27 Ways To Improve GESTATIONAL DIABETES DURING PREGNANCY

Diabetes is a medical condition in which a patient has either too little insulin or her or his body does not properly use the insulin. Insulin is created or made by an organ in the body called the pancreas and then the pancreas releases the insulin and the job of the insulin is basically to control a patient’s blood sugars.

Gestational Diabetes During Pregnancy

Basically what happens is the insulin is produced, it then captures the sugar or the glucose that is in a person's blood stream. And pushes it over into the body's cells, so that way your blood sugars are never too high or too low so you don't have to eat all the time. And gestational refers to pregnancy.

So gestational diabetes refers to diabetes that you only get in pregnancy and the pregnant woman's body just does not use her insulin properly. Gestational diabetes is a very common medical complication of pregnancy, it occurs in about 200,000 pregnancies each year in the United States or approximately 7% of all pregnancies. Metabolism changes in pregnancy as any pregnant woman can attest to, there's a lot of changes that a pregnant woman undergoes.

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And one of them is metabolism of blood sugars, the pregnancy hormones which are basically hormones that are produced by the placenta, change how the body reacts to the food that it takes in. So the insulin that's being produced is not used properly in a pregnant woman, therefore here blood sugars increase and she develops gestational diabetes. Most pregnant women are screened for diabetes and you might ask, well who does actually get screened.

Most OB providers will screen every pregnant patient that they see, although this is somewhat controversial. Some OB providers will only screen women who have risk factors, however in general if you're pregnant you're most likely going to be screened for gestational diabetes. Risk factors that might increase your chances of developing gestational diabetes are number one if you've had gestational diabetes in a previous pregnancy, number two if you have a family history of diabetes, your mother, your father, a sibling, brother or sister has diabetes.

Number three if you've previously had a very large baby such as a nine pound baby or greater, then you're more likely to develop gestational diabetes. If you've had a previous loss, a previous stillbirth or if you are overweight, those are all increased risk factors for developing gestational diabetes. If you do have one of those risk factors, most likely your OB provider will want to screen you at your first prenatal visit. So that very first time that you come in, either in your first or early second trimester, you will undergo screening for diabetes. If you are diagnosed with gestational diabetes you will work with your OB provider and most likely a group of other specialized providers.

Someone such as myself a maternal field medicine or a high risk pregnancy doctor. You might also work with a dietitian, a diabetic educator or even a doctor who specializes in diabetes. We will work with you on your diet, exercise and possibly blood sugar monitoring and treatment if necessary. What we usually like you to do is to have three small meals with three snacks in between each meal.

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We also usually like you to count your carbohydrates, about 40% of your diet everyday should be carbohydrates and about 20% protein and your OB provider can go over that more with you. We also like you to have exercise but first you have to ask your doctor to make sure that the exercise that you're going to do is appropriate for your pregnancy. Good exercises are walking, swimming. Swimming is a great exercise for pregnancy, you want to avoid jogging, running or a certain kind of weight lifting, so make sure you check with your doctor first. Usually we suggest about three exercise periods per week of about 20 to 45 minutes each. Then we also suggest that you have blood sugar monitoring, where your OB provider will teach you how to do finger sticks to check your blood sugars.

We ask you to do them fasting, so first thing in the morning before you wake up. Before you've had anything to eat or drink and we also ask you to check anywhere between one to two hours after each meal, the values that you're looking for are your fasting should be anywhere between 60 to 95 and two hours after your meal should be below 120. About 60 to 70% of pregnant women with gestational diabetes will be able to control their diabetes just with diet and exercise. Unfortunately the remaining 30 or 40% will need medical treatment and this is either with oral hypoglycemic agents or insulin.

What I've just said is basically if you're not able to control your blood sugars with diet and exercise you will either need pills for your diabetes or you'll need to give yourself insulin shots. The most common pills that we give for diabetes in pregnancy are Glyburide or Metformin. Insulin if you need it, you will be taught how to give yourself the insulin injections and you'll usually give yourself insulin anywhere from one to three or four times a day depending on your blood sugars. In addition to monitoring your blood sugars and exercising and maintaining your diet and a healthy lifestyle we will also need to monitor the baby. So, you will have very specialized ultrasounds, looking at the baby's growth and well being. You may need to have specialized testing of the baby, to make sure that the baby is in good health. Usually around eight months of pregnancy, somewhere between 32 to 36 weeks.

3. Your Key To Success: GESTATIONAL DIABETES DURING PREGNANCY!!

They're often done one to two times a week and they're either done by ultrasound, which is called a Biophysical Profile or BPP. Where it's actually an ultrasound examination of the baby, looking for the baby's movement, the tone of the muscles, breathing movements, things like that, or what we call a non stress test or a NST test. Where they put you on a fetal heart rate monitor and they monitor the baby's heartbeat for about 20 or 30 minutes. In addition depending on how you're doing in your pregnancy, you may need to be delivered a little early. If you're diagnosed with gestational diabetes, there are several things that are very important. Number one you need to work with your OB provider and the rest of your specialized team in order to control your diabetes. Number two you should know what your blood sugars are, and you should know what values or what number your OB provider wants you to achieve, that's very important. Number three you need to keep a blood sugar log everyday that includes not only your blood sugars but what you ate that day, what exercises you did.

If anything unusual happened. Number four you should maintain your diet and you may need some extra help from the diabetic educator or your doctor. In working with you to achieve a good diet. And number five you wanna make sure that you exercise properly, and number six you wanna pay attention to your doctor's recommendations and make sure that you follow your provider's recommendations. Gestational diabetes most likely will not hurt you or your baby, and that depends on how well controlled you are or how high or how low your blood sugars are. If you're well controlled, most likely you will not have any problems during the pregnancy and neither will your baby.

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If you're poorly controlled, if your blood sugars are high or you're not following your diet then you may have complications from pregnancy. The complications that you yourself can have will be elevated blood pressures or hypertension, you can get preeclampsia, which is a disease that only occurs in pregnancy. It causes your blood pressures to go up, you have spasms in your blood vessels throughout your body. You can have seizures, you can have kidney damage, things like that, you may develop polyhydramnios which is too much fluid in the womb and that can cause you to go into pre-term labor, or your placenta can separate early. Problems that the baby can have, the baby can be too big, so it could be a nine, 10, 11 pound baby and it's not a healthy big baby.

It's an unhealthy big baby. So we're not looking at -- the baby is not a healthy football player size baby that has good muscle tone and very little fat. This is a baby that has a lot of fat, a lot of subcutaneous tissue and is unhealthy. At birth the baby can have jaundice, it can have breathing problems, it can low blood sugars because the baby has been used to having -- to being exposed to high blood sugars, that you as the mom are having high blood sugars that gets transferred to the baby as high blood sugars. So the baby's pancreas produces insulin in order to decrease those sugar levels and so when the baby is born, the baby's pancreas is still producing a lot of insulin and so the baby is no longer getting all that extra sugar from his or her mom and the baby's blood sugars go down.

The baby can actually have enough problems that the baby can expire after birth from diabetes related complications. Gestational diabetes usually goes away after delivery in most cases. And a lot of it depends on how well controlled you are during your pregnancy, whether there are other risk factors that you may have, whether you are overweight. Anytime that you have gestational diabetes your OB provider will check for regular or type two diabetes after you deliver, this is usually done at your postpartum visits somewhere around six to eight weeks. And in this you get a 75 gram glucose test, so it's that same orange sugary drink and what they do is they test your fasting sugar. So before you have anything to eat or drink, they test it one and two hours. And then if those values are abnormal you have type two diabetes, unrelated to your pregnancy.

Unfortunately up to 50% of women who have gestational diabetes will develop type two diabetes at some time during their lifetime, most often within the first 10 years. Ways to decrease your risk would be to live a healthy lifestyle, have a healthy diet, a healthy weight and then work with your provider. If you are overweight, if you lose weight, that dramatically decreases your risk of developing type two diabetes later on in your life. If you are diagnosed with gestational diabetes, don't panic, the most important thing to do is to listen to your OB provider, and follow his or her recommendations. Maintain a healthy lifestyle, follow your new diet, watch your blood sugars, exercise, and enjoy your pregnancy.

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