Risk of complications in pregnancy and delivery are increased in women with gestational diabetes. However, with the help of appropriate control on blood sugar levels, the risk of problems in the baby and mother can be limited. According to experts, blood sugar levels should be tested in all pregnant women to screen for diabetes irrespective of age and risk factors. The tests are done in both first trimester and second trimester of pregnancy. If your doctor considers you at high risk of gestational diabetes, he or she may recommend testing as necessary.
If you are diagnosed with gestational diabetes, regular self-monitoring of blood sugar levels daily will be needed. Monitoring blood sugar helps to determine if your exercise, eating patterns and insulin dose are maintaining your blood sugar levels.
You will be advised by your doctor to maintain a daily food record and home sugar levels. Blood sugar monitoring at home is done by glucose meter. Your doctor will teach you how to use a glucose meter. Based on your sugar readings your doctor will make changes needed in your treatment plan. The aim of monitoring is to maintain blood sugar levels nearly as normal as possible. Here is how you can manage your diabetes during pregnancy.
All pregnant women should eat healthy and nutritious foods to meet her nutritional needs and the needs of the growing fetus. In addition women with gestational diabetes should eat a proper diet to maintain blood sugars as normal as possible. In second and third trimesters of pregnancy the need for calories increases by 300 calories per day. So if you were having 1500 calories per day and your weight was normal, a calorie intake of 1800 calories per day will be needed from 14 weeks until delivery.
Protein requirement increases in pregnant women. Eat a diet rich in proteins. The need for vitamins and minerals also increases during pregnancy. Ensure that your diet contains low fat dairy products, whole grain cereals and breads, and fruits and vegetables. Take supplements as prescribed by your doctor to get enough folate (B vitamin critical during pregnancy) and iron. Avoid foods that are rich in carbohydrate or sugar.
Eat foods that are rich in dietary fiber. Fiber is a part of plant food that is not digested (e.g., skins, membranes, seeds, bran). Whole grain cereals and breads, fruits, vegetables, and legumes (dried peas and beans) have high fiber content. Fiber helps to prevent rapid increase in blood sugar levels and it may prevent the need for extra insulin as well.
Avoid alcohol, as there is no known safe level of alcohol during pregnancy. Excessive alcohol intake can result in severe defects in development of the body and brain of the fetus. Take caffeine (found in coffee, tea, and some sodas) in moderation. Avoid smoking as smoking during pregnancy increases the risk complications such as fetal death, pre-term delivery, impaired fetal growth, low birth weight.
All pregnant women should have a daily exercise program. It is essential for a healthy pregnancy. If you have gestational diabetes, exercise is especially important. Regular exercise improves the action of your body's own insulin. It may help to keep your blood sugar levels in the normal range while using less insulin. Exercise also helps to maintain your weight to normal levels.
Weight gain in pregnancy is a common concern. It is a particularly important concern for women with gestational diabetes. It is recommended that you have a slow and steady rate of weight gain as it is the right way of weight gain in pregnancy. Your weight gain gives an indication of the nutrition that is available to your baby for growth.
Pregnancy is divided into three trimesters—first, second and third trimester. The duration of each trimester is 3 months or approximately 13 weeks. Most women on an average gain 10–12kg. Recommended total weight gain depends on your body weight before pregnancy.
If your weight gain is not adequate it may result in a small baby. Low birth weight babies are more prone to illness during the first year of life. An excessive weight gain during pregnancy can result in high blood sugar values, insulin resistance and poor control of your diabetes
If you have gestational diabetes, your health care providers will want to monitor your day-to-day blood sugar levels, as appropriate control blood sugar reduces this risk of problems in the baby and mother. Your doctor will advice you to keep a record of daily diet, exercise and blood sugar levels.
As your pregnancy advances more hormones that affect the function of insulin are released by the placenta. Testing your blood sugar level before and after meals daily helps to determine if your diet and weight gain are enough to keep blood sugar levels under control or if insulin is needed to keep the blood sugar levels to normal and the fetus protected.
Self blood glucose monitoring is done at home with glucose meter using a drop of your blood. Your doctor can teach you how to use the glucose meter. Follow your doctor’s recommendations regarding blood sugar monitoring and recording. You may need to test your blood several times a day like the fasting sugar (first thing in the morning before you eat) and 2 hours after each meal, or more frequently during the day or at night. Record your sugar readings regularly as these can help your doctor to determine if your treatment for blood sugar control is adequate.
In many women with gestational diabetes as pregnancy advances more hormones that affect the function of insulin are released by the placenta. Hence the blood sugar levels cannot be maintained to normal levels with diet and exercise. Pregnant women who do not have gestational diabetes rarely have blood glucose reading that exceeds 100 mg/dl in the morning before breakfast (fasting) or 2 hours after a meal. In gestational diabetes the aim is to keep sugar levels to as normal as possible.
The exact sugar reading on which insulin injections have to be started are not fixed. Your doctor will recommend insulin based on clinical examination findings and your sugar readings. Record of self monitoring of blood sugar at home will help your doctor know when it is necessary to begin insulin. Your doctor will teach you how to check blood sugar with a glucose meter and take insulin in the form of injections during pregnancy.
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