Gestational Diabetes

There is a fair amount of controversy over gestational diabetes - how serious it is really, and whether it is just an early manifestation of Type II diabetes or not.

A large percentage of women who have problems with blood sugar during pregnancy will develop Type II diabetes at some point in their life. That is fairly strong evidence that gestational diabetes is really just one of the first indications that your body type has that potential. Either way, women may need to control blood sugar during pregnancy, when they don't ordinarily have to worry about it.

Gestational diabetes is typically managed like diabetes in any other situation, with two exceptions:

1. Medications are not generally used as readily. Doctors are more frequently prescribing Metformin (Glucophage), or Glyburide, but there is not enough evidence to really know whether they are safe, or just what the risks might be. Insulin has been the traditional medication of choice, because its use does not negatively affect the baby.

2. Weight must be more carefully watched. Normally, weight loss with insulin resistant diabetes is no big deal, because it simply improves diabetic control if the person loses a little. With pregnancy though, weight loss can be harmful if you lose too much, so your dietician will set a goal of maintenance if you are overweight, or of reasonable gain if you are not.

The negative affects of gestational diabetes mostly have to do with the health of the baby. It does hurt the mom some too, since a larger baby can be harder to birth, and since high blood sugar does damage her cells, but most risks are to the baby. Higher birthweights are common, and babies are at risk for hypoglycemia after birth, because they are used to producing high amounts of insulin to compensate for the high blood sugar.

Polyhydramnios is also more common if maternal blood sugar is high. Polyhydramnios is excess amniotic fluid. Maternal diabetes causes high blood sugar in the baby, which causes excess urination, and more amniotic fluid. Controlling blood sugar levels can make the last months of pregnancy much more comfortable!

Most obstetricians are very strict about how tightly they want a mother to control her blood sugar. I have learned that tight control is a good thing, since cellular damage is known to occur with blood sugar levels of 140 and higher.

A healthy diet with plenty of fresh whole foods can help both to control blood sugar, and to provide the best possible health benefits for your baby.

Many mothers assume when they are pregnant that the dizziness and fatigue they feel after meals are hypoglycemia. Most often it is not. In our society, high blood sugar is far more common than low blood sugar, and it can start within days of pregnancy. Most women also will not show sugar in their urine until blood sugar levels are very high, so your periodic urine tests are of little value.

A GTT (Glucose Tolerance Test) is usually performed at about 5-6 months pregnant, but its value is also questionable. The test uses either 75 or 100 grams of glucose, which will show problems if you are very sensitive. The problem comes in with people who routinely consume large amounts of carbohydrates and sugars. They may be consuming MORE than that on a regular basis, and the test may show a response that is within normal ranges, while they are having frequent blood sugar highs which have not shown up on the test. Those high spikes after large meals will be enough to cause polyhydramnios, and large birthweight babies and the accompanying problems of high blood sugar. The only way to truly know if your blood sugar is spiking in daily life is to test it two hours after a meal.

Controlling blood sugar during pregnancy may not be the most fun thing to do, but it does actually help with appetite, fatigue, nausea, and other pregnancy issues. The one pregnancy that I continued full term that I knew to control my blood sugar with, was the healthiest pregnancy I ever had, with the least physical discomforts. I believe a lot of that had to do with blood sugar control.

Written by Laura Wheeler, Owner of Firelight Business Enterprises, Inc.