Our Health Information Line receives calls and emails from women on a broad range of health issues. This regular column features answers to some of the most commonly asked questions.
Question: I have just been diagnosed with gestational diabetes. What does this mean?
Diabetes is a condition characterised by high glucose levels in the bloodstream. When it begins or is first recognised during pregnancy, it is called gestational diabetes. Usually the condition appears after 24 weeks of pregnancy and resolves after childbirth, and most pregnant women are screened for it between 26 and 28 weeks.
Glucose is a simple sugar (obtained from the carbohydrates we eat) that is used as fuel by the body. Following digestion, glucose is helped into the body's cells by the hormone insulin. During pregnancy, the body's need for fuel or energy is increased. To fulfil this need, more insulin is required to move glucose from the bloodstream into the cells. However, during pregnancy hormones that partially block this action are also produced, causing cells to 'resist' insulin. This means pregnant women need to produce extra insulin to shift glucose into their cells.
Women who develop gestational diabetes are either unable to produce enough insulin or are unable to overcome this insulin resistance. As a result, glucose builds up in their bloodstreams. During pregnancy, high blood glucose levels can cause many health problems including pregnancy related hypertension (high blood pressure), pre-eclampsia, and resulting complications.
The risk of birth complications also increases. The excess glucose in the mother's bloodstream crosses the placenta, causing the fetus to produce high levels of insulin. This leads to increased energy, growth and fat storage, and babies become large as a result. To deliver these babies, women are more likely to require induction or caesarean section. They also have an increased incidence of bladder infections during pregnancy.
Women with gestational diabetes also risk preterm delivery, which means their infants could be underdeveloped at birth. These babies may have breathing problems and will need to be monitored closely, often in special care nurseries.
Managing diabetes requires following a high-fibre and low-glycaemic (low GI) diet (with ample vegetables, legumes, wholegrains and fruit). Sugary foods and saturated fat are best avoided and small regular meals are recommended so that carbohydrate consumption can be spread throughout the day. Regular exercise also plays an important role. Exercise helps glucose enter cells for energy use, reducing blood glucose levels and helping cells respond to insulin. Walking for at least 30 minutes a day, especially after eating, is beneficial. Women who are unable to manage their blood glucose levels through diet and exercise may also require medication such as insulin injections.
Although gestational diabetes usually subsides after childbirth, the mother's blood glucose levels should be checked six weeks after birth. Newborns may also have unstable blood glucose levels immediately after birth and should have their blood glucose levels monitored for up to 48 hours. Breastfeeding is recommended to help mothers return to a healthy weight, and possibly to help reduce the risk of developing diabetes later in life.
Women who have experienced gestational diabetes are at increased risk of developing diabetes in subsequent pregnancies, or of developing Type 2 diabetes in the future. Their offspring also have a higher risk of developing diabetes throughout their lives. For both mothers and children, the best protection against developing diabetes in the future is following a nutritious diet, exercising regularly and maintaining a healthy weight.
Last updated: June 2012
© Women's Health Queensland Wide Inc. This article was has been reviewed by the Women's Health Queensland Wide editorial committee. It was published in Health Journey Issue 2 2012.
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