Blood Sugar During Pregnancy
Preventing Gestational Diabetes
Childhood obesity makes headlines every day. We hear how children are getting larger and this is a nationwide concern. Now you may be able to help prevent childhood obesity before your child is even born.
About 5 percent of women who are pregnant in the United States and don’t have diabetes will develop it while they’re expecting. This is called gestational diabetes. Gestational diabetes occurs when the mother’s body has problems producing or using the hormone insulin to get energy from glucose, or sugar. The result is high levels of blood sugar.
In a new study, about 9,500 women underwent screening for gestational diabetes. Five to seven years later, their children stepped on the scale. The lower each woman’s blood sugar level was at the initial screening, the less likely her child was to be obese years later. This was true even after the researchers considered other traits related to childhood obesity, such as the mothers’ weight gain during pregnancy. Researchers did not speculate about the differences among the women in healthy lifestyle choices at home.
Stop Gestational Diabetes Before It Starts
Many risk factors for gestational diabetes cannot be changed. These include a family history of diabetes, being older than age 25, and having had a large baby before.
Having gestational diabetes during pregnancy may be an indicator for problems later with processing blood sugar – particularly if the woman has a family history of diabetes.“ Often, it’s a signal that maybe they’re destined to be a frank diabetic later in life,” said obstetrician/gynecologist Kenneth Sekine, MD, with the Jacksonville practice of Sekine, Rasner and Brock. “The pregnancy has put stress on their pancreas.”
However, studies suggest that maintaining a healthy weight and eating a high-fiber diet before you get pregnant may ward off high blood sugar. If you have any risk factors for diabetes, talk to your doctor about screening as soon as you know you’re pregnant.
Some good news: Having gestational diabetes doesn’t mean your child is doomed to be heavy. Women in the study who received treatment after they were diagnosed were less likely to have obese children than those who weren’t treated.
Dr. Sekine says all of his patients receive an initial gestational diabetes-screening test at about the 25th week of pregnancy – earlier if the mother is overweight or has already had a large baby.
The expectant mother drinks a liquid containing 30 grams of glucose, and one hour later a finger stick test is performed. Based on the glucose level in the blood, Dr. Sekine may order a 3-hour glucose tolerance test for the patient. This second test is a fasting test.
“If the second test indicates gestational diabetes, we send the patient for nutritional counseling and they are instructed to do a finger stick four times a day,” Dr. Sekine said. “If their numbers stay within acceptable range, we consider them controlled. If they are not controlled by diet, we have to go to insulin.”
Patients are monitored closely and receive ultrasound exams once a month, he said. Dr. Sekine measures the baby’s weight, and at a safe weight, he may induce labor to prevent the baby from growing so large that a C-section is required.
Fight Weight Fate
There are things pregnant women can do to help keep their weight down and keep their bodies in good physical condition to help prevent gestational diabetes.“They’re pregnant, they’re not sick, so they really need to stay active,” said Kym Dunton, RN, BA, IBCLC, clinical resource nurse and lactation consultant for Women’s Services at Baptist Medical Center. “Be out and moving and walking. In the heat, they can do water aerobics – just literally walking around in the pool,” Dunton said. “Being in the pool will also help reduce swelling.” Be sure to get your physician’s approval first. Also, don’t overdo the eating because you are expecting.
“We talk about the myth of eating for two. That’s so wrong,” Dunton said. She advises eating small, nutritious meals several times a day. Your physician can provide guidance. Watch out for sugar – especially in vitamin waters, juices and other drinks. Many drinks are loaded with calories from added sugars, Dunton said. Read the labels. Make your own healthy and tasty drink by adding a little juice to sparkling water or blending your own smoothies so you can control the ingredients.