Gestational Diabetes Self-Care Tips and Management

What is Gestational Diabetes?

Gestational diabetes is a condition characterized by high blood sugar that starts or is first diagnosed during pregnancy. Unlike type 1 and type 2 diabetes, gestational diabetes only occurs in pregnant women and usually resolves after giving birth.

During pregnancy, the placenta produces hormones that help nourish the growing baby. But these hormones also block the action of the mother's insulin. This insulin resistance causes higher blood glucose levels, resulting in gestational diabetes in some women.

Gestational diabetes affects around 9% of pregnancies in the U.S. If left untreated, it can cause complications for both mother and baby. The good news is gestational diabetes is treatable with lifestyle changes, monitoring, and if needed, medication.

Symptoms of Gestational Diabetes

Many women with gestational diabetes have no obvious symptoms. That's why screening is recommended between 24-28 weeks of pregnancy for most women.

Possible symptoms that may prompt earlier screening include:

• Excessive thirst
• Frequent urination
• Fatigue
• Blurry vision
• Slow healing of cuts/wounds
• Recurrent infections like yeast or UTIs

Keep in mind, these vague symptoms also occur normally during pregnancy. But if they seem excessive or concerning, contact your doctor right away.

Causes and Risk Factors

The exact cause of gestational diabetes is not fully known. But some key risk factors and contributors include:

Pregnancy Hormones

Hormones made by the placenta, like human placental lactogen, estrogen, and progesterone, are essential for nourishing the baby but block the effects of the mother's insulin. This insulin resistance leads to elevated blood glucose levels.

Family History

Having a close family member with type 2 diabetes increases your risk of developing gestational diabetes. Genetics likely play a role.

Weight and Diet

Being overweight or obese before pregnancy is associated with increased risk of gestational diabetes. A diet high in processed carbs and inflammatory foods may also contribute.

Ethnic Background

Women of Hispanic, African, Native American, South or East Asian, or Pacific Island descent have a higher risk of gestational diabetes compared to Caucasian women.

Age

Older women have an increased risk of gestational diabetes compared to younger women. Women over age 25 are at greater risk.

History of Gestational Diabetes

Once you've had gestational diabetes in a prior pregnancy, your risk is higher in subsequent pregnancies. Around half of women get it again in later pregnancies.

Screening and Diagnosis

Most medical groups recommend gestational diabetes screening between 24-28 weeks of pregnancy using a two-step process:

1. Initial glucose challenge test - You drink a sugary solution then your blood sugar is checked 1 hour later.
2. 3-hour glucose tolerance test - If your blood sugar is elevated on the initial test, you'll do a longer 3-hour glucose tolerance test to confirm.

You'll need to fast for 8-12 hours before each test. Diagnosis is based on the following blood sugar levels:

• Glucose challenge test: 140 mg/dL or higher indicates you need the 3-hour test
• Glucose tolerance test: 2 or more elevated levels means you have gestational diabetes

Early screening may be recommended if you have risk factors like obesity, family history, previous gestational diabetes, or belong to a high-risk ethnic group.

High-Risk Groups

Screening in the first trimester is sometimes done for those at very high risk for developing gestational diabetes. This includes:

• Severely obese (BMI over 35)
• History of unexplained stillbirth
• Known impaired glucose metabolism
• Diabetes in first degree relative

Your doctor can help determine if earlier screening is appropriate based on your health profile and risk factors.

Potential Complications

Untreated or poorly controlled gestational diabetes can increase the risk of problems for both mother and baby. Some potential complications include:

For Mother

• Preeclampsia - high blood pressure in pregnancy
• Preterm delivery
• Cesarean delivery
• Future Type 2 diabetes risk

For Baby

• Excessive growth (macrosomia)
• Birth injuries due to large size
• Low blood sugar after birth
• Respiratory distress syndrome
• Future obesity and diabetes risk

Thankfully most complications can be avoided with vigilant monitoring of blood sugar, lifestyle changes, and treatment when needed.

Treatment and Management

Treatment for gestational diabetes focuses on controlling blood sugar through medical nutrition therapy, physical activity, and if needed, medication or insulin therapy.

Medical Nutrition Therapy

The main treatment approach is following a meal plan designed to help maintain healthy blood sugar levels. A registered dietitian can create a customized nutrition plan just for you.

General guidelines usually include:

• Eating regular meals and snacks
• Limiting carbohydrates to 35-45% of total calories
• Choosing high fiber, low glycemic index carbohydrates
• Getting adequate protein at meals and snacks
• Balancing carb intake with physical activity

Your dietitian may provide sample meal plans or carb counts to guide your food choices for meals and snacks.

Physical Activity

Along with your diet, a regular exercise routine helps improve insulin sensitivity and blood sugar control. Try to get at least 20-30 minutes per day of moderate activity like walking, swimming, or stationary cycling.

Strength training 2-3 days per week also helps improve insulin response. Stay well hydrated and listen to your body to avoid overexertion.

Blood Sugar Monitoring

Checking your blood sugar regularly lets you see how well your treatment plan is working. Typical testing includes:

• Fasting blood sugar - Check first thing when you wake up before eating
• 1-hour postprandial - Check 1 hour after the first bite of each meal
• Occasional 2-hour postprandial - Check 2 hours after the start of a meal

Aim for glucose levels below 95 mg/dL fasting and below 140 mg/dL after meals. Work closely with your healthcare provider to interpret your results and determine if medication is needed.

Oral Medications

If changes in nutrition and physical activity aren't enough to control blood sugar well, your doctor may prescribe diabetes pills or insulin. Some commonly used oral medications are:

• Glyburide
• Metformin
• Acarbose

These help the body produce more insulin, reduce glucose production by the liver, slow carb absorption from food, and make cells more sensitive to insulin.

Insulin Therapy

Some women require injected insulin to achieve blood glucose targets. This may include a long-acting insulin at bedtime or short-acting insulin with meals. Your doctor will teach you how to properly inject and adjust insulin doses.

The goal with any medication is to use the lowest dose needed to maintain healthy blood sugar levels and prevent complications.

Prevention

While some risk factors for gestational diabetes like family history can't be changed, you may be able to lower your risk by:

• Achieving a healthy weight before pregnancy
• Following a balanced, low-processed carb diet
• Exercising regularly pre-pregnancy and staying active during pregnancy
• Losing weight if overweight and maintaining weight loss
• Keeping blood sugar well controlled if diabetic before becoming pregnant

Getting any prediabetes or diabetes in control prior to a pregnancy can help prevent developing gestational diabetes.

Gestational Diabetes Self-Care Tips

Making lifestyle changes and closely monitoring your condition is key to minimizing risks of gestational diabetes. Here are some self-care tips:

Learn All You Can

Read up on gestational diabetes from trusted sources to understand what to expect. Learn how to track blood sugar, count carbs, and recognize signs your levels may be high or low.

Follow Your Meal Plan

Plan out carb-controlled meals and snacks. Focus on lean proteins, fiber-rich vegetables, healthy fats, and complex low-glycemic carbs. Drink plenty of water and watch portion sizes.

Check Blood Sugar Routinely

Check your fasting and post-meal blood sugar as recommended by your doctor to see if your levels stay within target ranges. Record the results to monitor patterns.

Stay Physically Active

Fit in at least 20-30 minutes per day of moderate activity like a walk after a meal. Also aim for 2-3 strength workouts per week. Move more throughout the day.

Practice Stress Management

Find healthy ways to manage stress levels like prenatal yoga, meditation, listening to music, journaling, or talking with a friend. High stress negatively affects blood sugar.

Get Plenty of Sleep

Aim for 7-9 hours of quality sleep per night. Lack of rest can disrupt blood sugar control. Go to bed and wake up at consistent times.

Monitor Baby's Growth

Go to all your prenatal visits to monitor baby's growth rate, which gives clues about blood sugar control. Report any decreased movement.

Seek Support If Needed

Reach out to loved ones, a therapist, or support group if you feel overwhelmed. Share your experience and get encouragement from other moms.

Remember, working as a team with your healthcare providers leads to the best outcome for you and your baby!

Gestational Diabetes and Future Health

For most women, blood sugar returns to normal after delivery and gestational diabetes goes away. But there are some important considerations for future health:

Increased Type 2 Diabetes Risk

Having gestational diabetes significantly raises your lifetime risk of developing type 2 diabetes, especially if you needed insulin during pregnancy. Work with your doctor on screening and prevention after delivery.

Breastfeeding Encouraged

Breastfeeding can help lower your future diabetes risk and helps stabilize your baby's blood sugar after birth. Aim to exclusively breastfeed for at least 3-6 months.

Follow-up Screening

Your physician will advise an oral glucose tolerance test 6-12 weeks after your baby is born to check if your blood sugar levels have normalized.

Maintain Healthy Lifestyle

Eating healthy, staying active, and keeping your weight in check after pregnancy is key to reducing diabetes risk long-term. Seek support and resources if needed.

Working with your doctor for ongoing monitoring and preventive care helps ensure the best health for you and your baby after gestational diabetes.

The Bottom Line

Gestational diabetes is a common concern during pregnancy. But the good news is it's treatable and temporary in most cases. Close monitoring, lifestyle management, and maintaining an open line of communication with your healthcare team helps minimize risks.

Pay attention to your body, follow nutritional guidelines, stay active when possible, and keep up with screening and doctor visits. With proper treatment and self-care, you can have a healthy pregnancy and baby despite gestational diabetes.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.