a great idea to stay on the healthy eating plan that you had during pregnancy. Keeping weight at healthy levels, exercising and following a low GI diet can help prevent you from going on to get Type 2 diabetes. You’ll look great, too!
How can I avoid gestational diabetes?
- The best place to start is before you become pregnant. If you are overweight, start to lose weight. Being overweight is the biggest risk factor for developing gestational diabetes. Any weight loss will help, even a few pounds.
- Start to cut back on any sugary foods you eat. Foods like fruit and yoghurt are good to eat, but it is a great idea to start reducing or cutting out soft drinks, sweets, chocolate and desserts. You don’t need to ban them but keep them to once or twice a week at most.
- Exercise – especially any exercise that builds some muscle. The more muscle you have, the better your insulin will work and this is a great way to avoid gestational diabetes. Try pilates or yoga, brisk (really brisk) walking, going to the gym and learning to use weights, kettle bell classes – really, do anything that will give shape to your muscle.
- Follow a low glycaemic index diet. A low GI diet also helps to get your insulin working. Talk to your dietitian for advice on losing weight without cutting the key nutrients you will need for pregnancy.
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