Recently I discovered that I have diabetes and high blood pressure running through the family genes. This is a concern to me for two reasons: 1. I don’t want to have either of those issues now or later in life and 2. I don’t want to develop gestational diabetes (GD) when I eventually decide to have little ones. The GD is more concerning at the moment because in general it rules you out for a midwife attended birth out of hospital [and even sometimes within]. As a birth doula who wants to have a birth center or home birth this is kind of scary and I want to do as much research and preventative measures that I can. If it comes down to it, I’ll obviously not risk myself or my future child and birth in the hospital but if I can prevent it, Why Not?
Now if you know even a glimmer of information about diabetes you know it has to do with blood sugar control. You also may assume that it only affects those who are overweight, this isn’t true and is one of the main points I’d like to make with this post. So, please enjoy and ask any questions that you’d like I’d love to answer to the best that I can or refer you to someone who’d know more 🙂
Since this is such a close issue to me I’ve done some research. There are two main books that I read where most of the following information comes from. The first is Diabetes Reset by George L. King M.D. and the other is When You’re Expecting Twins, Triplets, or Quads: Proven Guide for a Healthy Multiples Pregnancy by Dr. Barbara Luke and Tamara Eberlein.
- You have an increased risk of developing gestational diabetes if you’re age 30+, are overweight, or have a family history
- Pregnancy causes expectant mothers to become highly insulin resistant, especially during the third trimester.
- Insulin resistance is caused by hormones released by the placenta which interfere with the insulin’s action in the muscle and fat tissues.
- Excessive fat gained during pregnancy can also contribute to insulin resistance
- As the fetus grows the insulin blunting effect can reduce the mother’s insulin sensitivity as much as 50%
- Due to all of the above, a pregnant woman’s body must produce 2-3 times more insulin to keep blood levels stable
- If their body can’t produce enough they may have to take medication to prevent ill effects for their child (usually injectable insulin)
Health Risks of GD
- Short-term: Increased complications during pregnancy and delivery
- Preeclampisa: High blood pressure with possible kidney/organ damage
- Large Baby Complications
- Long-term: High risk of developing Type 2 diabetes later in life (50% of women who had GD developed Type 2 within 7-10 years), High risk of having GD with next pregnancy
- For women with Type 1: higher risk of birth defects or miscarriage
- Insulin doesn’t cross the placenta so fetus has to produce more to counteract the mother’s blood sugar level
- Causes fat storage equating a bigger baby
- When the baby is born they are cut off from mother’s blood sugar but they are sill producing insulin. This causes low blood sugar in baby which causes respiratory distress
- Delivering a large baby can be dangerous to mother and infant
- A large baby can be overweight in the future and lead to Type 2 diabetes
Testing for GD
Around 24 weeks your care provider will test for gestational diabetes unless something unusual came back from a urine test beforehand. There are two ways that care providers can test for GD they are described as follows:
- Traditional: You come in for a regular appointment where you drink 50 grams of glucose. They then will take a blood test in one hour. If your blood sugar is greater than 130 mg/dL you’ll have to have further testing
- Further testing: On a new day you’ll come in after fasting for at least 8 hours (usually in the morning before breakfast). They’ll take a blood test, have you drink 100 grams of Glucose, blood test in one hour, two hours, and three hours. If two out of four of the blood tests come back high blood sugar then you are diagnosed with gestational diabetes.
- New: Basically they skip the first set of testing and just follow the procedure of the further testing. Meaning they take your fasting blood sugar levels, give you glucose, and then take blood at an hour, and two hours. If one out of three tests is high then you are either diagnosed with gestational diabetes or are asked to monitor your blood sugar at home for however long your doctor wants. Then they review it and conduct another set of three tests, if there are abnormalities you’ll most likely be diagnosed with GD.
- Follow a diabetic diet plan to achieve and maintain blood glucose levels within a normal range
- Consume 20-25% daily calories from protein, 30% from fats, and 45-50% in complex carbohydrates
- Stable blood sugar guidelines:
- Eat often 3 meals with snacks in between
- Eat lean proteins rich in iron (lean red meats), fish, poultry, dairy, and nuts
- Healthy fats: unsaturated and omega 3s
- Unprocessed carbs (fruits and veggies)
- Have proteins and carbs together at every meal/ snack
- Have a bedtime snack that had dairy because it digests slowly so to not have low blood sugar at night
- If you perviously had a very active life style then, in general, you can stick to it as long as you be sure to listen to your body when you’re tired/ hungry/ thirsty etc.
- If you weren’t active before pregnancy then ask your care provider what exercises you can start
- Some common low-impact exercises include: prenatal yoga, dancing for birth, walking, swimming [Not Hot tub]
***If you have other medical concerns where you are on bedrest then exercise is not the preventative measure for you ***
Ok this was the bare minimum of information about gestational diabetes, there’s much more out there but it’s too overwhelming to look at all in one go. If you have any questions please let me know or ask your care provider.
Have a good day!