A 27-week pregnant woman recently faced a challenging situation when her doctor advised her to undergo a re-examination following her gestational diabetes test. Despite her results being only slightly above the normal range, she struggled to accept the diagnosis, particularly given her lack of family history with diabetes and her minimal consumption of sugary foods. The possibility of being diagnosed with diabetes and needing to manage the condition for life left her feeling anxious about the potential effects on her unborn child.
Gestational diabetes occurs when a woman who did not have diabetes before pregnancy develops insulin resistance, often influenced by hormones from the placenta, leading to blood sugar levels that exceed the normal range.
In a healthy pregnancy, the pancreas produces enough insulin to counteract the insulin resistance induced by placental hormones. However, in gestational diabetes, the pancreas fails to secrete adequate insulin, resulting in elevated blood sugar levels.
Dr. Kwon Ha Yan, an obstetrician-gynecologist, explained, “During pregnancy, many women report feeling hungrier or experiencing drops in blood sugar. This happens because the demand for glucose increases to supply the fetus, while placental hormones can impair insulin function. Approximately 10% of all pregnancies are diagnosed with gestational diabetes, and this trend is rising, particularly as more women are becoming pregnant at older ages.”
Receiving a diagnosis of gestational diabetes makes blood sugar management critically important, as it can have adverse effects on both the mother and the fetus.
Dr. Kwon stated, “Babies born to mothers with gestational diabetes are more likely to be larger than average for their gestational age. After birth, they may experience hypoglycemia and are at a higher risk of conditions like jaundice and respiratory distress compared to infants born to mothers without diabetes.”
Research suggests that children born to mothers who had difficulty managing their blood sugar during pregnancy may face an increased risk of childhood obesity, diabetes, hypertension, and cardiovascular diseases.
Not only can this be detrimental for the child, but it can also signal issues for the mother. Dr. Kwon noted, “Research on mothers with poorly managed gestational diabetes shows that about 50% develop type 2 diabetes within ten years.”
Unfortunately, a significant challenge is that it is impossible to predict whether a woman will develop gestational diabetes, and currently, there are no specific preventive measures available.
Dr. Kwon mentioned, “While it’s challenging to identify which mothers will develop gestational diabetes, certain groups are considered high-risk. These include older women, those who are overweight, mothers expecting multiples, individuals with a history of gestational diabetes, and those who have experienced unexplained miscarriages or preterm births.”
The treatment for gestational diabetes begins with dietary changes and exercise. Maintaining a balanced diet while avoiding sugars and fructose is crucial to manage blood sugar levels effectively.
Aerobic exercise, such as walking for 20 to 30 minutes at a moderate pace, can also help lower blood sugar levels.
Dr. Kwon explained, “If gestational diabetes is deemed uncontrollable, insulin may be used immediately, with stricter management than for typical diabetes. Insulin does not cross the placenta, so it does not negatively affect the fetus; instead, it helps the mother manage her blood sugar levels effectively.”
A common misconception is that simply eating less can effectively manage gestational diabetes. However, consistently low blood sugar levels can produce ketones, which are byproducts formed when the body uses fat for energy instead of sugar.
Dr. Kwon cautioned, “Ketones can impact the mother and may harm the fetus’s brain and nervous system, making excessive fasting inadvisable. It is essential to manage blood sugar levels effectively while ensuring regular meals and exercise.”
Research indicates that breastfeeding can have positive effects for mothers who have experienced gestational diabetes.
Dr. Kwon stated, “Those with gestational diabetes can certainly breastfeed. Research shows that mothers who breastfeed tend to have better blood sugar control after giving birth.”
However, a lack of gestational diabetes diagnosis between 24 and 28 weeks does not guarantee that a woman is out of risk.
Dr. Kwon advised, “Just because a woman isn’t diagnosed with gestational diabetes during the 24 to 28-week window doesn’t mean she won’t develop it by 40 weeks. Even if she passes the tests, it’s important to manage her diet carefully by avoiding foods such as bread, snacks, fruits, and fruit juices.”
She also emphasized, “Upon examining the blood sugar logs provided by mothers, we frequently observe spikes in blood sugar levels after they consume certain dishes. Although these foods may not taste sweet, they often contain high levels of sugar. It is advisable to obtain carbohydrates from sources such as potatoes, milk, and sweet potatoes while limiting fructose intake.”