By Virginia Kennedy, BSN, RN
A mother's dream of an easy pregnancy begins as early as the positive test result. However, about midway through five percent of pregnancies, some unwelcome news arrives: the mom has developed gestational diabetes (GD).
As the third trimester of pregnancy starts, mothers have a surge of pregnancy-related hormones, which can create "insulin resistance." This means insulin has a harder time doing its job, which is to deliver glucose (or sugar) to cells throughout the body. Instead, the glucose builds up in the bloodstream, causing high blood sugar.
If GD remains untreated or "uncontrolled," both mom and baby can have complications. Babies can be large - over nine pounds - at birth. Large babies increase the chances for a cesarean section. If the baby grows too large too fast due to the extra glucose in the bloodstream, moms can go into early labor. If delivered early, the baby's lungs may not be fully developed, causing difficulty in breathing. An early arrival can also mean the liver isn't fully developed, resulting in a yellowing of the baby's skin called jaundice.
Another complication after birth for the baby is hypoglycemia, or low blood sugar. If mom's blood sugar stays high throughout the pregnancy, the baby becomes used to those levels. After delivery, the baby can't rely on mom as sugar source, and the baby's blood sugar may drop significantly, causing hypoglycemia. The baby may need treatment to stabilize his sugar levels.
By working with their health care team and with help from their families, most moms can successfully manage GD with a mix of a balanced diet, exercise and medication. And GD is generally temporary. After the baby's birth, mom's ability to maintain normal blood sugar levels return.
Eating well: The entire family can participate in a healthy eating plan. Healthy food choices, correct portion sizes and eating regular meals benefits mom and baby, but making this a permanent lifestyle change can help the family achieve long-term health goals.
Staying on the move: Exercise is a powerful weapon in fighting diabetes. In pregnancy, safety issues like balance need to be considered when choosing a physical activity. Many moms find 30 minutes of walking or swimming every day an easy way to meet their exercise goals.
Keeping a log of your blood sugar: Moms with GD should regularly test their blood sugar and keep a log of the results to share with their health care team. The team uses the log to determine the best care plan for mom and baby and achieve a positive birthing experience.
Taking medications as needed: If healthy eating and exercise cannot adequately control the mother's blood glucose, her doctor may add medications to her plan of care.
Moms and babies with GD get some special follow-up care after delivery. Newborns are checked regularly to make sure they can regulate their blood sugar, and moms are checked at six weeks to make sure their ability to produce and correctly use insulin has returned.Moms are encouraged to keep up with their pregnancy diet and exercise plan since both contribute to overall good health for themselves and their families. Moms with GD are more are likely to develop Type 2 diabetes later in life, so starting and keeping a healthy lifestyle is particularly important to preventing Type 2.
Pregnancy is a special and wonderful time of anticipation. Don't let a manageable complication like GD hamper your experience. If you are diagnosed with GD, you can turn this into an ongoing healthier lifestyle for you and your entire family.
To learn more, give us a call at (512)324-1891.
If you or someone you know needs help managing gestational diabetes, please call Seton's Diabetes Education Center at (512)324-1891. Seton offers gestational diabetes classes several times a week in English and Spanish. The classes are held in Travis and Williamson County. These classes are covered by most insurance plans with a physician order.
Also, if you had GD while you were pregnant and are concerned about developing diabetes in the future, now is the best time to participate in a prevention seminar. Our next session is August 8, 2012 and it is free.
Nutritional counseling is another service coordinated through the Diabetes Education Center. Call (512)324- 1891 if you have nutritional concerns during pregnancy.
About the author: Virginia Kennedy is a registered nurse and diabetes educator at Seton Diabetes Education Center. She has 30 years experience in perinatal nursing and gestational diabetes before shifting her focus to diabetes education and diabetes prevention. Virginia works with all aspects of diabetes and regularly teaches diabetes education classes for gestational diabetes, Type 2 diabetes and sees persons with Type 1 diabetes.