The big moment is here! Finally pregnant.
The future parents as well as the whole family are looking forward to this moment.
Often, everything is fine until the expectant mother learns that you are suffering from gestational diabetes.
This is the moment in which your own lifestyle must be changed.
This is the only way to protect the child’s own health and that of the child and to reduce the risk of later diabetes.
A lack of treatment can lead to serious risks for mother and child.
Thus, the likelihood that the child suffers from obesity and reduced glucose tolerance at school age at the latest is increasing rapidly.
But for the mother also increases the risk of a later diabetes type 2 disease.
On average, 50% of all gestational diabetes patients develop type 2 diabetes within the next 10 years.
Fortunately, however, in most cases, this risk can be greatly reduced by treating gestational diabetes in a timely manner and changing the lifestyle through a healthy diet and regular exercise.
Accordingly, the following contribution deals with all necessary questions about the topic of gestational diabetes and attempts to present them bundled and clearly arranged.
- Gestational diabetes is the most common concomitant disease that can occur during pregnancy.
- Between the 24th and 28th week of pregnancy, the so-called screening takes place. This is a test to determine if gestational diabetes is present.
- The cause lies in the diminished effect of the hormone insulin. This is responsible for lowering blood sugar levels and does not respond as well to pre-pregnancy gestational diabetes.
- Effective treatment requires a change in lifestyle. This includes a change in diet and regular exercise.
- During pregnancy, the consumption of carbohydrates should be reduced.
- After birth, gestational diabetes disappears on its own in most cases.
- 50% of all patients develop type 2 diabetes in the 10 years after pregnancy. Therefore, early treatment can save a lot of suffering.
What is gestational diabetes?
Gestational diabetes is a so-called glucose tolerance disorder that first occurs during pregnancy. Thus, it is a form of diabetes mellitus or, in other words, diabetes.
Gestational diabetes is the most common concomitant disease that can occur during pregnancy. Thus, about 2 to 12 percent of all expectant mothers develop gestational diabetes.
Gestational diabetes is diagnosed with the help of a 75 gram glucose tolerance test. This test usually takes place between the 24th and 28th week of pregnancy.
In order to detect gestational diabetes at an early stage, the so-called screening test, is used. More about the tests can be found in the chapter Values and tests later in the article.
However, the test should be performed in any case because gestational diabetes can lead to a health risk for the expectant mother and the unborn child. The consequences are partly still felt years later.
Diabetes, even before pregnancy, is not called gestational diabetes. Here then either diabetes of type 1 or type 2 is present. You can find out more about type 1 and type 2 diabetes in my contribution written here. Click here for the post.
Why is it dangerous?
On the one hand, diabetes represents a huge health risk for both the expectant mother and the unborn child.
Therefore, every pregnant woman should definitely take part in the legal screening (screening test), which takes place in prenatal care.
If it is now established that gestational diabetes is present, the treatment must be started as soon as possible. Only then can the risks and dangers that arise for the child be minimized.
In gestational diabetes, the mother’s blood sugar is increased either constantly or unusually long after the meal.
The problem that arises here is that this greatly increased amount of sugar passes directly to the baby and this is thus almost over-nourished.
This causes it to grow very fast and it gets used to the constant carbohydrate oversupply before birth.
Therefore, if gestational diabetes already occurs early in pregnancy, it can lead to malformations of the baby’s heart and slower maturation of the alveoli.
For this reason, springs are also more likely to struggle with respiratory distress. So it can happen that at times an artificial respiration is necessary.
Tip: The baby should be breastfed or fed within 30 minutes after birth
In addition, an elevated blood sugar level also causes the amniotic sac to collect too much amniotic fluid and overstretch the uterine wall. Here summarized again:
- An elevated blood sugar level leads to increased growth of the fetus
- Due to the elevated blood sugar level, the child is over-nourished during pregnancy. This causes it to be hypoglycemic after birth. This in turn can cause the newborn after birth extremely irritated and screams.
- In extreme cases, seizures and respiratory distress may occur
- Increased risk of the child developing reduced glucose tolerance during school hours and becoming overweight.
- Later in life: High risk of developing the metabolic syndrome.
Even with the mother, gestational diabetes can lead to problems. This can lead to the development of high blood pressure associated with edema, kidney problems, and an increased risk of seizures.
In addition, infections of the urinary tract are more common. This increases the risk of premature birth.
In addition, it is due to the too large child and complications at the end of pregnancy also more often to caesarean sections.
Symptoms, signs and causes
Similar to normal diabetes, the cause of gestational diabetes is the absence or diminished effect of the hormone insulin. The job of insulin is to lower blood sugar levels.
Gestational diabetes is now a special form of diabetes mellitus and is a carbohydrate metabolism disorder that only exists during pregnancy.
The transition between high blood sugar and gestational diabetes is fluid. So there is no real limit that defines when exactly is a gestational diabetes.
This is because there is an altered metabolism during pregnancy in which the sugar is absorbed more slowly after eating than it was before pregnancy.
This is also the reason why pregnant women often have high blood sugar levels. Now the question arises, how it actually comes to gestational diabetes?
During pregnancy, so-called reduced insulin sensitivity may occur. In the process, the cells no longer react very well to the hormone insulin during pregnancy.
The hormonal changes during pregnancy play a role that should not be underestimated.
Thus, between the fourth and fifth month of pregnancy, the female body begins to produce large amounts of certain hormones such as estrogen, progesterone, cortisol, placental lactogen and prolactin. The hormones cause the body to use more energy.
This in turn ensures that the child can develop better. At the same time, however, this also ensures that the mother’s body no longer responds so well to insulin and at the same time develops an insulin resistance that lasts until birth.
In our lay language, we refer to this process as gestational diabetes.
Normally, the metabolic disease is quite symptom-poor. Signs such as strong thirst and increased urination are usually missing. These are part of the signs that occur in Type 1 and Type 2 diabetes.
But beware, just because it is said that the disease is usually fairly symptom-poor, does not mean that it can not lead to symptoms.
Following are now listed possible symptoms that may indicate that gestational diabetes is present:
- Increased thirst
- urinary tract infections
- Sugar in the urine
- Change in amniotic fluid quantity
- Growth disturbances of the fetus
- excessive weight gain
- increased blood pressure
As we already know, elevated blood levels occur during pregnancy. However, not only the mother, but also the unborn child is affected.
In the long term, however, these elevated blood levels can cause major problems for both parties.
For example, about 50 percent of women with gestational diabetes will develop type 2 diabetes within the next 10 years.
However, the child also has a much greater likelihood of becoming overweight and suffering from type 2 diabetes during their lifetime.
The causes that contribute to the fact that it comes to gestational diabetes can be summarized as follows:
- Type 2 diabetes in the family
- Increased age of the mother, i. over 30 years
- Gestational diabetes (gestational diabetes) already during a previous pregnancy
- Previous birth of a child with a birth weight of over 4500 grams
- More than 3 abortions of unknown cause
- Extreme weight gain during pregnancy
Prevention and screening
It is recommended to screen i.e.. to participate in the screening test. This is a procedure offered since 2012, which determines whether the expectant mother is suffering from gestational diabetes.
The interesting thing is that the health insurance companies take over the costs incurred and therefore there are no excuses not to participate in this test.
During the screening, the specialist in gynecology and obstetrics inquires about possible complaints and other problems.
This usually performs a physical examination, in which, inter alia, a blood pressure measurement and an equilibrium determination are included.
In addition, the doctor will look for typical clues such as thirst, fatigue, dizziness and urinary tract infections.
In addition, it is also necessary to take into account the causes already mentioned. These include: overweight, older age and diabetes in the family.
The risk factors just presented increase the likelihood that the expectant mother will develop diabetes during pregnancy.
Note: 40% of all women with gestational diabetes are slim and have no other risks. Thus, gestational diabetes is not strictly related to obesity.
Values and test
During the 24th to 28th week of gestation usually takes place the so-called screening test (screening). In this test, the pregnant woman is tested for impaired glucose tolerance. For this one uses the oral glucose tolerance test.
In certain cases, for example, if the expectant mother suffers from certain risk factors, it may happen that the test takes place already in the first trimester of pregnancy.
Depending on when the test took place and in so far this has turned out to be negative, it is repeated again either between the 24th and 28th week of pregnancy and between the 32nd and 34th week of pregnancy.
This is necessary because it is the only way to really make sure that gestational diabetes is present or not.
The oral glucose tolerance test is divided into two parts. This is once the addiction test, also called screening or pretest and once the diagnostic 75 grams oral glucose tolerance test.
In the addiction test, the pregnant woman drinks 200 milliliters of water mixed with 50 grams of glucose. An hour later, the blood sugar in the venous blood is then measured.
This test usually takes place regardless of the time of day and previous ingestion.
If the blood glucose value is above 135 mg / dl, there is a suspicion of gestational diabetes and the diagnostic 75-gram oral glucose tolerance test comes.
In this test, the expectant mother drinks 75 grams of glucose mixed with 300ml of water. This takes place within 3-5 minutes.
Two hours later, it is checked if this test also shows elevated values. The defined limits are defined as follows:
- Fasting: 92 mg / dl
- After 1 hour: 180 mg / dl
- After 2 hours 153 mg / dl
If at least one of these blood values is above the defined limits, the diagnosis of gestational diabetes is considered to be certain.
Important: The test is sober. This means that nothing should be eaten in the previous 8-10 hours.
In order to be able to treat gestational diabetes effectively, a change in one’s own lifestyle is necessary. So a change in diet and also regular exercise in 9 out of 10 cases to normal blood glucose levels.
Only if this does not help, is usually started with an insulin therapy. However, this decision is made by the doctor.
When eating, it is important to use balanced and high-fiber foods. On sweets and the consumption of sweetened drinks should be waived in any case.
As a result, blood sugar levels can be kept low and radically reduce potential dangers. It is important that in addition to the regular blood sugar control and the movement is not too short.
When the expectant mother considers and implements all of this, it usually causes the dangers that arise for oneself and for the child to be radically reduced.
The diagnosis usually works as follows:
- If the tests have established that gestational diabetes is present, the pregnant woman receives a referral to the diabetologist
- There is now a consultation instead. In most cases, the diabetologist is a close to adjust your own diet, as this helps to lower blood sugar.
- If the diet change and the recommended regular exercise do not help, you will start injecting insulin temporarily.
The most important question that exists during gestational diabetes is, what should I eat and what should I avoid?
In short, pregnancy diabetes is a carbohydrate metabolism disorder. Therefore, it is necessary to reduce the carbohydrates in your own diet.
Carbohydrates such as sugar, white flour and ready-to-eat foods are among the most commonly consumed carbohydrate-rich foods.
These so-called simple carbohydrates should disappear as much as possible from the nutritional plan.
Alternatively, you can use complex carbohydrates during pregnancy. These include in particular wholemeal bread, wholemeal pasta as well as brown rice. These ensure that there is a slower rise in blood sugar levels.
Tip: Combine proteins with complex carbohydrates. This leads to a slower metabolism. For starters, you can add quark to your morning jam bread (wholemeal bread).
|High fiber diet||Vegetables, salad, fruits, whole grains, legumes|
|beverages||Fruits and herbal teas, mineral water, coffee (not too much)|
|Bread and pastries||Wholemeal bread, Graham biscuits, pumpernickel, rye bread made from sourdough|
|Side dishes||Wholegrain cereals (oatmeal), wholemeal pasta, polenta, brown rice|
|Sweets||Consume only in very small amounts after a regular meal. Better to use whole grains such as biscuits and cakes made from whole grains|
|fruit||Citrus fruits, strawberries, raspberries, blackberries, blueberries, apples, kiwi, melons|
|Low fat products||Meat, fish, eggs, milk products, other low-fat products|
Here I have presented a small diet plan that shows approximately what should be considered in the diet. So the diet should be rich in fiber.
It is therefore advisable to especially to vegetables, salad, fruit and to access to whole-grain products and legumes. It is important that you should avoid sweets and sugary drinks during pregnancy.
If sweets are used anyway, you should use wholegrain products such as wholegrain biscuits. Also, sugary drinks such as sodas, coke etc. should not be consumed.
Herbs and fruit teas are also recommended here, if you want to experience a different taste like long-lasting water.
Tip: Better to eat less rice, pasta, potatoes and bread. Also refrain from sweets and other highly sugared foods and drinks. Complete renunciation of: sodas, fruit juices, cakes, pies.
Ideally, daily meals should be divided into up to six small meals a day. As a result, the blood sugar level stays constant and he does not have such a hard time.
The breakfast should be divided into two parts for exactly this reason. So it is advisable to take up to 2 hours break between these two partial meals.
The first part of the breakfast may thus consist, for example, of a wholemeal roll which is subsequently dosed. two hours later with a cereal (with low-fat milk) is supplemented.
After birth, gestational diabetes disappears on its own in most cases. Nevertheless, increased attention is needed.
This is especially important because every other gestational diabetes patient develops type 2 diabetes within ten years.
Unfortunately, the child also has the risk of developing type 2 diabetes in the course of his life. And especially when pregnancy diabetes has not been discovered and treated during pregnancy.
Therefore, the blood sugar value is checked again 1 to 2 days after the birth and also a few weeks later in the baby.
Warning: Even if the mother’s values are within the acceptable range after birth, there is still a risk of developing type 2 diabetes over the following years.
Fortunately, a study has found that this risk can be reduced by as much as 40 percent when the mother is nursing her baby. By the way, this is the study.