How common is gestational diabetes?
Gestational Diabetes Mellitus affects up to 15% of pregnant women worldwide, and
in India alone an estimated 4 million women have Gestational Diabetes Mellitus.
So, you can take comfort in the fact that you are not alone.
In most cases, gestational diabetes is managed by diet and exercise and goes away
after the baby is born. Very few women with gestational diabetes require insulin
to control this type of diabetes. If you do need insulin, it will ensure blood glucose
stays in the acceptable range, thereby reducing the risks to you and your baby.
Gestational diabetes should not be taken lightly. Immediate risks to the mother
and fetus are very real; however, these risks can be minimized with good care and
follow up.
Who are at the risk?
- Positive family history of Diabetes
- Having a previous birth of an overweight baby of 4 kg or more
- Previous stillbirth
- Recurrent vaginal infection in present pregnancy
- Excessive amniotic fluid
- Persistent glycosuria
- Age over 30 years
- Obesity
- Ethnic groups ( East Asian , Pacific Island)
Causes
During pregnancy, various hormones typically block the usual action of insulin to
make sure your baby gets enough glucose for its own development. To compensate,
your body produces more insulin. Gestational diabetes develops when your body can’t
compensate properly. As a result your blood sugar levels rise, and this can lead
to problems for you and your baby.
No one knows why some women develop gestational diabetes and others do not, but
you are more at risk if you have above said conditions.
Symptoms
Symptoms of gestational diabetes are uncommon. This is because the condition is
usually diagnosed from screening tests before symptoms develop. However, if diabetes
isn’t detected and or treated, you may develop symptoms such as:
- Increased urination
- Increased thirst
- Nausea
- Vomiting
- Fatigue
- Infection of urinary tract, bladder, vagina
- Increased appetite and decreased weight The specific feature of this disease told
by Sushruta, that Madhumehi if she is walking she desires to stand, if she is standing
desires to sit, and if sitting desires to lie down and, if she lies down she desires
to sleep. In other words patient of Madhumeha always feels to be tired.
Risk for mothers:
During pregnancy:
- Recurrent spontaneous abortion
- Preterm labour may be due to infection or polyhydramnios.
- Maternal distress
- Pre-eclampsia/ eclampsia.
- Diabetic neuropathy which causes renal failure
- Diabetic retinopathy.
- Ketoacidosis.
- Increased risk of urinary tract infection.
During labour:
- Increased chances of operation
- Perianal injuries.
- Prolongation of labour.
- Abnormal presentation.
- Postpartum haemorrhage.
Puerperium(after delivery):
- Puerperal infection.
- Lactation failure.
Risk for baby
Your new born baby may also have low blood sugar (hypoglycaemia), because after
birth he or she may continue to make extra insulin. Fortunately, in many cases normal
feeding with breast milk is enough to balance a baby’s blood sugar levels, but in
some cases your doctor may recommend that your baby be given a sugar (dextrose)
solution through a drip. Very rarely, if doctors can’t bring your baby’s blood-sugar
levels under control, there is a slightly increased risk of infant death. Your baby
is more likely to develop jaundice. This usually isn’t serious, and will fade without
the need for medical treatment. Gestational diabetes can increase the risk of your
baby being born with congenital problems, such as a heart defect or respiratory
distress syndrome and your child may be more prone to obesity and diabetes in later
life – but the risks are very small.
Life Style Changes to Deal with Gestational Diabetes:
If you’re diagnosed with diabetes, you should be offered an appointment with a joint
diabetes and antenatal clinic. The doctors and nurses here will be experienced in
looking after pregnant women with diabetes. You will have more frequent antenatal
appointments than women who don't have gestational diabetes.
Your treatment will be aimed at keeping your blood sugar lowered enough to help
prevent complications. You will need to regularly test your blood sugar level. You
will be given advice on how to test it, how often, and the level that you're aiming
for.
Your Diet
Everything you eat and drink affects your blood sugar levels. Your daily diet won’t
actually be that different from a healthy pregnancy diet, but you will need to stick
to it rigidly. In general…..
- You will need to drink lots of water (at least eight glasses a day).
- Eat three regular meals and three regular snacks a day. It is important to space
your meals over the course of the day and to mix good wholegrain carbohydrates with
healthy protein at every meal, and snack to keep your blood-sugar level steady.
- You will need to avoid sugar and sweet foods, but also refined carbohydrates, such
as white bread, cakes, sweets and processed foods, because your body converts them
into sugar too quickly.
- Eat fresh, natural, unrefined foods like wholegrain, nuts, seeds, legumes and vegetables
– that release their glucose steadily.
- Don’t skip meals and be consistent about what time food is consumed
- Avoid undiluted fruit juices, as the sugar in undiluted fruit juices will hit your
bloodstream too quickly.
- Vitamin C is connected to glucose metabolism and can help to regulate blood sugar
and prevent diabetes. Amala ( gooseberry ) is the best source of Vitamin C.
- Omega – 3 Fatty Acids are important against gestational diabetes, because they help
to keep your cells soft, so that the insulin receptors on the surface of your cells
are more able to use insulin effectively. Apricot and flax –seeds are the best source
of Omega – 3.
Your Exercise
Exercise forms an important part of treatment for gestational diabetic patients.
A morning walk is the best form of exercise. Yoga and meditation can also be beneficial,
especially to relieve stress and bring clarity to the mind. If your health permits,
opt for exercises such as jogging, swimming, cycling, etc. Exercise forms an important
part of treatment for diabetic patients. A morning walk is the best form of exercise.
Yoga and meditation can also be beneficial, especially to relieve stress and bring
clarity to the mind. Swimming is also another option for you.
Treatment According Ayurveda
The treatment of Diabetes recommended in Ayurveda – as against modern medicine –
is aimed at rejuvenating the body to not only balance sugar levels, but also foster
a positive change in the patient’s life. Ayurvedic medicines work on the root cause
of the disease; strengthening the patient’s immunity, enhancing digestion and helping
him lead an overall healthy life. Along with medication, dietary and lifestyle changes
are also recommended to rejuvenate the body’s cells and tissues, allowing them to
produce insulin properly. A number of herbal remedies may help to stabilize glucose
level in your blood, and these include Mamejava, Guduchi, Amalaki etc. However,
some herbs can have a rapid effect on blood-sugar level and their effects vary from
person to person, its important to talk to a qualified Ayurvedic doctor and let
him or her known what you are doing rather than self-prescribing.