Prevention
It may be possible to prevent gestational diabetes by leading a healthy lifestyle! This can include:
- Changing one’s diet if overweight/ obese
- Which involves cutting down on carbohydrates, which release sugars during digestion, but still getting enough fibre
- Eating a balanced diet to ensure the foetus receives sufficient nutrients
- Weight gain during pregnancy is unavoidable, but this should be within a healthy range depending on their weight before pregnancy. Consult with your doctor to find out what is suitable for your pregnancy!
- Having frequent exercise
- 30 minutes of moderate intensity exercise 3-4 times a week is enough!
It must be noted that one should not try to lose weight if already pregnant.
Close follow-up
After delivery, it is also necessary to follow-up on your condition to ensure that complications can be minimised! This is usually done through:
- Taking an OGTT (oral glucose tolerance test) 6-12 weeks after delivery
- This is to check if abnormal blood glucose levels remain or are resolved
- Breastfeeding your baby is also encouraged as it can reduce the risk of obesity and diabetes in children!
- Going for a diabetes screening every 1 to 3 years
- As women who have had GDM have a greater risk of getting diabetes in the future, it would be good to take such precautions for early intervention.
- Diabetes is a disease that can lead to serious health complications in the kidneys, blood vessels, eyes and nerves if not detected early or well-controlled.
- Adopting a healthy lifestyle
- This can involve being more watchful of one’s diet, having more frequent exercise, etc.
- One can follow the “My Healthy Plate” guideline if interested!
- Maintaining healthy BMI
- If one is overweight/ obese, it would be good to lose weight to have a healthy BMI, which can lower the risk of getting diabetes in the future.
- However, weight loss is a slow process, and should be done gradually.
- If planning for future pregnancy, let your doctor know about your condition.
Aside from that, your baby may be at risk of having low blood glucose (hypoglycemia) at birth, so his or her blood glucose will be tested. If he/ she is found to have low blood glucose, it will be treated until it is in normal range.
Routine Pregnancy Screening
If one has GDM, throughout your pregnancy, these are some measures that may be taken to ensure that your blood glucose levels are well-controlled, and the baby is healthy!
At antenatal visits:
- Blood pressure and urine will be checked at every visit. This is due to having an increased risk of developing pre-eclampsia (high blood pressure during pregnancy)
- Ultrasound scans performed to monitor growth of baby closely
- Regular blood glucose tests will also be performed to monitor one’s blood glucose levels
- Doctor will also provide individualised advice about the delivery method and timing which would be suitable.
Self-monitoring of blood glucose levels.
- One will need to purchase a glucometer, which is a handheld device that can scan a small amount of blood to determine blood glucose level.
- A doctor and diabetes care nurses will also provide information on:
- How to use the finger prick test:
- What the ideal glucose level should be (around 5.5mmol/l in pre-meal or fasting state, and/or 7.8mmol/l 1 hour after meal, 6.7mmol/l 2 hours after meal)
- Frequency of blood sugar monitoring: usually 7 tests/day, at least 2-3 days a week, one will be informed if their frequency should be higher!
Treatment Options
For treatment of gestational diabetes, controlling one’s diet and changing their lifestyle habits is usually the first approach taken for management of blood glucose levels. One may also be referred to a doctor who specialises in diabetes during treatment.
Lifestyle & diet
In most cases, having a healthy eating and exercise plan is sufficient to keep one’s blood glucose levels in check!
A dietitian will work with you to build an individual healthy eating plan that fulfils your needs. It is important for pregnant women to have a well balanced diet with adequate nutrition for mother and baby. This can be achieved by balancing several factors:
- State of pregnancy (what stage of pregnancy are you at?)
- Pre-pregnancy weight and BMI
- Rate of weight gain during pregnancy
- Activity levels (how much exercise do you do?)
- Blood glucose level
This will help one to manage blood glucose levels while not compromising the health and growth of the baby! The doctor will also advise you on controlling meal portion sizes and having regular meal times.
Exercise is also very important for controlling blood glucose levels and improving overall health. Pregnant women are able to engage in lighter exercises such as walking and swimming!
Aside from that, there are some nutrients which are fairly important during pregnancy:
- Folic acid
- This can be found in leafy green vegetables, yeast, and meat extracts, citrus fruits and juices (i.e. orange juice), and beans
- Iron
- There are 2 types of iron: haem iron and non-haem iron
- They can be found in both animals and vegetables!
- Iron can help to prevent anaemia in the mother, and help the baby build up his/ her iron stores
- Calcium
- It is recommended that pregnant women take 1000mg of calcium per day
- This can help to develop the baby’s teeth and bones, while maintaining one’s own calcium stores.
Medication
In some cases, diet and exercise will not be enough to control one’s blood glucose levels, and additional medications will be prescribed. This can be in the form of:
- Oral tablets (i.e. metformin, a type of drug used to lower blood glucose levels)
- Insulin injections
- Insulin is a hormone secreted by the pancreas, and it stimulates the conversion of glucose to glycogen in target cells.
- GDM is often caused by a form of insulin resistance.
Pregnancy is an exciting time full of anticipation, but it can also be a period of anxiety for expectant mothers. If you have been diagnosed with GDM, it is important to remember that you are not alone and there are steps that can be taken to ensure a healthy pregnancy for both you and your baby.
Share this information with your pregnant friends and let them know that they too can take measures to control their blood sugar levels.
References:
https://www.kkh.com.sg/news/medical-news/gestational-diabetes-mellitus
https://www.thomsonmedical.com/article/a-guide-to-gestational-diabetes/
https://www.kkh.com.sg/news/patient-care/new-care-model-for-women-with-gestational-diabetes
https://www.moh.gov.sg/docs/librariesprovider4/guidelines/cpg_diabetes-mellitus-booklet—jul-2014.pdf
https://www.cdc.gov/diabetes/basics/gestational.html
https://www.nhs.uk/conditions/gestational-diabetes/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes