How to Control Diabetes In Pregnancy

Gestational diabetes is a common disease that affects women who are expecting or are pregnant.If you have been diagnosed with gestational diabetes or are anxious that it could affect your pregnancy and the baby, you are not alone. Luckily, the condition is manageable through proper diet, exercise and,if necessary, taking medication which can help you keep your blood glucose or sugar levels under control. We’ll let you in on all there is to know about gestational diabetesand what you can do to keep your blood sugar levels under control in order to ensure a healthy pregnancy and to avoid complications.To keep you and your baby healthy, it is important to keep your blood sugar as close to normal as possible before and during pregnancy.

What is gestational diabetes? 

Gestational diabetes is a diabetic conditionwhere there is high blood sugar level that develops at the onset of pregnancy or during pregnancy. In other words, it is a condition that occurs in a pregnant woman who was not diabetic prior to conceiving, develops high blood sugar or glucose level during pregnancy.

Gestational diabetes affects how your cells use sugar or glucose just like other types of diabetes. Generally, your body uses a hormone called insulin that helps move sugar or glucose from your blood to your cells for energy.During pregnancy, your body hormone levels change your body to process blood sugar inefficiently. When the body is unable to generate sufficient insulin or stops using insulin, it leads to the rise in blood sugar or glucose levels. The high blood sugar level or gestational diabetes can affect your pregnancy and your baby’s health.

What are the risk factors?

There are various factors that put some women at a greater risk of gestational diabetes. These include:

• Obesity or overweight
• Sedentary or inactive lifestyles
• Polycystic ovary syndrome (PCOS)
• Poor dietary habits
• Diabetes in family member
• Ethnicity of Black, Hispanic, American Indian and Asian American
• Previous gestational diabetes

What are the complications?

Gestational diabetes can affect you and your baby’s health. If your blood sugar levels remain high during your pregnancy, you may experience some complications such as:

• Macrosomia or an extra-large baby leading to difficult delivery and injury during birth
• Fetal death or miscarriage or stillbirth in extreme cases
• You are at higher risk of developing high blood pressure during pregnancy
• You are also at greater risk of developing diabetes in later life or type 2 diabetes.

However, with your doctor’s help, you can manage and control your blood sugar level and avoid these complications. Therefore, prompt and appropriate management of sugar level when expecting is pivotal to reduce the risk for complications. It is also crucial to seek continued care both before and after baby is born.

How to manage and control blood sugar level when expecting?

There are several ways to control your blood sugar levels to keep yourself and your baby healthy during your pregnancy and delivery. These include:

• Eating a healthy diet
• Staying active or exercising
• Maintaining a healthy weight
• Monitoring of sugar levels regularly
• Taking medicine as prescribed

• Eating a healthy diet
  If you have gestational diabetes, maintaining a healthy diet may help you manage your symptoms without needing medication. 
• Foods you should eat
  If you’re diagnosed with gestational diabetes or are at risk for developing gestational diabetes, it is crucial to consume foods that are rich in folic acid, calcium and iron.  A dietitian can help create a healthy meal plan and guide you how to control your blood sugar when you are expecting. Follow the diet plan and eat healthy foods from a meal plan which should consist of 50% green vegetables, 25% lean proteins and 25% whole grains. Include foods rich in fiber and low in fat and calories in your diet. You also need to watch the portion sizes to avoid overeating.
• Foods you should avoid
  As a general guideline, however, women should avoid foods that have a lot of starch and those with a high glycemic index, because these foods tend to cause a spike in blood sugar levels. Foods you should to avoid in your gestational diabetes diet include potatoes, tapioca or sabudana, white bread, pasta, and noodles, fruits such as mango, grapes, sapota, banana, and custard apple. You should also avoid or limit your intake of  processed foods and packaged foods. Carbohydrate drinks or soft drinks that are high in sugar should be avoided to control blood sugar levels. You should also avoid eating sweetmeats during the festive season such as Diwali. However, if you cannot resist the temptation of a ladoo or barfi, make sure that you check your sugar levels before and after the consumption. This will help you understand the impact on your sugar levels and  guide you in adjusting your next meal accordingly.
• Don’t skip meals
  Eating too much at a time or eating after long gaps can cause irregularities in your blood sugar levels. So, in order to regulate your blood sugar levels, you should eat a healthy snack or small meal every 2 or 3 hours. Pregnant women are strictly warned against observing fast and taking long gaps between meals. Eating nutrient-rich foods regularly can help keep you full and you are less likely to crave less nutritious alternatives. A healthier choices for snacks are sprouts which are rich in proteins, curd and apples containing calcium, proteins and iron, boiled lentils, black chickpeas, and kidney beans with some coriander, tomatoes or onions for some flavour.
• Staying active or exercising
  Keeping yourself physically active is crucial in managing your blood sugar when expecting. Regular and moderate physical exercises such as running, walking and swimming for 30-45 minutes every day can lower your blood sugar levels and keep you fit.  It can also relieve various pregnancy discomforts such as back pain. However, if you want to begin any other physical activity, you need to consult your doctor first. Your doctor and physiotherapy team who can guide you the best exercises keeping in mind your medical history and conditions.
• Maintaining a healthy weight
  It is also crucial to watch the weight you are gaining from the time you learn that you are pregnant. Putting on some weight during pregnancy is normal and healthy. However, gaining too much weight and too quickly could be a sign of a problem and also raise your risk of gestational diabetes. Thus, it is important to discuss with your doctor about the healthy range of weight gain or the reasonable amount of weight gain that is good for you.
• Monitor Blood Sugar Levels Six Times a Day
  It is crucial for pregnant women to check their blood sugar levels at least six times a day as blood sugar levels can change very quickly. This will enable you to understand the impact of your food intake, exercise routine, and insulin, and learn how to adjust them depending on the results of your blood sugar tests.You can use a glucometer to test your blood sugar levels which is easy and handy.

The ideal blood sugar levels during pregnancy are: 

• Fasting – less than 90 mg/dl
• Pre-meal or before eating- less than 95 mg/dl
• 1 hour after meals – less than 140 mg/dl
• 2 hour after meals – less than 120 mg/dl

It is also significant to follow up with your doctors regularly, to understand whether your treatment plan needs to be modified in any way.

Medicines for gestational diabetes

In case these measures don’t affect your blood sugar levels, your diabetologist may advise you to take medicines. When the medicines are not effective in controlling the blood sugar levels, you may be suggested insulin. Insulin injections and metformin pills are safe for both the mother and the baby. Moreover, insulin is also the safest way to reduce high blood sugar levels in pregnant women which will be administered till delivery.

If you have any concerns or queries regarding gestational diabetes, consult the experts at Yashoda Hospital & Research Centre.