There is no greater gift for a mother than the joy of giving birth to a healthy child.
But sometimes, for some expectant mothers, the joy and promise of the pregnancy can be clouded by the possibility that they will develop a form of diabetes called gestational diabetes mellitus (GDM).
GDM is a temporary form of diabetes, a condition in which higher than normal blood sugar levels exist in the blood. While any form of diabetes can cause problems if allowed to go untreated, the pregnant mother can, by following the advice of her doctor and with the assistance of her health care team, look forward to a healthy and happy pregnancy that will provide a great start in life for the new baby.
Gestational diabetes only occurs in about 4 to 7 percent of pregnant women but is more frequent at up to about 10 percent and above in certain higher risk populations, those of African, Hispanic and South Asian descent and even higher for pregnant women of aboriginal descent. There are some other known factors that also increase the risk, all of which are well known and monitored by the medical profession.
If it should occur, gestational diabetes commences during the second and third trimesters and lasts until the baby is delivered. It is important to treat gestational diabetes during pregnancy to avoid complications to mother and baby.
Why sugars are in the blood
Sugars are needed by the cells of the body and occur in the blood quite naturally after eating food. The primary nutrients in food are classified as proteins, fats and carbohydrates, and together with water are essential for life to exist. The main source of the sugars are the carbohydrate portion of foods such as potatoes, pastas, breads, beans, and vegetables and they are also found in sweets, candies and soft drinks. The cells of the body use the sugars as fuel to provide the energy to maintain the complex processes of life. The problem of diabetes arises when the cells cannot take up the sugars because of an impaired system of control within the body.
The ways to manage and minimize the effects of gestational diabetes are well understood but they do depend to a large degree on the cooperation and understanding of the mother to be. That is not a lot different than all types of diabetes, but in the case of GDM, the condition normally ends when the baby arrives whereas for the full diabetic it lasts for a lifetime.
The treatment of gestational diabetes
Since the condition involves higher than normal levels of blood sugars, the objective is to do what is necessary to bring them down to safe levels and keep them there, the safe levels being those normally experienced by pregnant women who do not have GDM.
Treatment usually includes the adoption of a special but easy to follow meal plan that provides adequate nutrition while controlling blood sugar levels. The right amount of physical activity and weight gain are also factors that help a successful pregnancy and these would be monitored by the doctor to ensure the intensity of the activity is reasonable and the amount and rate of weight gain is appropriate for the pregnancy and any related risk factors.
If difficulty is encountered in achieving and maintaining recommended blood sugar levels, the doctor may prescribe medication including insulin, a special type known to be safe for use during pregnancy.
It may be necessary to self monitor blood sugar levels, a simple process done with a hand held metering device, the same as that used every day by most persons with diabetes. It is easy and quick, it takes about 30 seconds to get a reading, one soon gets used to it. It is valuable because it immediately shows how close to the necessary levels that the measured blood sugars are are at the time of the reading.
The recommended target levels for blood glucose during pregnancy:
The values listed below are guidelines only and are based on publications of the Canadian Diabetes Association (CDA) dated 2008. As for everything related to diabetes, always follow the advice of the doctor. The Canadian Diabetes Association's data is equal to the best available in the world, Canada is a leader among nations in the treatment of diabetes and the CDA has an aggressive stance in promoting good practices and treatment of the disease.
Early this year, 2010, a report of gestational studies was published by Chicago's Northwestern University stating the belief of researchers that the currently accepted blood sugar levels should be lowered to reduce the risks of the disease. If this was to happen, it would increases significantly the number of cases of gestational diabetes in North America,
Target levels for most pregnant women:
· Level after fasting are: 68.4 to 93.6 mg/dL (3.8 to 5.2 mmol/L)
· Level 1 hour after eating a meal are: 99 to 139 mg/dL (5.5 to 7.7 mmol/L)
· Level 2 hours after eating a meal are: 90 to 119 mg/dL (5.0 to 6.6 mmol/L)
· A1c Levels are: 6.0 % or less
Fasting is usually for about 8 to 10 hours overnight from the last meal in the evening until before breakfast the following morning
The A1c test provides an average read of blood glucose levels during the previous 120 days and measures the percentage of hemoglobin molecules that have glucose attached to them. Hemoglobin makes up about 35 percent of blood constituents.
After the arrival of the baby, that lovely bundle of joy, a warning
When labor begins, the gestational diabetes usually ends, but if the blood sugar levels of the mother are still high at the time of birth, which means that higher than normal levels of insulin may also be in the blood of mother and baby, the baby might immediately experience a significant drop in blood sugar levels, the opposite of diabetes. The doctor will be aware of and be prepared for this and may need to give a glucose injection to the baby to avoid a seizure or other complications. For this reason it is wisest for the birth to take place in a hospital where every care for mother and baby is readily available.
In cases where GMD has been a factor, and as a precaution, it is usual to test the blood of the new baby for glucose between about 6 weeks and 6 months after birth.
It should also be noted that a mother who has had gestational diabetes has a statistically increased risk, later in life, of developing type-2 diabetes, the most common form of all types of diabetes. Knowing that, it is wise to continue to follow a healthy diet and include physical activity in a daily lifestyle. Also, check periodically with your doctor who can order a blood test to monitor for the possibility of diabetes developing. Prevention beats cure but for type-2 diabetes there is no cure anyway.
It is also recommended, in order help reduce the risks of developing type-2 diabetes at a later time, that mothers breast-feed their new baby. And check with the doctor when planning another pregnancy.
Author's Comments:
For more information on gestational diabetes, including the conclusions from the Northwestern University report, referred to above, see the article titled: "Currently Accepted Blood Glucose Levels in Pregnancy Pose Risks to Mother and Child", here: Gestational Diabetes and for many other diabetes topics see Normal Blood Sugar Levels.
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