Gestational Diabetes: Dealing Day-to-Day

Gestational diabetes affects many pregnant women. It can be a silent condition, with no obvious symptoms, but it can have serious consequences. Gestational diabetes has been linked with numerous problems for the child and the mother, during pregnancy and after the baby has been born. There is no sure way to prevent, but you can take steps to reduce your risk. And treatment can keep your blood sugar under control and help you have a safe delivery.

1. Know your risk. Understanding the potential causes and risk factors involved in gestational diabetes can greatly help you to understand the condition and your risk of developing it. Women at high risk of gestational diabetes benefit from earlier screening for the condition.

There is no single cause for gestational diabetes. Scientists believe that an important factor is the hormones produced by the placenta. These natural chemical messengers interfere with another hormone called insulin. An abdominal organ called the pancreas makes insulin to help regulate glucose (blood sugar), the body's main fuel.

Factors that contribute to this insulin resistance include being obese, overweight or physically inactive. Many racial and ethnic groups are also at greater risk for gestational diabetes, including Hispanics, African Americans, Native Americans, South and East Asians, Pacific Islanders and indigenous Australians. Other factors that increase the chance of developing the condition include:

Being 25 or older
Having a family history of diabetes
Having polycystic ovarian syndrome
Having prediabetes
Having had gestational diabetes in a previous pregnancy
Previously giving birth to a stillborn baby or baby over 9 pounds
Having too much amniotic fluid

Genetics may play a role in the development of gestational diabetes. Researchers have identified a gene variant called calpain-10 that might lead to it. Other factors that might increase the risk of gestational diabetes include sleep apnea, gum disease and short stature, according to some research.

2. Undergo screening. Gestational diabetes may cause no apparent symptoms, but blood tests reveal its presence. Most women are screened for gestational diabetes between the 24th and 28th weeks of pregnancy. Testing takes place at this time because the placenta is producing increased levels of hormones that sometimes lead to insulin resistance.

High-risk women are checked for gestational diabetes earlier, such as at their first prenatal visit. If the results are normal, these women are usually checked again later. Women with no risk factors for the disorder might not be tested for it.

3. Watch what you eat. A nutritious diet is an essential part of managing gestational diabetes and maintaining a healthy pregnancy. Meals and snacks play a big role in determining glucose levels.

In general, a diet for a woman with gestational diabetes contains foods that are high in nutrition and low in fat and calories so as to control weight gain. A recommended diet usually includes more vegetables, fruits and high-fiber whole grains, adequate protein and water, and less sugar and saturated fat. Important nutrients include folate (folic acid), calcium and iron. Several small meals and snacks throughout the day may be advised rather than two or three large meals.

No single diet is right for every woman. A knowledgeable team of medical professionals can design the correct diet for an individual woman based on her glucose level, activity level and weight. This team of medical professionals may include a doctor, registered dietitian, nutritionist, certified diabetes educator, or any combination of these.

4. Exercise. Staying fit and active before pregnancy improves a woman's chance to have a healthy pregnancy and a healthy baby. Furthermore, most pregnant women, and especially those with gestational diabetes, can benefit from continuing to exercise throughout their pregnancy. Exercise is strongly linked to lowering glucose, such as by helping to move sugar from the blood to cells of the body, lowering the body's sensitivity to insulin and using less insulin to transport glucose. In some cases, exercise and diet can avert the need for insulin injections to treat gestational diabetes.

Regular physical activity can also help improve a woman's general health and reduce symptoms associated with pregnancy and delivery. In addition, women who maintain high levels of fitness during pregnancy may more quickly return to their pre-pregnancy health, figure and weight after their babies are born.

The American College of Obstetricians and Gynecologists recommends that pregnant women engage in moderate exercise for at least 30 minutes on most days of the week. Women should consult with their doctor before beginning an exercise routine. Certain forms of exercise are more appropriate during pregnancy than others.

In addition, pregnant women need to adjust their exercise routine because of changes associated with their pregnancy. Failure to do so can leave a pregnant woman more vulnerable to injury. However, in most cases, a well-planned exercise routine can provide health benefits that far outweigh the risks associated with exercising during pregnancy. A doctor can give individually tailored advice about the exercise routine, including the necessary changes throughout pregnancy.