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Gestational Diabetes

What is gestational diabetes?

Gestational diabetes is the development of diabetes during pregnancy. Although the symptoms disappear after the baby is born, according to the U.S. Centers for Disease Control, about half of all women diagnosed with gestational diabetes will develop type 2 diabetes later in life. Diabetes occurs when the body does not produce or properly use insulin, a hormone necessary to convert sugar, starches and other food into the energy needed for daily life. According to the National Institutes of Health, gestational diabetes occurs in about 5 percent of all pregnancies in the United States, resulting in about 200,000 cases a year.

What are the symptoms?

Most women have no symptoms at all, although in rare cases, excessive thirst and increased urination may occur. However, when gestational diabetes develops, women are at increased risk of high blood pressure throughout the pregnancy as well as at increased risk of having a large baby and needing a cesarean section at delivery.

What are the causes?

Hormones produced by the placenta to sustain pregnancy can make cells throughout the body more resistant to insulin. The placenta produces more and more of these hormones as pregnancy progresses making it harder for insulin to “unlock” cells so that glucose can enter. Gestational diabetes is most likely to develop during the last three months of pregnancy when hormone production by the placenta is at its highest.

Risk factors for gestational diabetes (besides being pregnant) include being overweight (the more overweight you are, the higher your risk), a family history of diabetes, your age (women over 25 have a higher risk), having had gestational diabetes during a previous pregnancy, having had a stillbirth or a very large baby with a previous pregnancy, or a history of abnormal glucose tolerance. In addition, the following ethnic groups are at high risk for diabetes of all types: Hispanic, African-American, Native American and Pacific Islander.

What is the conventional treatment?

Treatment involves dietary measures, exercise and, in some cases, insulin injections. Your doctor may refer you to a dietician or diabetes educator who will design a meal plan to help keep blood sugar in your target range. This may involve:

  • limiting sweets and other carbohydrate-rich foods.
  • eating three small meals and one to three snacks daily.
  • making sure that you get fiber with your meals in the form of fruits, vegetables, and whole-grain cereals, crackers and bread.

What therapies does Kelley recommend for gestational diabetes?

  • Dietary changes: Since being overweight can cause cells to become resistant to insulin, not gaining excessive weight during pregnancy can make a big difference. In addition, try to keep your blood sugar in a healthy range by eating small frequent meals. Learn about the glycemic index of carbohydrate foods and choose foods that are low on that scale. Mostly that means avoiding refined and processed carbohydrates. Also, learn about the glycemic load.
  • Exercise: Regular physical activity is the single most important thing you can do to support a healthy pregnancy. Every pregnancy is unique, and there are stages of pregnancy when particular exercises will be especially helpful, and when some types should be avoided. Talk with your OB-GYN about his or her recommendations and any restrictions.
  • Supplements: All pregnant women should be taking a prescribed prenatal vitamin,
    and should also supplement with fish oil or another source of omega-3 fatty acids
    to help support the nervous system of their developing child.

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