By Kemi Olatunde
Gestational diabetes is diagnosed during pregnancy when the body cannot cope with the extra demand for insulin production resulting in high blood glucose levels. Gestational diabetes is managed by monitoring blood glucose levels, adopting a healthy eating plan and performing regular physical activity.
Gestational diabetes can often initially be managed with healthy eating and regular physical activity.
However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life and should be tested for diabetes at least every 2 – 3 years.
If gestational diabetes is not well looked after (blood glucose levels remain high) it may result in problems such as a large baby, miscarriage and stillbirth. A large baby can create the risk of injury at delivery, caesarean delivery, forceps delivery and a need for the baby to be looked after in special care until the glucose level stabilises after delivery. Other complications may include pregnancy loss and premature delivery. If any problems occur, the hospital will care for you and your baby.
It is important to monitor your blood glucose levels so as to keep your blood glucose levels within the target range. Your Credentialled Diabetes Educator can show you how to check your blood glucose levels and help you understand your blood glucose patterns. This is to ensure appropriate treatment can be administered and changed as necessary.
If your blood glucose levels cannot be managed by healthy eating and physical activity alone, your doctor may suggest medication.
An important part of managing gestational diabetes relates to diet. Following a healthy eating plan will assist in:
Managing blood glucose levels within the target range advised by your doctor
Providing adequate nutrition for you and your growing baby
Achieving appropriate weight changes during your pregnancy.
It is advisable to see an Accredited Practising Dietitian to work out a meal plan that is appropriate for mother and the growing baby.
Women with gestational diabetes are encouraged to:
Eat small amounts often and maintain a healthy weight
Include some carbohydrate in every meal and snack (e.g. Multigrain bread, bulgur, pasta, potato, lentils, chickpeas, beans)
Choose foods that are varied and enjoyable that provide the nutrients you especially need during pregnancy. This means foods which include: calcium (e.g. Milk and cheese), iron (e.g. Red meat, chicken and fish), folic acid (e.g. Dark green leafy vegetables lightly cooked, low in fat, particularly saturated fat(e.g. use oils such as canola, olive and polyunsaturated oils and margarines and use lean meats such as skinless chicken and low fat dairy foods)
Carbohydrate foods are broken down into glucose and used for energy. To help manage your blood glucose levels, it is important to spread your carbohydrate foods over three small meals and 2-3 snacks each day. Foods that contain carbohydrate include:
Try to limit the amount of fat you eat, particularly saturated fat. Use healthy fats like canola, olive and polyunsaturated oils and margarines, avocados and unsalted nuts. T
Include two small serves of protein each day as protein is important for the growth of the baby and maintenance of healthy mum.
Calcium and iron requirements increase during pregnancy. Try to include 2-3 serves of low fat calcium rich foods each day (1 serve = 250 ml milk, 200 g of yoghurt or 2 slices of cheese). The iron from red meat, chicken and fish is readily absorbed.
Nutritious foods that will not cause excess weight gain or cause your blood glucose levels to go up can be eaten freely. These foods include fruits such as strawberries, passionfruit, lemons and limes and all vegetables (except potato, corn, sweet potato, taro, beans, lentils and chickpeas). Try to include at least 2 cups of vegetables each day.
The best drink for your body is water, plain mineral water and soda water – try it with fresh lemon or lime for something different. ‘Diet’ or sugar-free drinks are suitable for people with diabetes.
However carbonated and caffeinated varieties can increase the risk of osteoporosis and may affect mood so should be consumed in moderation by everyone.
Keeping active with gestational diabetes
For women with gestational diabetes, moderate intensity physical activity can help to manage blood glucose levels. ‘Moderate’ means a slight but noticeable increase in breathing and heart rate. If there are no specific obstetric or medical conditions, you should be able to safely exercise during pregnancy.
Benefits of keeping active
Physical activity helps to reduce insulin resistance. Regular exercise, like walking, helps to increase fitness and prepares you for the birth of your baby. Physical activity also helps manage blood glucose levels.
Remember, before starting or continuing any form of physical activity, always check with your obstetrician or midwife.
It’s never too late to start moving, and there are many ways that you can keep active as a part of your everyday routine. Basically, anything that gets you moving is generally good for your diabetes and will also improve your overall feeling of wellbeing. For example, walking is a great way to move.
A recent research revealed that one out of every eight pregnant women in Ondo State suffers from Gestational Diabetes according to the Gestational Diabetes Society of Nigeria (GDSN).
To this end, the World Diabetes Foundation donated a lot of Point of Care Testing device known as Glucometers among others to some health facilities in Ondo State for detection of the disease.
Principal Investigator, Strategy for Comprehensive Gestational Diabetes Control Project funded by World Diabetes Foundation in Denmark, Dr. Biodun Olagbuji stated this during a feedback meeting on Tuesday in Akure.
According to him, a survey was carried out in the state in the last three years and the discovery was made saying “the prevalence of Gestational Diabetes is high in our society.”
He explained that the project is aimed at expanding access to Comprehensive Gestational Diabetes Care through screening and diagnosis of Gestational Diabetes Mellitus (GDM)among others.
He said; “Some of the objectives of the project is to advocate for a policy on GDM, raise awareness on GDM among pregnant women, capacity building of health care providers to deliver GDM care services, strengthen infrastructure for improved GDM screening and diagnosis, screening and diagnosis of GDM, establish GDM clinics and determine associated birth outcomes and incidence of Type 2 diabetes among women with GDM among others.”
Speaking with Living healthy, Dr. Olagbuji noted that pregnant women with poorly controlled or undiagnosed GDM could develop kidney failure, cardiac arrest or other abnormalities later in life.
The Gynaecologist who revealed that Gestational Diabetes is common among pregnant women in the Southern Senatorial district of the state, advised pregnant women to always go for routine tests to prevent pregnancy complications.
However, he recommended an adoption of a multi-disciplinary approach to care of pregnant women while adding that a policy on comprehensive GDM care be formulated by government.
Additional info: www.diabetesaustralia.com.au