Gestational diabetes is usually diagnosed during the second or third trimester of pregnancy when the body may become resistant to the hormone insulin, which is what enables body cells to take up glucose from the blood. The resistance occurs because hormones produced by the placenta have an anti-insulin effect. Symptoms can include excessive thirst, passing large amounts of urine, and fatigue, but often there are no symptoms.
In about 90 per cent of cases, blood glucose levels return to normal after delivery, but these women remain at increased risk of developing diabetes in later life.
The aims of treating gestational diabetes through nutrition are to provide enough calories for the appropriate weight gain in pregnancy, to achieve and maintain normal levels of glucose in the blood, and to avoid the production of chemicals known as ketones.
Because in diabetes the body cannot use glucose efficiently as a source of energy, it derives energy by breaking down fats instead. This produces waste products called ketones. The build-up of ketones (ketosis) in the body causes symptoms such as nausea, abdominal pain, and fruity-smelling breath.
If you are diagnosed with gestational diabetes, you will be asked by your doctor to monitor your blood glucose levels via a finger stick test and to test your urine or blood for ketones. Most women who have gestational diabetes will be referred to a state-registered dietitian for nutritional counselling and for the design of a meal plan that will be adjusted through pregnancy based on levels of glucose in the blood.
Generally, 40-45 per cent of calories in the diet should come from carbohydrates, eaten throughout the day. An evening snack is recommended to prevent ketosis overnight. Carbohydrate is not as well tolerated at breakfast as at other meals, possibly due to the levels of certain hormones, so an initial meal plan may limit carbohydrate in the morning.
If your blood sugar levels are persistently high, you will most likely have to have insulin injections. This is the best thing for your baby, and with the help of your ante-natal care provider, you can have a healthy pregnancy. The main goal of this therapy is to prevent complications associated with gestational diabetes developing in both the mother and baby. If your blood sugar levels are not treated, your baby might gain too much weight and then might need to be delivered by caesarean section.
BDST: 1612 HRS, Oct-12, 2013