PUBLISHED: 4:36 PM on Wednesday, July 2, 2008
Gestational Diabetes can occur in expecting mothers
The first thing Amy Gordon said to her doctor after he told her the news was "How can I have diabetes? I feel fine."

Amy was 26 weeks pregnant and enjoying every bit of her pregnancy, looking forward to her baby's due date with great anticipation. With this diagnosis came visions of poking her fingers and insulin injections; not exactly how she had envisioned her first pregnancy.

How could this have happened? Amy had no family history of diabetes in her family.

Gestational diabetes is a type of diabetes that can occur in women during pregnancy. Diabetes means that blood glucose (sugar) levels are elevated above normal limits. Between 3 and 14 percent of pregnant women develop gestational diabetes. (see side-bar)

Risk factors for developing gestational diabetes:

• Women age 25 and older who are overweight

• Have a condition known as pre-diabetes,

• Have a history of gestational diabetes

• Have given birth to a baby weighing more than 9 pounds during a previous pregnancy

•Women of African American, Hispanic/Latino, American Indian or Alaska Native, Asian American or Pacific Island heritage

•Women who have a parent or sibling with diabetes

Glucose is the body's main source of energy. It comes from the digestion of foods known as carbohydrates (bread, rice, fruit, milk and yogurt, and pasta). Insulin is a hormone produced in the body's pancreas that tells glucose to move into body cells where it gets burned up - similar to a car burning gasoline for fuel.

Weight gain and changing hormones are a normal part of a healthy pregnancy. During pregnancy, the placenta surrounding the baby produces hormones to sustain pregnancy. During the second and third trimesters the placenta grows and secretes more hormones, which can impede how the body burns glucose for energy. If the placenta produces too many hormones, the insulin may not be able to move enough glucose into the cells, leading to excess glucose building up in the bloodstream.

Gestational diabetes usually develops during the second trimester. It can occur as early as the 20th week but often does not occur until later in the pregnancy.

It is recommended that screening for Gestational diabetes should take place between 24-28 weeks (or earlier if there is a high risk) as a routine part of prenatal care as there are usually no symptoms when a mother develops gestational diabetes.

Excessive glucose in the bloodstream is not good for the unborn baby or mom. It can cause babies to be born very large and with extra fat (a condition called macrosomia), making delivery difficult and more dangerous. Babies can be at risk for respiratory distress syndrome, low blood glucose (hypoglycemia) and jaundice. Women with gestational diabetes have an increased risk of pre-eclampsia, a serious and sometimes life-threatening condition characterized by high blood pressure and excessive protein in urine. The risk of delivery via C-Section also increases.

The good news is that gestational diabetes can often be controlled through meal planning, exercise, and knowing blood glucose levels. The meal plan provides guidelines on which foods to eat, how much to eat, and when to eat.

The meal plan for gestational diabetes recommends women eat 3 meals and 3 snacks a day! Most women are amazed to know they can still eat some sweets like ice cream.

Physical activity such as walking can help women reach target blood glucose levels. Exercise is the natural way to lower glucose levels.

It is valuable to know how foods affect blood glucose levels through blood metering at home. If these methods fail to help lower glucose levels, insulin is a quick and effective tool, allowing more freedom in food selection.

If planning to become pregnant, talk with your medical provider. Take the extra steps to make sure you are in good health before becoming pregnant. This will help to get your baby off on a good start.

For more information contact Cynthia Nickerson, RN, CDE at Bartlett Regional Hospital at 796-8469

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