Wednesday, September 4, 2013

Gestational Diabetes

Gestational diabetes is a form of diabetes that affects pregnant women. The symptoms are usually minor such as blurred vision, fatigue, and increase thirst and urination. However, these symptoms can signal a dangerous increase in blood glucose that can affect the lives of you and your unborn baby. Gestational diabetes is usually diagnosed through an oral blood glucose tolerance test. It can also be diagnosed through a fasting blood glucose test. If the pregnant mother’s blood sugar is elevated above 126 then the diagnosis is confirmed. Usually the mother’s blood sugar returns to normal after the baby is born. However, she is now at increased risk to developing Type 2 diabetes within the next 10 years. It is recommended that she continue to eat healthy and exercise to help prevent Type 2 diabetes.

It is important to get regular prenatal care especially if you have gestational diabetes. The increase blood sugar can put undue stress on the mother and baby. The baby will be unusually large at birth, could have hypoglycemia after birth, and can get jaundice. Babies born to women with gestational diabetes are more prone to childhood – and adult - obesity and type 2 diabetes.

Women diagnosed with gestational diabetes will need to monitor their blood sugar and make the recommended dietary changes to keep their blood glucose within normal limits. This can be done with diet alone but sometimes women will need insulin or other anti-diabetic drugs. The diet for gestational diabetes is very similar to other forms of diabetes. Women must monitor their intake of carbohydrates to keep their insulin levels working normally. Carbohydrate counting is the process of counting how many carbohydrates you are eating and balancing that with the amount of insulin you will need to inject. The process works for those on insulin and those you do not need it. The steady carbohydrate intake is the main driver of insulin production. If the amount of carbohydrates you take in is not steady blood sugar will go haywire. You will need to see a Registered Dietitian who will give you a diet that spells out how many carbohydrates you will need to consume at each meal. Following this diet will help keep you and your baby healthy.

In general, carbohydrate counting consists of choosing complex carbohydrate foods that will slowly raise blood sugar and keep spikes in check. The goal is to keep blood sugar in the normal limits and avoid wild ups and down. Be sure to eat enough calories to support you and the growth of your baby. You need to eat about 300 extra calories a day to support the extra growth. Be sure to choose high fiber, nutrient dense foods. Eating a variety of healthy fruits, vegetables, and whole grains, with some protein is the best way to keep blood sugar in check and for the fetus to grow normally. Choose foods that are filled with fiber. Aim for at least 25 grams of fiber a day. Meals should be spread out into three main meals and two snacks, while avoiding high sugar beverages, such as juice, right before bed. This raises the risk of a blood sugar spike in the middle of the night and possible hypoglycemia in the morning.  For breakfast eat a protein based meal with little carbohydrate. Insulin tends not lower blood sugar as well in the morning as at other times of the day. Eating protein will help insulin lower blood sugar more effectively.

Moderate physical activity is also recommended to help keep blood sugar in the normal limits. Ask you doctor about how much and how intense the exercise should be. Over exercising can cause more problems and should be avoided. Usually a brisk walk is all that is needed to keep mother and baby healthy. If you work out to much you risk not only injuring yourself but you risk starting preterm labor.  Be sure to drink plenty of water, at least 64oz or 10 (8oz) glasses a day, whether you exercise or not. Both you and the baby need to stay hydrated. You may need to drink more water if you sweat a lot during physical activity.

Eating when you have diabetes can be confusing. A Registered Dietitian can help make sense of it all. To contact one in your area, visit www.eatright.org.

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