2nd Pregnancy: Gestational Diabetes

As I mentioned during my previous post, I had to take an oral glucose tolerance test to check if I might have gestational diabetes.  I have never really considered myself to be at risk of gestational diabetes simply because I don’t have many of the risk factors.

Risk Factors for Gestational Diabetes

For instance, individuals considered to be at risk of developing gestational diabetes are usually:

  • obese
  • have a history of gestational diabetes
  • have a strong family history of diabetes

Out of those three factors, I only have one – a family history of diabetes and not a very strong one at that.  Generally to be in the high risk category, either of your parents would have had to have diabetes.  In my case, it was my maternal grandfather.

Other risk factors include (of which I have none):

  • the presence of sugar in your urine (mine has been negative all the while)
  • previously giving birth to a big baby – larger than 8 pounds, 13 ounces (Gavin was only 8 pounds, 8 ounces)
  • unexplained stillbirth
  • baby with birth defect
  • high blood pressure

However, it appears that some women do develop gestational diabetes even without the risk factors for it so perhaps I fall into this category.  In my case, the suspicions were raised because the baby in utero is large – about two weeks ahead of the average sized baby – and there is an excess of amniotic fluid above what is considered acceptable.

Although my urine tests have been clear, it is apparently not a fool-proof method of testing for gestational diabetes.  So to screen out the possibility that I may have developed gestational diabetes, the doctor sent me for an oral glucose tolerance test.

Oral Glucose Tolerance Test

I was required to fast from midnight of the day before – no food, no fluids.  It was surprisingly tough.  Upon arrival at the path lab, I had some blood withdrawn and was given a glucose solution to drink.  I’m not sure of the concentration but it was sickeningly sweet.  According to MedlinePlus, the glucose solution contains about 75g of sugar.

I was then sent away for an hour before I had to return for another blood sample to be withdrawn.  That was followed by another hour of waiting without food or drink before a third blood sample was withdrawn.

I haven’t received the results yet, but the doctor said he would call me if there were any immediate concerns.  Otherwise, he would wait until our next appointment in two weeks to share the news with me.  Since I haven’t heard from him, I’m assuming “no news is good news”.

Apparently it is quite common for some pregnant women to throw up after consuming the sugar solution on an empty stomach.  Thankfully that didn’t happen to me or I would have had to come back the next day to repeat the test.

The test results should show:

  • the fasting sugar levels to be between 60 -100 mg/dL (mg of sugar per dL of blood volume)
  • at 1 hour, it should be less than 200 mg/dL
  • after 2 hours, it should less than 140 mg/dL

If your results are between 140 – 200 mg/dL, you are considered to have impaired glucose tolerance (sometimes called “prediabetes”). In other words, you are at increased risk for developing diabetes. If you have a blood sugar level greater than 200 mg/dL, then you have gestational diabetes.

Medical Significance of Having Gestational Diabetes

I think the most pertinent part of the whole exercise is what it means if I do have gestational diabetes.  How will it affect the baby and me?

According to Family Doctor, high sugar levels in the blood increases the likelihood of problems at birth, such as jaundice, baby with low blood sugar levels, or a baby that weighs more than normal.  Aside from the negative health effects that gestational diabetes has on the mother, such as preeclampsia, it can also create difficulties during delivery and increase the likelihood of requiring a cesarean section.

If you do have gestational diabetes, the first line of management is to control it with an appropriate diet.  It is also important to exercise regularly and monitor your blood sugar levels.  It may also be necessary to use medicine to control your blood sugar levels if diet and exercise alone are not enough.

Dietary Recommendations

Ideally, you should avoid eating foods containing simple sugars, such as cake, cookies, candy or ice cream.  Foods that contain natural sugars, such as fruits, are okay.  Snacks between meals should consist of healthy foods, such as raisins, carrot sticks or fruit.  Whole-grain pasta, whole-grain breads and rice are good foods to take during meals.  You may also have to eat less at each meal depending on your weight gain during the pregnancy.

The Importance of Exercise

Exercising appropriately will help to control blood sugar levels.  Your doctor can usually recommend what sort of exercises you can do, but usually light exercises like walking and swimming are quite safe to take up.

If you haven’t been exercising, start with 5-10 minutes a day.  As you build up your strength and endurance, you can slowly increase it to 30 minutes or more.  The longer you exercise and the more frequently you exercise, the better your control over your blood sugar levels.

It is important not to exercise too hard or get too hot.  Remember you are pregnant and there are certain factors you need to take into consideration to stay safe and healthy.  Your heart rate should not be more than 140-160 beats per minute.  If you experience any pain, dizziness, contractions, bleeding, etc. stop exercising immediately and call your doctor.

Future Consequences

Although gestational diabetes usually goes away after the delivery, it may take some time before it goes away.  Because an experience of gestational diabetes puts you at greater risk of developing diabetes in future, it is important to continue exercising, watch your diet and your weight.

You should avoid eating foods that contain a lot of simple sugar, such as cake, cookies, candy or ice cream. Instead, eat foods that contain natural sugars, such as fruits.

If you get hungry between meals, eat foods that are healthy for you, such as raisins, carrot sticks or a piece of fruit. Whole-grain pasta, whole-grain breads and rice are also good for both you and your baby.

It’s important to eat well-balanced meals. You may need to eat less at each meal, depending on how much weight you gain during your pregnancy. Your doctor or dietitian will talk to you about this.

Published by Shen-Li

SHEN-LI LEE is the author of “Brainchild: Secrets to Unlocking Your Child’s Potential”. She is also the founder of Figur8.net (a website on parenting, education, child development) and RightBrainChild.com (a website on Right Brain Education, cognitive development, and maximising potentials). In her spare time, she blogs on Forty, Fit & Fed, and Back to Basics.

3 thoughts on “2nd Pregnancy: Gestational Diabetes

  1. Is it still possible to have gestational diabetes even if you urine samples have been negative for urine all this while?

    Hope the results turn out favourable. It would be a real lost to lose that taste tester position.

    Like

  2. Mephala – I wouldn’t have picked you to be a candidate for gestational diabetes either… Then again, looks like everything turned out okay for you.

    Chin Li – Apparently so. My urine tests have been negative all this while but the doc says it’s not foolproof. The reason he suspected a risk is because my baby is large and because my amniotic fluid levels are in excess of what is considered “normal”. That usually suggests developmental abnormalities in the baby (which we have ruled out with a detailed scan), or gestational diabetes – hence the need to take the OGTT.

    The doc said he would call me if the test showed anything. Considering he hasn’t called me, I’m guessing the test is clear – fingers crossed!

    Like

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