Gestational Diabetes Mellitus is the development of high blood sugar levels during pregnancy. It is shown to affect 15% of all pregnancies globally. In 2019, the prevalence of gestational diabetes has been reported from 3.8% to 17.9% in different parts of India. Gestational diabetes like type 2 Diabetes Mellitus, is an insulin resistant state.
Glucose is known to be the main source of fuel for the body, while the hormone insulin plays the key role in bringing glucose from the bloodstream into the cells in order to be used as energy for the body. When the cells of the body stop responding to insulin and the pancreas begins making more insulin in order for the cells to respond, eventually the body faces an imbalance and the blood sugar levels sharply begin rising instead. This process is known as Insulin resistance.
During pregnancy the mother’s body naturally tends to use more fat for itself instead of carbohydrate for energy. This is done by her body in order to make carbohydrate available for the growing fetus instead. In order to keep sufficient stores of glucose in the bloodstream for the use of the growing fetus, the mother’s body tends to shift towards the insulin resistive state during pregnancy. To maintain this balance between the mother & fetus’s body, the pancreas increases insulin production as well.
Complications, more specifically sugar levels beyond permissible limits begin to rise during pregnancy when the mother’s diet and lifestyle do not help in balancing these hormonal insulin changes and pregnancy naturally occurring insulin resistive changes. Research also indicates that having
gestational diabetes during pregnancy increases the risk of developing type 2 diabetes within 5-10 years by a whopping 60%.
Risk factors leading to the possibility of gestational Diabetes include:1. Family History of Type 2 Diabetes.
2. Maternal Age over 35 years
3. Long term use of Oral Contraceptives
4. Maternal obesity
5. Vitamin D deficiency
6. Previous history of gestational diabetes in previous pregnancies
7. Smoking
8. Stress and emotional disturbances
9. Asian Origin
10.Hormonal Imbalances like PCOS, Hypothyroidism
While these risk factors increase the chances of developing gestational diabetes, it is important to note that 44% of women who develop high sugar levels during pregnancy have been found to not possess any of these risk factors globally. Hence an active pregnancy & practicing moderation with diet has proven to be the key to reducing chances of gestational diabetes whether predisposed to the condition or not.
Screening for diabetes mellitus during pregnancy is normally carried out in the second trimester, between week 24-28. This is also done during these specific weeks as this coincides with the natural insulin resistive surge that is known to occur during pregnancy as part of the mother’s body naturally trying to balance the glucose needs for both her and the baby(process as mentioned above at the start of the write up).
Gestational Diabetes poses a threat to both the mother & baby. The abnormally high levels of glucose in the mother’s blood result in more glucose being delivered to the fetus.
Higher glucose in the unborn baby can lead to their excessive growth termed as macrosomia. During a vaginal birth, the baby’s being larger can result in an injury to both the mother and/or the child. The baby’s head may enter the canal but the shoulder may get stuck- a dreaded delivery complication in
the labor room.
Chances of a C-section delivery are also higher in women with Gestational Diabetes since the baby could be larger and the mother’s blood sugar levels may be unstable. It has also been found that post-delivery such newborns often suffer from initial low blood sugar levels as excessive insulin in their body was produced during gestation to compensate for the excessive blood sugar in the mother’s body.
Tips to keep blood sugar levels under control during pregnancy:1. Avoid large meals, instead opt for three well balanced meals with two small snacks.
2. Avoid skipping breakfast, as the first meal of the day will help stabilize blood sugar levels and stop you from overeating.
3. If you find yourself constantly hungry, increase protein in meals and up the water intake.
4. Focus on leafy greens, non-starchy vegetables, one serving of carbohydrate per meal, with high-quality protein and fat.
5. A pinch of cinnamon to warm water is proven to help balance blood sugar levels.
6. Focus on at least 30 minutes of activity a day, in the form of a walk, prenatal yoga, stretches or a swim. Exercise is known to delay the need of insulin in the body.
(By Dr. Vanshika Gupta Adukia, Pregnancy/Childbirth Expert, Pelvic Floor Physiotherapist, Founder of Therhappy)
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