What is Gestational Diabetes?

Did you know that Gestational Diabetes is a thing?  Many of us have never heard of it, until we go for our GDM (Gestational Diabetes Mellitus) testing at around week 28 of our pregnancy. In this blog post, we’ll give you a little overview of what Gestational Diabetes is, what it isn’t, and how we work with GDM patients in our practice. As always, we’re here to help! Please feel free to get in touch with any questions.

Please note that this blog post does not constitute medical advice.  For more information on your own specific health, please contact your healthcare provider.  

What is Gestational Diabetes?

Gestational diabetes (GDM) is a relatively common condition that women experience while pregnant and it usually resolves in the postpartum period. Recent research suggests that roughly 13% of pregnant people will get GDM during their pregnancy.

At its most basic, the body uses sugar for energy. In order for the body to use this sugar (otherwise known as Glucose), you need insulin. The insulin releases the sugar from your bloodstream into your cells, where it can be used. When you’re pregnant, you may become less responsive to insulin – this means your body would require more insulin in order to get the glucose out of your bloodstream and into your cells. When your body becomes less resistant to insulin, it’s known as insulin resistance. Your body almost always tries to help you overcome this by secreting more insulin, but sometimes that’s not enough…and that’s when you may be diagnosed with gestational diabetes.

Effects of Gestational Diabetes

Some of the effects of gestational diabetes include:

  • Possible pre-eclampsia
  • Higher c-section rate because of potentially larger babies – though this is less of a risk if the GDM is well controlled during pregnancy
  • Hypoglycemia once your baby is born
  • Increased risk of developing type 2 diabetes after baby is born/later in your life
  • Increased shoulder dystocia/brachial plexus injury in baby – again, this is if the diabetes is not well controlled throughout pregnancy and your baby is large

Risk Factors for Gestational Diabetes

Increased risk factors for gestational diabetes include:

  • Personal history of GDM
  • Family history of diabetes
  • Over 35 years old
  • Pre-pregnancy BMI over 30
  • History of PCOS, acanthosis nigricans
  • Corticosteroid use
  • Member of a high-risk population (ex. Aboriginal, African, Asian, Hispanic, South Asian)
  • Previous baby over 9lbs

Screening for Gestational Diabetes

In Canada, screening usually happens between 24-28 weeks in higher risk moms. It begins with an oral glucose challenge test (OGCT) where you’re given a super sweet 50g glucose drink, and your blood glucose is measured 1 hour later. If the results come back positive, then you may be at risk for gestational diabetes.

The diagnostic test for GDM is known as the oral glucose tolerance test. Your fasting blood glucose will be measured and then you’re given a 75g glucose drink. After consuming the beverage, your blood sugar will be measured for the next 2 hours. If you get 1 abnormal blood glucose value, you’ll be diagnosed with GDM.  

Managing GDM

GDM can be remarkably well managed through diet and lifestyle, and depending on your risk factors and blood glucose levels, your midwife or Ob/Gyn will choose your best course of treatment.

Some diet and lifestyle tips include:

  • Be super critical about the types of carbohydrates you’re eating.
    • Consider swapping out simple carbohydrates (like cookies and cake) with complex carbohydrates (sweet potato, brown rice, berries).
  • Include high fibre foods in your diet like: vegetables, beans, legumes, and fruit.
  • Be sure you’re pairing your meals and snacks with protein and fat to keep your blood sugar balanced.
  • Being active during pregnancy helps with glycemic control and can improve outcomes in both mom and baby. Pregnant women without medical and/or obstetrical complications should aim for 150 minutes of movement per week. Women with GDM, should be engaging in some type of movement at least 3-7 days per week.
  • Myo-inositol is a relative of the vitamin B family and supplementation in pregnancy has lowered the risk of GDM development, blood glucose levels and other fetal outcomes (ex. birth weight, preterm delivery, etc.).

Working with a Naturopathic Doctor (ND)

It’s worth noting that while gestational diabetes technically means “gestational” – during pregnancy – there is the risk of getting type 2 diabetes a few years later.

Naturopathic Doctors can help you manage this condition, and take the guesswork out of what you should be eating or supplementing with! Our Naturopathic Doctors, Dr. Alexsia and Dr. Kinga work with women who have gestational diabetes, and would be happy to work with you! You can book an appointment with either of them here.

References

Berger, Howard et al. “Diabetes In Pregnancy”. Journal Of Obstetrics And Gynaecology Canada, vol 38, no. 7, 2016, pp. 667-679.e1. Elsevier BV, doi:10.1016/j.jogc.2016.04.002.

Brawerman, Gabriel M., and Vernon W. Dolinsky. “Therapies For Gestational Diabetes And Their Implications For Maternal And Offspring Health: Evidence From Human And Animal Studies”. Pharmacological Research, vol 130, 2018, pp. 52-73. Elsevier BV, doi:10.1016/j.phrs.2018.02.002. Accessed 24 Jan 2019.

Di Biase, N. et al. “Review Of General Suggestions On Physical Activity To Prevent And Treat Gestational And Pre-Existing Diabetes During Pregnancy And In Postpartum”. Nutrition, Metabolism And Cardiovascular Diseases, 2018. Elsevier BV, doi:10.1016/j.numecd.2018.10.013. Accessed 23 Jan 2019.
Crawford, Tineke J et al. “Antenatal Dietary Supplementation With Myo-Inositol In Women During Pregnancy For Preventing Gestational Diabetes”. Cochrane Database Of Systematic Reviews, 2015. Wiley, doi:10.1002/14651858.cd011507.pub2.


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