GESTATIONAL DIABETES



GESTATIONAL DIABETES

Gestational Diabetes is a condition where blood sugar levels rise above normal during pregnancy.

Gestational Diabetes usually develops after the 24th week of pregnancy although it can occur earlier. During this time the body has increased energy requirements and extra insulin is needed to move the sugar from the blood into the muscle cells. At the same time the mother produces a hormone which works against the insulin. If the mother cannot meet these demands for extra insulin, blood sugar rises, and gestational diabetes develops.

If the blood sugar remains too high during the pregnancy there is a greater risk that the baby's blood sugar will be too high and the baby will respond by producing more insulin. Extra glucose is then laid down as fat in the baby's body and large babies (over 4 kilograms) may result. This can lead to difficult deliveries, risk or injury to the baby and stress to the baby from a dangerous drop in blood glucose level directly after birth. Jaundice (yellow skin), low calcium levels and respiratory problems may also occur.

Thus good control of the blood sugar levels during pregnancy is very important. The baby will not be born with diabetes but there is an increased risk that mother and child will develop Diabetes later in life. It is important to establish a healthy diet and life style for the mother and her family.

BLOOD GLUCOSE MONITORING

You should learn to monitor your blood sugar levels using a blood glucose monitor.

Initially doctors may ask for blood sugar levels to be checked 4 times a day.

Before breakfast 4.0 –5.5 mmol/L

Before lunch/evening meal 4.0 –6.0mmol/L

2 hours after each meal 4.0 – 7.0mmol/L

We generally recommend testing before each meal and 2 hours after the main meal. Some doctors prefer before breakfast and 2 hours after each meal.

CONTROL OF DIABETES

The control of Diabetes depends on the interaction of insulin, diet and exercise on blood sugar level.

The aim of the diet is to keep blood sugar within a normal range of 3.5 –6.7 mmol/L

The three main nutrients in food are:-

Protein - used for growth and repair and for energy when carbohydrate is low eg meat, fish, eggs, cheese and milk. Moderate amounts of protein foods are required.

Fats - used for energy. Fats should be kept to a minimum. Monounsaturated and polyunsaturated oils and fats eg Safflower, Canola, Olive oil and Sunflower and Canola margarine are preferred to saturated fats e.g. butter, coconut and palm oil.

Carbohydrates - break down to glucose and are used for energy. There are two types of carbohydrates - sugars and starches. All sugars and starches break down to glucose once they have been digested. To maintain a steady blood sugar level over the day some foods containing carbohydrate should be eaten at each meal. This is preferably in the form of carbohydrate starch such as cereals, rice, pasta, bread, potato that contain more fibre and nutrients than simple sugars such as honey, jam and sugar. Carbohydrate foods that raise the blood glucose level slowly are said to have a low Glycaemic Index (GI). These foods help to stabilize blood sugars but the quantity must be watched carefully.

The end result that every pregnant women wants is a healthy baby. A dietitian can be very supportive and help to ensure that this occurs. At the Perth Diet Clinic, we can also sell and teach how to use a glucose monitor.

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