Gestational Diabetes

What is gestational diabetes?
Gestational diabetes is a type of diabetes that starts during pregnancy. If you have diabetes, your body isn't able to use the sugar (glucose) in your blood as well as it should, so the level of sugar in your blood becomes higher than normal.
Gestational diabetes affects about 4% of all pregnant women. It usually begins in the fifth or sixth month of pregnancy (between the 24th and 28th weeks). Most often, gestational diabetes goes away after the baby is born.

How can gestational diabetes affect me and my baby?
High sugar levels in your blood can be unhealthy for both you and your baby. If the diabetes isn't treated, your baby may be more likely to have problems at birth. For example, your baby may have a low blood sugar level or jaundice, or your baby may weigh much more than is normal. Gestational diabetes can also affect your health. For instance, if your baby is very large, you may have a more difficult delivery or need a cesarean section.

What can I do if I have gestational diabetes?
You will need to follow a diet suggested by your doctor, exercise regularly and have blood tests to check your blood sugar level. You may also need to take medicine to control your blood sugar level.

What changes should I make in my diet?
Your doctor may ask you to change some of the foods you eat. You may be asked to see a registered dietitian to help you plan your meals. You should avoid eating foods that contain a lot of simple sugar, such as cake, cookies, candy or ice cream. Instead, eat foods that contain natural sugars, like fruits.
If you get hungry between meals, eat foods that are healthy for you, such as raisins, carrot sticks, or a piece of fruit. Whole grain pasta, breads, rice and fruit are good for both you and your baby. It's also important to eat well-balanced meals. You may need to eat less at each meal, depending on how much weight you gain during your pregnancy. Your doctor or dietitian will talk to you about this.

Why is exercise important?
Your doctor will suggest that you exercise regularly at a level that is safe for you and the baby. Exercise will help keep your blood sugar level normal, and it can also make you feel better. Walking is usually the easiest type of exercise when you are pregnant, but swimming or other exercises you enjoy work just as well. Ask your doctor to recommend some activities that would
be safe for you.
If you're not used to exercising, begin by exercising for 5 or 10 minutes every day. As you get stronger, you can increase your exercise time to 30 minutes or more per session. The longer you exercise and the more often you exercise, the better the control of your blood sugar will be. You do need to be careful about how you exercise. Don't exercise too hard or get too hot while you are exercising. Ask your doctor what would be safe for you. Depending on your age, your pulse shouldn't go higher than 140 to 160 beats per minute during exercise. If you become dizzy, or have back pain or other pain while exercising, stop exercising immediately, and call your doctor. If you have uterine contractions (labor pains, like stomach cramps) or vaginal bleeding, or your water breaks, call your doctor right away.

What tests will I need to have during my pregnancy?
Your doctor will ask you to have regular blood tests to check your blood sugar level. These tests will let your doctor know if your diet and exercise are keeping your blood sugar level normal. A normal blood sugar level is less than 105 mg per dL when you haven't eaten for a number of hours before the test (fasting) and less than 120 mg per dL 2 hours after a meal. If your blood sugar level is regularly higher than these levels, your doctor may ask you to begin taking a medicine called insulin to help lower it. You may be asked to see a specialist if you have to start taking insulin.

What happens after my baby is born?
You may not need to have blood tests to check your blood sugar while you're in the hospital after your baby is born. However, it may be several weeks after your baby's birth before your gestational diabetes goes away. To make sure it has gone away, your doctor will ask you to have a special blood test one or two months after you have your baby.
Even if the gestational diabetes goes away after the baby's birth, it makes you have a higher risk for diabetes in your next pregnancy and later in life. That is why it is important that you continue to exercise, watch your weight and eat a healthy diet. If you do these things, you may not get diabetes when you're older.
(AAFP)