Expecting a child is normally a time of joy and wonder, but certain conditions, such as gestational diabetes, can complicate this stage of your life. Fortunately, there are a number of steps that can help control gestational diabetes and ensure the good health of both mother and unborn baby.

What is gestational diabetes?

There are 3 types of diabetes: Type 1 diabetes, type 2 diabetes and gestational diabetes. The latter type is different from other forms of diabetes in that it occurs specifically during pregnancy, persists throughout, and usually subsides after delivery.

Affecting between 3% and 20% of pregnant women in Canada, gestational diabetes occurs when hormones produced by the placenta interfere with the action of insulin, a hormone secreted by the pancreas to regulate the amount of glucose in the blood. This imbalance leads to an increase in blood sugar levels (hyperglycemia). Although temporary in most cases, this type of diabetes can nevertheless cause certain complications for both mother and foetus. This is why all pregnant women are systematically screened for gestational diabetes.

When should I get tested for gestational diabetes?

Testing for gestational diabetes is usually carried out between 24th and 28th week of pregnancy, the time when the risk of developing hyperglycemia is highest. However, testing can be done earlier, in the first trimester of pregnancy, if certain risk factors are present, such as obesity, a family history of diabetes or gestational diabetes in a previous pregnancy.

Who is more at risk of gestational diabetes?

Some people are more likely to develop gestational diabetes due to personal, family or medical factors. The women most at risk are those who:

• are over 35;
• are carrying more than one baby;
• have a family history of type 2 diabetes;
• had gestational diabetes during a previous pregnancy;
• gave birth to a baby weighing over 4 kg (9 lb);
• have a body mass index (BMI) above 30;
• are of Indigenous, Asian or Afro-descendant origin;
• have polycystic ovary syndrome;
• take cortisone-based medications on a regular basis (such as corticosteroids).

What are the symptoms/early signs of gestational diabetes?

There are several signs that may suggest the presence of diabetes in a pregnant woman:

• frequent urination;
• persistent thirst;
• increased appetite;
• blurred vision
• an unusual level of fatigue;

Consult a health care professional as soon as possible if you experience similar symptoms or any other unusual symptoms during your pregnancy.

Is gestational diabetes dangerous for pregnant women?

Untreated hyperglycemia can affect the mother’s health during and after pregnancy:

• impaired vision;
• high blood pressure;
• a higher risk of type 2 diabetes;
• a more difficult delivery, notably due to a high-weight baby (macrosomy);
• excess amniotic fluid, which can cause premature delivery;
• preeclampsia, a pregnancy complication caused by high blood pressure and protein in the urine;
• more difficult post-partum recovery;
• long-term diabetes, even after childbirth.

What are the risks of gestational diabetes for the baby?

In the unborn child, maternal hyperglycemia increases insulin production, which can have repercussions such as:

• intrauterine growth retardation;
• delayed lung development;
• heart problems;
• jaundice;
• breathing difficulties;
• premature birth;
• a birth weight of over 4 kg (9 lb);
• calcium deficiency in the blood.
• glucose intolerance;
• episodes of hypoglycemia (abnormal drop in blood glucose levels) after birth.

 

How to prevent and avoid gestational diabetes?

Although certain factors, such as age or family history, are beyond your control, it is still possible to reduce the risk of gestational diabetes by adopting a healthy lifestyle, both before and during pregnancy. A balanced diet, regular physical activity, maintaining a healthy weight and medical supervision throughout pregnancy are all effective ways of helping pregnant women control their blood sugar levels.

Controlling blood sugar means controlling gestational diabetes

The key to gestational diabetes is to manage blood sugar levels so that they remain stable over a certain interval. Adopting an appropriate diet can make a big difference in this respect and, in some cases, can even save you from having to resort to medication. Regular physical activity is also beneficial, as it contributes to the mother’s general health and helps maintain adequate blood sugar levels.

What to eat and what to avoid in gestational diabetes?

A healthy diet is essential for better diabetes management an controlling blood sugar levels during pregnancy.

In the case of gestational diabetes, the aim is to distribute carbohydrates throughout the day, avoiding simple sugars and favouring foods with a low glycemic index (GI). Here are some dietary recommendations:

• Focus on complex, fibre-rich carbohydrates, such as legumes, whole grains (quinoa, oats, brown rice) and whole-wheat bread.
• Eat a variety of vegetables at every meal, and prefer those that are low in starch, such as broccoli, spinach and peppers.
• Choose lean proteins such as chicken, fish, eggs, tofu or low-fat dairy products.
• Eat foods rich in folic acid, such as leafy greens (spinach, broccoli), legumes (lentils, chickpeas), citrus fruits and whole grains.
• Limit high-sugar foods and drinks such as pastries, juices and soft drinks as much as possible.
• Choose three main meals and two to three balanced snacks a day to avoid major variations in blood sugar levels.
• Drink plenty of water and avoid sugary or energy drinks.

Above all, do not choose a diet that drastically reduces the number of calories, as this could be detrimental to the baby’s growth. Follow-up with a nutritionist may be necessary to receive advice tailored to your situation.

Keep a close eye on your blood sugar

In spite of all the preventive and treatment measures for gestational diabetes described above, glucose levels may still be too high. Treatment with injectable insulin may then be necessary.

Regular monitoring of blood sugar levels using a small device called a blood glucose meter is essential to achieve good glycemic balance. Choose a model that suits your preferences and lifestyle to simplify your daily blood glucose monitoring. Your pharmacist or doctor can help you make the best choice for your needs.

Gestational diabetes, you need to be aware!

Whether for a current or upcoming pregnancy, make sure you’re well informed and supported to prevent or better manage diabetes daily. Your pharmacist is there to ensure your health and that of your baby, before, during and after pregnancy.