Gestational diabetes does not increase the risk of birth defects or the risk that the baby will be diabetic at birth. Show
Also called gestational diabetes mellitus (GDM), this type of diabetes affects between 3% and 20% of pregnant women. It presents with a rise in blood glucose (sugar) levels toward the end of the 2nd and 3rd trimester of pregnancy. In 90% if cases, it disappears after the birth, but the mother is at greater risk of developing type 2 diabetes in the future. CauseIt occurs when cells become resistant to the action of insulin, which is naturally caused during pregnancy by the hormones of the placenta. In some women, the pancreas is not able to secrete enough insulin to counterbalance the effect of these hormones, causing hyperglycemia, then diabetes. SymptomsPregnant women generally have no apparent diabetes symptoms. Sometimes, these symptoms occur:
Importance of screeningThese symptoms can go undetected because they are very common in pregnant women. Women at riskSeveral factors increase the risk of developing gestational diabetes:
ScreeningThe Canadian Diabetes Association 2018 Clinical Practice Guidelines for the Prevention and Treatment of Diabetes in Canada recommends diabetes screening for all pregnant women, between the 24th and 28th week of pregnancy. Women with a higher risk of developing gestational diabetes should be tested earlier. Two screening methods: 1. Most centres use a method done at two separate times. It begins with a blood test measuring blood glucose (sugar) levels 1 hour after drinking a sugary liquid containing 50 g of glucose, at any time of day. If the result is:
2. The second method the oral glucose tolerance test (OGTT), with a sweetened liquid containing 75 g of glucose and three blood tests. A diagnosis is made if at least one of the three blood tests has values equal to or greater than: 5.1 mmol/L fasting Risks and possible complicationsThere are numerous risks when gestational diabetes is not properly controlled and blood glucose (sugar) levels remain high. For the mother:
For the baby:
Slight risk of:
Proper diabetes control considerably reduces the risks of complications. TreatmentWhen gestational diabetes is diagnosed, a personalized meal plan should be developed to control the mother’s glycemia Generally, a healthy diet with proper portion control and distribution of carbohydrates (sugars), as well as a healthy lifestyle (stress management, enough sleep and physical activity), are sufficient to control gestational diabetes. If blood glucose (sugar) levels remain too high, the physician will prescribe insulin injections or, in some cases, oral antidiabetics. Target blood glucose (sugar) levels for the majority of pregnant women:
The target values for controlling gestational diabetes differ from those of other types of diabetes. Importance of a balanced dietA balanced diet is essential for the control of blood glucose (sugar) levels and for a healthy pregnancy. When there is gestational diabetes, certain modifications need to be made to the mother’s diet, including to the amount of carbohydrates in each meal. A carbohydrate-controlled diet is the foundation of the treatment. It is essential not to eliminate carbohydrates completely but rather to distribute them throughout the day. Your meal planA dietitian will help you establish or modify your meal plan based on your energy needs. The dietitian will also advise you about the important nutrients to incorporate in your diet during your pregnancy:
For more information about balanced meals, consult The Balanced Plate. Importance of being physically activePhysical activity helps control diabetes during pregnancy and has numerous health benefits for pregnant women. It is recommended that most pregnant women do a total of 150 minutes of physical activity per week, ideally in at least 3 to 5 sessions of 30 to 45 minutes each. If you weren’t active before your pregnancy, start gradually. Safe cardiovascular activities (done at light to moderate intensity) during pregnancy include:
Consult your doctor before starting these activities and avoid physical activities where you risk falling, losing your balance or have sudden changes in direction (for example: soccer, badminton, etc.). Stay well hydrated before, during and after exercise, in addition to having with you at all times your blood glucose (sugar) meter and a source of rapidly absorbed carbohydrates in case of hypoglycemia. Before engaging in physical activity, your insulin dosage may have to be reduced to limit the risk of hypoglycemia. Your medical team will help you adjust your dosage as required. During the birthDuring the birth, the medical team regularly monitors the mother’s blood glucose (sugar) levels and adjusts treatment based on the readings. The baby’s blood glucose (sugar) levels are also monitored in the hours following the birth. After the birthIn the majority of cases, the diabetes disappears after the birth. However, the risk of developing diabetes in the future increases, especially if you keep your excess weight. To avoid this situation, you should maintain a healthy weight, eat a balanced diet and exercise regularly. Furthermore, it is recommended that you have a blood glucose (sugar) test between 6 weeks and 6 months after the birth to check whether your blood glucose (sugar) levels have returned to normal values. Before getting pregnant again, you should consult a doctor. BreastfeedingBreastfeeding is recommended for all women, diabetic or not. Mother’s milk is an excellent food for your infant. Breast feeding not only helps the mother lose the weight gained during pregnancy, it also reduces blood pressure and helps control blood glucose (sugar) levels and thus prevent type 2 diabetes. It also reduces the risk of obesity and diabetes later on in the child. The nutritional needs of nursing mothers are essentially the same as in the last trimester of pregnancy. It is recommanded to start breastfeeding immediately after birth to prevent hypoglycemia in the newborn, and to continue for a minimum of 6 months. See the list of high-risk pregnancy clinic (French only). Research and text: Diabetes Québec Team of Health Care Professionals Adapted from: Diabète Québec (2013), “Diabète et grossesse.” June 2014 (updated on July 2018) ©All rights reserved Diabetes Quebec References:Feig D, Berger H, Donovan L et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Diabetes and Pregnancy. Can J Diabetes 2018; 42 (Suppl 1): S255-S282. Canadian Paediatric Society (Feb 28 2018). Weaning from the breast [Online]. Found at https://www.cps.ca/fr/documents/position/sevrage-de-allaitement (Web page consulted on July 18, 2018). What is the normal blood sugar level for a pregnant woman non diabetic?A normal FBS level is lower than 95 mg/dL, one hour lower than 180 mg/dL, two hours lower than 155 mg/dL, three hours after drinking the glucose solution, and a normal blood glucose level is lower than 140 mg/dL.
What is the ideal sugar level during pregnancy?We suggest the following target for women testing blood glucose levels during pregnancy: Before a meal: 95 mg/dl or less. One hour after a meal: 140 mg/dl or less. Two hours after a meal: 120 mg/dl or less.
What is normal blood sugar for non diabetic?A normal blood glucose level for adults, without diabetes, who haven't eaten for at least eight hours (fasting) is less than 100 mg/dL. A normal blood glucose level for adults, without diabetes, two hours after eating, is 90 to 110 mg/dL.
What should a pregnant woman's blood sugar be in the morning?Blood sugar monitoring
Your levels should be within these ranges: Fasting (in the morning before eating): 60 to 95. One hour after the start of each meal: less than 140.
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