A sweet pea in the pod: Controlling your gestational diabetes

Decorating the nursery, picking out tiny clothes and shoes, studying sonogram printouts to determine whose nose he has—for most expectant mothers, these are the activities that consume the time awaiting baby’s big arrival. But for some, the biggest concern isn’t how to dress the bump—it’s how to manage their blood sugar to keep the bump safe.

Finding out you have gestational diabetes can trigger a slew of questions and even more concern, but it doesn’t have to be scary. Most of the time, gestational diabetes can be controlled and treated during pregnancy so you can go on to deliver a healthy, bouncing baby. Much like birthing classes prepare expectant mothers for delivery, attending a gestational diabetes class can give you a leg up on controlling your blood sugar and may even put your mind at ease.

One such class is offered by Texas A&M Healthy South Texas in conjunction with Driscoll Children’s Hospital in Corpus Christi. Claudia Perkins, registered dietitian and health educator with the program, has helped many worried moms-to-be gain control of their gestational diabetes by making a few adjustments to their lifestyle. Here’s a peek at her answers for some of the most common questions she is asked on the subject.

What is gestational diabetes?

A woman who has never had diabetes before but experiences high blood glucose (sugar) levels while pregnant is considered to have gestational diabetes. It occurs in up to 10 percent of American pregnancies and typically doesn’t manifest until the tail end of the second trimester (between 24 and 28 weeks).

How is it diagnosed?

Around week 24 into pregnancy, your health care provider will administer a screening glucose challenge test. It involves drinking a sugary beverage, waiting about an hour, then having your blood glucose level checked. If the results are above normal, you may need to have an oral glucose tolerance test, which requires fasting for at least eight hours before it’s administered. The results will help your health care provider determine whether you have gestational diabetes.

Who is at risk of developing gestational diabetes?

You may be at risk if you:

• Are obese (have a BMI of 30 or higher)
• Have a family history of type 2 diabetes
• Are 35 years of age or older
• Previously delivered larger babies (weighing more than 8 pounds, 5 ounces)
• Have high blood pressure
• Have had gestational diabetes before

How does gestational diabetes affect my baby?

If blood sugar is not controlled, the baby is put at higher risk for:

• Large birth weight
• Neural tube defects
• Neonatal hypoglycemia (low blood sugar)
• Stillbirth
• Shoulder dystocia (occurs when shoulders are too big during delivery)
• Injury to mother and baby during delivery
• Increased risk for obesity and diabetes in the future

How can I control my gestational diabetes?

Fortunately, gestational diabetes is very controllable, but it requires careful attention to diet and exercise and may require medication and/or insulin.

Diet

Sorry, moms, but you’ll want to think twice about eating that midnight ice cream if you’ve been diagnosed with gestational diabetes. Diet recommendations for good blood sugar control typically involve limiting carbohydrates and maximizing nutrients from lean protein, non-starchy vegetables and healthy fats. But the key is portion control.

Knowing what foods have carbohydrates and how many you can have throughout the day will help control blood sugar levels. In class, your health educator will look at foods that have carbohydrates, teach proper portions and how many you can have to help control blood sugar levels.

Special dietary considerations are made for pregnant women, including limiting certain kinds of fish, caffeine, sources of unpasteurized milk and raw eggs (like soft cheeses) and cold cuts. And there is no amount of alcohol that is known to be safe during pregnancy.

Physical Activity

Being physically active while pregnant can not only help control blood sugar, but it also relieves stress, helps build stamina for labor and delivery, can help keep “baby blues” (also known as post-partum depression) away, and help mom return to her pre-pregnancy weight.

It is recommended that women who are pregnant get at least 20 minutes of moderate exercise per day. If you were physically active before becoming pregnant, you should be able to continue your activity in moderation. If you have never exercised regularly, you can safely begin an exercise program while pregnant after consulting with your health care provider.

Low-impact activities, such as swimming, walking, indoor stationary cycling, step or elliptical machines and modified yoga or aerobics are considered safe and productive during pregnancy. However, if signs or symptoms of preterm labor occur, stop your activity immediately and contact your health care provider.

Monitoring

To ensure that blood glucose levels are within normal range, testing is required. With gestational diabetes, testing is typically done four times a day: fasting and one hour after each meal, unless otherwise recommended by your physician.

Blood glucose level recommendations for gestational diabetes are different than for people with type 1 or type 2 diabetes. Your health care provider or health educator will provide these ranges to fit your specific needs, along with log sheets for records.

What happens after delivery?

Your health care provider will want to test your blood glucose six to 12 weeks after your baby is born to determine whether you still have diabetes. Most women’s blood glucose levels return to normal after pregnancy. However, for about five to 10 percent of women with gestational diabetes, blood glucose levels do not return to normal and they are diagnosed with type 2 diabetes.

Even if your blood glucose levels do return to normal after pregnancy, your chances of developing type 2 diabetes later in life are high, so you’ll want to be tested every three years for diabetes or prediabetes. But you can do a lot to prevent or delay type 2 diabetes by making a few lifestyle changes. These include reaching and maintaining a healthy weight, being physically active, eating a healthy diet, managing stress and keeping up with regular checkups.

If you’ve been diagnosed with gestational diabetes or think you may be at risk for developing it, talk to your health care provider about resources available in your area to educate yourself about the disease. Working together with your health care team—your physician, obstetrician, nurses and dietitian—can turn your concern into a healthy pregnancy for you and a healthy start for your baby.

If you live in the Corpus Christi area, you can register for a Controlling Your Gestational Diabetes class by calling 361.561.8584.