Gestational Diabetes Prevention

Introduction

During pregnancy, women experience a variety of metabolic and physiological changes. This normal shift can also increase blood sugar levels on a temporary basis. However, excessive levels of blood glucose during pregnancy indicates the presence of a health condition known as gestational diabetes.

Gestational diabetes is a transient form of diabetes mellitus which is associated with multiple risk factors ranging from being prediabetic, having a family history, obesity, and much more. The causes of gestational diabetes are still not fully comprehended. Fortunately, it is completely manageable by making healthier options, and choosing the right course of treatment can help to prevent the chances of developing future complications.

What is gestational diabetes?

Gestational diabetes (GDM) is a type of diabetes mellitus that temporarily develops during pregnancy, affecting women who have never been diagnosed with diabetes before.

Women typically experience a lot of bodily changes throughout the pregnancy phase. Gestational diabetes is defined as when the body is unable to handle elevated blood glucose levels due to hormonal changes that happen during pregnancy.

Under normal body function, glucose acts as the primary source of energy in the body and is regulated by a key hormone called insulin. Insulin manages blood sugar levels by delivering glucose to the cells. However, during pregnancy, the placenta (which connects the mother and the foetus) produces hormones that impair the maternal insulin action, causing glucose buildup in the circulation. This is generally referred to as insulin resistance

As the placenta grows larger, more hormonal production is induced, which demonstrates a much greater risk of insulin resistance.

A certain amount of insulin resistance is considered normal during pregnancy since it allows sugar to stay in the blood so the baby can access the nutrients.

Generally, the pancreas is able to adjust by producing additional insulin to overcome the condition. In some cases, the elevated levels of placental hormones may become too overwhelming for the pancreas to compensate for the insulin deficiency, resulting in gestational diabetes.

Gestational diabetes is common among females and can occur at any pregnancy stage. But it is more likely to happen during the second or third trimester. According to Diabetes UK, gestational diabetes affects nearly 4–5 out of every 100 women during their pregnancies.1

Symptoms

In most cases, women don't observe any noticeable signs or symptoms. It is usually determined when blood glucose levels are checked for gestational diabetes. Some women may experience the symptoms such as:

  • Increased thirst
  • The unusual urge to urinate, especially at night
  • Feeling more tired than usual
  • Genital itch
  • Increased weight gain
  • Blurred vision

Some of these symptoms are often associated with a healthy pregnancy. To detect concerns about gestational diabetes, it is advised that you converse with your doctor.

How can you reduce your risk of developing gestational diabetes?

The most effective way to lower the risks of developing gestational diabetes is to make preparations for the pregnancy by adapting to a healthier lifestyle and carefully monitoring the blood glucose levels if gestational diabetes is diagnosed. Moreover, lifestyle interventions can help to reduce the chances of developing future complications related to the mother and baby's health. It is always best to talk with your doctor to identify risk factors and manage them accordingly to ensure a healthy pregnancy. The following are the key factors that may assist in reducing the chances of gestational diabetes.

Maintain a balanced diet rich in foods with a low GI index

The Glycemic index (GI) is a rating system for carbohydrate-containing foods. It specifically measures how much consumed carbohydrates boost the sugar levels in the bloodstream. If you are at a high risk of having diabetes during pregnancy, it is safer to evaluate your food intake to limit the high spike in blood sugar. The right choice of carbohydrates can help to prevent various chronic conditions, including diabetes and cardiac problems.

It is essential to consider healthy, balanced dietary plans to control blood glucose during gestational diabetes. Swapping low GI index category foods is a prospective alternative for slow, constant effects rather than high glycemic foods. High GI index foods can cause rapid spikes in blood sugar levels, which can be harmful to the health of both the mother and the infant during gestational diabetes.

The GI index can be classified into three categories, as follows:

  • Low glycemic index (GI of 55 or less): Mostly consists of fruits and vegetables, whole wheat pasta, minimally processed grains, low-fat dairy foods, pulses, and beans.
  • Medium glycemic index (GI 56 to 69): Sweet potatoes, yams, corn, white rice, and breakfast cereals. 
  • High glycemic index (GI of 70 or higher): high sugary foods, white bread, cakes, processed potatoes, doughnuts, croissants, and packaged breakfast cereals.

Implement mild/moderate exercise daily

Regular physical activity has a positive impact on reducing the chances of gestational diabetes. A study showed that women who remain physically active, regardless of their weight, are less likely to develop gestational diabetes in comparison to women who do not exercise much.2

Implementing at least 30 minutes of mild to moderate exercise can help lower blood glucose levels. Physical activities like swimming, brisk walking, and cycling are considered the most suitable options during pregnancy.

However, performing extensive exercises might cause complications. It is advised to ask your gynaecologist about the types of physical activities suitable for your health needs.

Maintain a healthy weight

Obesity is one of the major factors associated with GDM. Due to rising incidence, particularly among obese females of reproductive age, it is documented that nearly 2-18% of pregnancies are globally affected by gestational diabetes, which can advance to type 2 diabetes.3

If you are planning to have a baby, it is best to consider weight loss and manage your calories. Losing a few pounds prior to pregnancy can reduce the risks of gestational diabetes.

Additionally, enhancing the nutritional quality and physical activity levels when pregnant might result in significant changes in the body.

In order to maintain a healthy weight, the following steps can assist in preventing gestational diabetes: 

  • Improve your dietary intake. Plan your meals into small portions. 
  • Engage in regular physical activity (example: low impact aerobics), or at least 3–4 times per week. 
  • Discuss your condition with your doctor for a healthy pregnancy. Early screening tests can help to identify the risk factors related to gestational diabetes.

Summary

Gestational diabetes is a temporary condition that affects blood glucose levels during pregnancy. Gestational diabetes typically occurs when placental hormone production impairs maternal insulin action, leading to insulin resistance. It is common and usually subsides after delivery. However, poorly managed GDM can risk future complications for both the mother and the baby.

With the help of lifestyle interventions such as controlling blood sugar levels, regular exercise, nutritional calorie intake, and doctor's recommendations, gestational diabetes is completely preventable. Adopting healthy habits before and during pregnancy can significantly affect having a healthy pregnancy and also reduce the chances of advancing risk factors.

References

  1. Diabetes UK. What is gestational diabetes? [Internet]. Diabetes UK. 2017.
  2. Institute for Quality and Efficiency in Health Care. What can help prevent gestational diabetes? [Internet]. Nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG); 2017.
  3. Koivusalo SB, Rönö K, Klemetti MM, Roine RP, Lindström J, Erkkola M, et al. Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL). Diabetes Care. 2015 Jul 29;39(1):24–30.

Sadaf Ahmed

Master of Science - MSc, Physiology, Clinical & Molecular Hematology, Karachi University, Pakistan

Sadaf is an experienced writer who creates a quality and well-researched scripts particularly related to Health Sciences.

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