If you have ever been pregnant, you know that dreaded 25-week visit. That is the one when the obstetrician hands you the lab slip to go get your blood sugar tested. Cue the frantic messaging to your friends to discuss which flavor of the gag-inducing sugar drink is the most tolerable one to choose (fruit punch, of course).
For most women, choking down that nasty drink is as bad as it gets. The test comes back normal and you move on with your pregnancy and look forward to delivering your beautiful little bundle of joy. For the ones who fail the test and have to go back for the three-hour glucose test, that is when the worry and hours of Google research starts. What even is gestational diabetes what are gestational diabetes symptoms and why are you dealing with it?
This guide goes over the ins and outs of gestational diabetes, along with some tips and tricks to help prevent and manage it.
What is Gestational Diabetes?
Gestational diabetes is similar to Type II diabetes in that the hormone levels in your body prevent it from properly using its natural insulin to control your blood sugar. All pregnant women have some degree of insulin resistance due to the vast hormonal changes in her body, but it is unnoticeable for most.
Risk factors for developing gestational diabetes include:
- Advanced maternal age
- Obesity
- A family history of diabetes
- Poor lifestyle habits
When you are pregnant, your body produces a hormone called the Human Placental Lactogen (HPL). This hormone helps your baby grow, but it also changes how you process carbohydrates and affects your metabolism. It is also mainly responsible for insulin resistance in pregnancy and higher levels lead to gestational diabetes.
When you are diagnosed with gestational diabetes, you will need to take some special measures to make sure that your blood glucose levels stay in the normal range. This could mean a few different things:
- Blood sugar monitoring
- Dietary changes
- Lifestyle changes
- Medication
Depending on the severity of your gestational diabetes, your doctor will tell you to do either some or all of these.
Diagnostic Criteria and Testing Parameters
Blood glucose levels are used to diagnose and treat gestational diabetes. The normal blood glucose range for an adult is less than 100mg/dl while fasting and 90-110 mg/dl two hours after eating.
To test for gestational diabetes, your obstetrician will send you to a blood lab to have a blood glucose test done. This is usually done in two steps. For both, your blood sugar will be tested on arrival, then you will be given five minutes to drink a very sugary liquid that is usually between 4-8 ounces, depending on the brand. For the first test, you will wait one hour and then have your glucose level tested.
If you do not pass this first test, you will be sent for another test. For the second test, you will be tested every hour for three hours after your glucose drink.
If you exceed these glucose levels, you will then be diagnosed with gestational diabetes:
- Fasting – 95 mg/dl
- One hour – 180 mg/dl
- Two hours – 155 mg/dl
- Three hours – 140 mg/dl
After your test, the doctor will call you with your results. If you receive a diagnosis of gestational diabetes, next steps will then be discussed.
Why Pregnancy is an Insulin Resistance State
During pregnancy, your baby’s placenta is responsible for producing several different hormones to help your baby’s growth. These include:
- Human Placental Lactogen (HPL)
- Estrogen
- Cortisol
All three of these are known to cause some level of insulin resistance for various reasons, though HPL is arguably the most potent. Whether or not you have gestational diabetes, you will still have some level of insulin resistance during pregnancy because of these hormones being produced.
Pregnant women who already had diabetes before pregnancy are also at risk for their diabetes being more uncontrolled. You may find that you need more insulin than usual to maintain your levels or have to be a bit more strict with your diet.
Risk Factors for Woman and Baby
There are many risks associated with gestational diabetes. Most of these risks are heavily mitigated simply by taking care of yourself, though. So long as you are following your doctor’s advice, gestational diabetes is often no more than an annoyance.
Untreated or uncontrolled gestational diabetes with consistently high blood sugar levels can increase the following risks to your unborn baby.
- High birth weight
- Higher risk of diabetes in life
- Premature birth
- Jaundice
- Hypoglycemia
- Respiratory distress
- Stillbirth
Your baby is not the only one you should be thinking about. Your health matters as well. If you are not properly taking care of your diabetes or it is uncontrolled, you have a higher chance of developing these problems.
- Blood pressure problems, including high or low blood pressure or preeclampsia
- Poorly controlled blood sugar, even when following your doctor’s treatment recommendations
- A higher likelihood of delivering your baby by cesarean section
- A higher risk of developing Type II diabetes later in life
These possible complications are why it is so important to stay on top of your gestational diabetes if you are diagnosed with it. Managing it is easy, but coming back from complications caused by neglect may not be.
Conventional Treatment Options
Conventional treatment options are the ones that your doctor will recommend when you are diagnosed with gestational diabetes. There are several options for you, from medication to specialists.
It is very important to follow your doctor’s advice. Most cases of gestational diabetes can be easily controlled, but it can get worse very fast if you just ignore it and do not take care of yourself.
Blood Sugar Monitoring
All women with gestational diabetes are typically expected to monitor blood sugar levels. You will be given a prescription for a monitoring system that most insurances cover. This will include:
- The blood sugar reader
- Lancets
- Test strips
To use these, you prick your finger with the lancet, load the strip into the blood sugar reader, and feed a droplet of your blood into the strip. The device will then show you what your blood glucose level is. Thankfully, the at-home test kits sting far less than hospital versions.
If you have particular trouble with your blood sugar or you choose to go that route, there are also many constant monitors out there. These adhere to the skin and monitor your blood sugar 24/7, alerting you if it is getting too low or too high.
Your doctor will likely ask you to keep a blood sugar record and/or food diary. There are some excellent free apps on smartphone app stores for diabetes monitoring that can make your life much easier!
Medication
Some women with gestational diabetes have a more severe case that may require medication. This is usually done in the form of insulin injections throughout the day. These medicines give your system a bit of extra insulin to compensate for the resistance that GD causes.
How much or little insulin you are told to inject will depend on how well your levels are controlled with diet alone. Having higher blood sugar levels even after a diabetes-friendly meal will mean that more units of insulin are needed. Conversely, you may only need a couple of units for just a small boost.
Specialists
Your doctor will most likely send you to a specialist of some sort to help you manage your gestational diabetes. Listening to your specialist is very important and should not be dismissed.
- Endocrinologist
- Dietician
- Diabetes Educator
The type of specialist you see will usually depend on the severity of your gestational diabetes. For mild cases, a dietician may be all you need. For more severe cases, you may see an endocrinologist to get on insulin injections.
Natural Prevention and Treatment Options
In addition to the above medical treatments and monitoring, there are several other steps that you can and should take to manage your gestational diabetes. These will often mean the difference between controlled and uncontrolled diabetes.
Supplements
The first medication you should be taking to help with your gestational diabetes is your prenatal vitamin that you were prescribed at the beginning of your pregnancy. If you do not have one, you should talk to your doctor about getting it. This is a potent multivitamin specifically tailored to give pregnant mothers the needed nutrition to stay healthy during pregnancy.
In addition to that, you can look into other supplements. If you are anemic, you may be prescribed an iron supplement along with your prenatal vitamin.
Over the counter supplements geared toward blood sugar management, such as Lowsitol, could be beneficial, as well. This supplement includes many different ingredients that have been shown to help pregnant women manage gestational diabetes.
- L-Carnitine can help you feel fuller while you get used to a diabetic diet
- MTF can help prevent birth defects in your unborn baby
- Choline has been shown to help improve insulin resistance
Many other ingredients in this powerful supplement can lead to a healthier pregnancy and more easily controlled gestational diabetes.
Gestational Diabetes Diet
You should follow a diet that is compatible with the management of diabetes, such as following the Glycemic Index. This generally means a diet that is low in carbohydrates and sugar, as well as high in protein. You should also take care to avoid caffeine, as this has been shown in studies to reduce insulin sensitivity.
For pregnant women who have mild or moderate gestational diabetes, following a good diet could mean that you will not need insulin injections to get you through your pregnancy. If you are unsure how to do this, you might want to consider a nutrition consult with a specialist.
Get the Right Amount of Sleep and Exercise
Sleep and exercise are both very important for controlling gestational diabetes. Your body needs both for all of your systems to work as well as they can, so these should not be skimped on or overlooked.
When you sleep, your body goes through many processes to prepare you for the next day. The most important part of this process for diabetics is the regulation of your hormones and related systems. Since hormones are responsible for maintaining your blood sugar levels, nighttime regulation is imperative.
Exercise lowers blood sugar, which is fantastic news if you tend to run high. Because of this, you should be careful while exercising to make sure that your blood sugar levels do not fall too low, since that can cause its own problems.
Stress Reduction
Stress is terrible for diabetes. When you are stressed, your body produces extra cortisol and adrenaline, the fight-or-flight hormones. Both of these hormones tell your liver to release some of its stored glucose into your bloodstream, then continue to keep that glucose in your blood longer instead of being absorbed into your cells. This is so you can respond to threats with a bit of extra strength.
When you are chronically stressed, your cortisol levels tend to build in your system, causing more problems with your blood sugar. Reducing your stress can have a nearly immediate effect in lowering your blood sugar. If you have a lot of stress in your life, you should take steps to relieve it so that you can be healthier.
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- Diagnosis Treatment
- Diabetes diet: Create your healthy-eating plan
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- The Pathophysiology of Gestational Diabetes Mellitus
- Sleep and Blood Glucose Levels
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