The saying goes that a woman is eating for two when she is pregnant. However what she chooses to eat has a drastic impact on her risk of gestational diabetes.
There are cravings we've heard of such as ice cream and pickles. But many find themselves also reaching more for bread, crackers or comfort food, and avoiding their normally healthy choices out of convenience, nausea or sudden aversion to foods they once loved.
These high-carbohydrate, high-sugar foods cause a considerable amount of weight gain and fill the system with glucose, leading to hyperglycemia and insulin resistance.
It is wellknown that everything changes with pregnancy. Anatomically, the body shifts completely to accommodate a growing fetus.
Hormones skyrocket and the brain seems to turn to mush (commonly called, mommy brain). A pregnant woman’s endocrine system also changes as the body has to adapt to all of the shifts. However if the output of insulin by the pancreas cannot keep up with the increase in carbohydrate/sugar heavy foods, she will become diabetic.
Having gestational diabetes also increases a women’s risk for type 2 diabetes later in life. It should therefore be monitored carefully both from a screening glucose/insulin test and a lifestyle standpoint.
It is also important to note that given the current increasing trend in overweight and obesity in the United States, research shows that 50-60 percent of women go into their pregnancy already carrying too many extra pounds on their frame, further increasing the risk.
There is not one set standard for diagnosing gestational diabetes. However a woman is more at risk if she has a body mass index (BMI) of 30 or more going into the pregnancy, has had gestational diabetes in a prior pregnancy, or has a strong family history of diabetes.
The most common test is the oral glucose tolerance test (OGTT) where a pregnant woman drinks a very sweet drink, then waits an hour and has her glucose tested.
A normal result (depending on the lab) is under 130-140 mg/dL. The drink is very syrupy and often can cause vomiting, in which case the test must be repeated at a later date.
Followup testing can include the three-hour oral glucose tolerance test where the same test is repeated, however glucose levels are drawn every hour for three hours. If two out of the three hours have abnormally high levels of glucose, gestational diabetes is diagnosed.
As there are considerable risks for the growing baby (heavy birth weight babies, early delivery, and shoulder dystocia) it is important that gestational diabetes be taken seriously.
Pregnancy is not the time to lose weight or go on a diet. However routine glucose monitoring, changes in diet and proper exercise can make a huge difference and can possibly avert the use of insulin in order to control glucose levels.
Make sure to eat a variety of vegetables, lean protein, good fats and fiber-rich foods for the health of everyone involved!
References:
1) Mild Gestational Diabetes. Web. 20 January, 2013.
http://www.medscape.com/viewarticle/775396
2) Gestational Diabetes. Web. 20 January, 2013.
http://www.mayoclinic.com/health/gestational-diabetes/DS00316
3) The Relative Contribution of Prepregnancy Overweight and Obesity, Gestational Weight Gain, and IADPSG-Defined Gestational Diabetes Mellitus to Fetal Overgrowth. Web. 20 January, 2013.
http://www.medscape.com/viewarticle/777162
Reviewed January 21, 2013
by Michele Blacksberg RN
Edited by Jody Smith