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Approximately four weeks ago, one of my patients was diagnosed with gestational diabetes. I met her couple of weeks ago. She had many questions about this condition. I later decided to put the main part of our discussion on paper. Hopefully, this review will help you to understand this form of diabetes a little better.
Not many people know that pregnancy promotes insulin resistance. For some of you, who are not familiar with the term insulin resistance, let me explain.
Insulin resistance
Insulin is a hormone that is needed to push sugar into the cells. When the body organs (e.g. muscles and liver) resist insulin’s entry into the cells, the sugar will not be able to enter the cells. This dysfunction will result in high blood sugar.
Over the long term, this condition can lead to pre-diabetes and type 2 diabetes.
Let us go back to our discussion about gestational diabetes.
The insulin resistance state during pregnancy is mostly because of the higher production of different forms of hormones (e.g. growth hormones, progesterone) by the placenta. These hormones guarantee a good supply of nutrients to the fetus.
Gestational diabetes develops in women…
Who are not able to compensate for insulin resistance and the amount of insulin produced by their pancreas is not sufficient to push the existing blood sugar into the muscles and liver.
Major complications of this condition are seizures, larger fetus, miscarriage and the need for cesarean surgery.
This condition is mostly seen in African Americans, Native Americans, Hispanic Americans and South and East Asian women.
How is it diagnosed?
Most of the patients are screened for diabetes during the initial prenatal visit. If hemoglobin A1C—a tool that provides information about average blood sugar over the past 90 days—is greater than 6.5%, then the patient is diagnosed with diabetes. Many women have unrecognized diabetes and these patients are diagnosed with this condition at their first prenatal visit.
To diagnose other patients who have mildly elevated blood sugar, performing a glucose tolerance test (GTT) is recommended.
To perform a GTT, the patient’s sugar level is measured before and two- hours after the ingestion of 75 mg of sugar.
How do you manage and prevent gestational diabetes?
The most important measure to prevent and manage this condition is to optimize nutrition.
An optimized nutrition will be able to help the pregnant women to facilitate weight loss and improve insulin resistance.
Folic acid
Patients with this condition are at a higher risk of having a child with birth defects. It has been recommended to prescribe a higher dosage of folic acid to these patients compared to other pregnant women.
The American Diabetes Association recommends a folic acid supplementation of 600 mcg/day.
Stop eating high caloric foods
Clearly, to reduce the total caloric intake and to improve the insulin sensitivity, it is essential to reduce the consumption of high caloric food intake such as chips, donuts, soda, cookies, cakes etc.
Don’t forget about veggies and fruits
I usually suggest eating veggies and fruits 5-7 times per day. You need to be cautious about fruit with high sugar content like grapes and to limit the consumption of starchy veggies such as potatoes. You should read this article about sweet potatoes and diabetes.
What about meat?
You can eat meat if you like, but make sure that you choose lean meat over fatty meat and remove the skin when enjoying chicken or turkey.
Do you like dairy products?
No problem, but choose the low fat ones. I would also suggest limiting egg intake to not more than two per week. If you like the egg whites it is much better.
Egg white doesn’t have any cholesterol and calories are only around 20 kcal in one serving.
How about olive oil?
Yes, olive and canola oils are preferred over butter and margarine.
At the end of this article, I want to provide you with a key statistic, did you know that?
Approximately, 40% of patients who are diagnosed with gestational diabetes are going to be diagnosed with type 2 diabetes in the following 10 years.
Don’t stop learning about diabetes. Please make sure to read all of the other articles about diabetes and also don’t forget to share them with your friends and followers.
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