Diagnosed With Borderline Gestational Diabetes? Here’s How To Manage It

Many women develop diabetes for the first time when they become pregnant. This is commonly known as gestational diabetes mellitus (GDM). A blood glucose level higher than 140 mg/dL is the diagnostic criteria for establishing GDM in pregnant women. Although the condition reverses soon after giving birth, it can pose several health complications in both the mother and the newborn baby. GDM is a potential risk factor for abortion, infections, preeclampsia (high blood pressure during pregnancy, C-section birth and future development of diabetes and hypertension in the mother. In the newborn child, GDM can increase the risk of stillbirth, breathing difficulties, preterm birth, excessive birth weight, birth defects and several other complications. If you are told to have borderline gestational diabetes, Dr. Tasneem Nishah Shah, Consultant - Obstetrics and Gynaecology, Manipal Hospital Whitefield is sharing tips to manage the condition. Read all of them in this article.

Borderline Gestational Diabetes Risk factors

Although the exact cause of borderline gestational diabetes remains unsolved, some pregnant women with specific characteristics are at a higher risk of developing the condition as compared to others. These include:

• Indian ethnicity
• family history of diabetes or GDM
• Obesity
• sedentary lifestyle
• polycystic ovary disease
• personal history of prediabetes or GDM and giving birth to an overweight baby.

How is Borderline Gestational Diabetes Diagnosed?

As per the reports published by the Ministry of Health, GDM is estimated to affect about 10-14.3% of all pregnant women, which is much higher compared to the Western population. The burden is expected to rise steeply in the coming years with one in every 5 pregnancies likely to have GDM. Given the complications associated with the conditions, the need of the hour is to raise awareness about the condition to enable early diagnosis and management in those at risk. 

Also Read: 6 Monitoring Factors For Gestational Diabetes

Your doctor will ask you to get an Oral Glucose Tolerance Test (OGTT) done during the first antenatal visit and also at 24-28 weeks of pregnancy to rule out GDM. 

Management Tips

Lifestyle plays an important role in the prevention and managing diabetes, including GDM. Your doctor will recommend you a healthy diet, regular physical exercise and keeping your weight in check to manage your blood sugar levels as the first step. Your doctor will also recommend tests to keep a track of your blood sugar. Women who fail to reach target glucose levels may require medications to prevent complications.

Borderline Gestational Diabetes Diet

Your diet should be planned in a way that you get optimal nutrition for the growing baby inside you, provide you energy but at the same time does not cause blood sugar spikes. Some of the basic rules of gestational diabetes diet include:

• Keeping a watch on the total amount of carbohydrate intake and choosing complex carbohydrates such as whole grains, brown rice, ragi, jowar, etcover simple carbohydrates that causes a rapid rise in blood glucose such as refined flour, white rice, sugar, fruit juices, processed and packaged food, etc.
• Do not miss out meals or fast for long hours. It is also important to avoid eating a heavy meal at one go. The best way is to have 3 major meals (breakfast, lunch, dinner) and 2-3 mid-day snacks. 
• Include lots of vegetables, especially non-starchy vegetables such as spinach, fenugreek, onion, broccoli, green beans, cucumbers, bell peppers, etc and fresh fruits in your diet
• Include lean proteins such as pulses, low-fat dairy products, chicken, eggs and fish in your diet to keep yourself fuller for long hours and at the same time provide your baby with essential nutrition.
• Choose healthy fats such as ghee, seeds, nuts, olive oil over refined oils, fried foods, bakery items.Choose boiled, steamed or sauteed food in low oil over fried food. 

Follow the plate method for lunch and dinner. Fill 50% of your plate with vegetables, 25% with lean protein and the rest 25% with a complex carbohydrate such as chapati, brown rice, millets, cereals, etc. Add a bowl of fruits of your choice and 1 cup of low-fat yoghurt, buttermilk or milk.

• Leave a 2-3 hours gap between every meal and snacks.
• Refrain from eating outside as much as possible and avoid junk. 
• Snacks may include sprouts, vegetable poha or dalia, idli, besanchilla, vegetable uttapam, etc. 
• Avoid sugar in tea, coffee and juice, soda or fruit juice. Consume a lot of water to keep yourself hydrated. 

Staying Active

Mounting evidence suggests that daily moderate-level exercising for 30 minutes during pregnancy not only helps the mother to maintain ideal body weight but exercising reduces the risk of GDM and related risks. If you have been diagnosed with GDM, try to stay active as much as possible along with 30 minutes of exercising every day including brisk walking, swimming, yoga, etc. But it is important to work out at a moderate level and not exhaust yourself. In case you were not very active before pregnancy, you can start slowly and gradually increase your workout time as per your comfort level. 

Conclusion

Nowadays we see many pregnant women with GDM. Close monitoring of mother and baby is very important. Majority of women who have gestational diabetes have healthy pregnancies and healthy babies. Gestational diabetes usually disappear after the baby is born but you have a higher chance of developing gestational diabetes in a future pregnancy and type 2 diabetes in later life. Controlling your levels of blood glucose during pregnancy and labor reduces the chances of complications for you and your baby.

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