Gestational Diabetes and how it affects pregnant women

Gestational Diabetes or Gestational diabetes mellitus (GDM) that affects pregnant women who have high blood glucose levels that are detected in their 1/2/3trimester during pregnancy. It is quite common and studies have shown that almost 10 to 20 % of women get affected by this.

Who are at Risk of Gestational Diabetes Mellitus?

The following women are more at risk.

1. Older women
2. Women who are overweight or obese
3. History of diabetes
4. Previous history of gestational diabetes
5. Hyperglycemia

All pregnant women will be screened on their first visit to an antenatal clinic with a Diabetes specialist in Chennai. Screening can be done using fasting plasma, glycosylated haemoglobin or by random plasma glucose. If a woman has high blood sugar early in pregnancy then she will be treated as having pre-existing diabetes. All women who have normal blood glucose levels early in pregnancy must be screened again with an oral glucose tolerance test (OGTT) between 24-28 weeks of the pregnancy to rule out Gestational diabetes mellitus (GDM).

They must come to the centre in fasting state at least 8 to 10 hours prior and not consume anything other than water before the test. Fasting blood and urine is collected. About 75 gms of oral glucose is given in about 250-300 ml of water. Blood is then drawn at 1-2 hours of the glucose load. If fasting plasma glucose is about 90-125 mg/dl or 1 hour of glucose load>180 mg/dl or 2 hours is >150 mg/dl the woman is said to have gestational diabetes. Regular monitoring of blood sugar helps to achieve better-glycosylated haemoglobin (HbA1C) level.

How to manage gestational diabetes

It can be managed through a balanced and healthy diet, medication as well as exercise. Medication is usually recommended if blood sugars do not come back to normal with diet and exercise. Recommended levels of glucose are the following

• Fasting <90mg/dl
• 1 hour<140mg/dl
• 1 hours<120md/dl

What are the general guidelines for healthy eating?

Diabetes specialists in Chennai will recommend good nutrition to be an important part of pregnancy and an effective way to manage gestational diabetes. A dietician can also guide you through concerning portion size, the right amount of protein, fat and carbohydrate.

1. Eat a variety of foods by distributing your calories, carbohydrates and take enough protein.
2. 4-5 servings of fruits and vegetables are generally recommended.
3. Taking adequate fluids of up to 2-3 litres must be taken but water has to be restricted if there is pedal oedema.
4. Include iron-rich food such as greens, lentils, nuts and grain.
5. Consume at least 650 ml of milk a day to meet calcium requirements.
6. Avoid all types of direct sugars and artificial sweeteners.
7. Avoid consuming alcohol and tobacco.
8. Include plant protein such as pulses and dal and restrict animal protein such as red meat.

Decide how much you can eat and divide your plate accordingly. More than half of your plate must contain fruits or vegetables. A quarter of your plate must contain starch or grains and the remainder must have protein and calcium-rich foods.

Coming to physical activity aerobic activity of moderate intensity for about 30 minutes a day on most days of the week are said to have many benefits in metabolic control. Start with light to moderate exercise. Any simple activity is better than no activity at all.

• Don’t exercise in a flat position.

• Stop if your heart rate is >140/min

• Stop if you feel a contraction