Diabetes is a worldwide issue. Simply put, it occurs to someone when their body is not able to produce enough insulin, which is what plays a part in keeping our body’s blood sugar levels regulated. Studies and trends suggest that the number of diabetics in Singapore could rise to 1 million when 2050 comes.
In this article we will be focusing on Gestational Diabetes Mellitus (GDM), which is a type of diabetes that happens to pregnant women. In this case, the high blood sugar content affects not only yourself, but also the foetus that you are carrying. As such, we want to help all mothers prevent and diagnose such an issue given the implications.
We have an interviewee Kate, who will give us a first-hand account of how it felt like to be diagnosed with GDM, including her insight on how to prevent GDM and what she did when she found out that she was positive for GDM.
More about Gestational Diabetes Mellitus
Most mothers will generally be tested for GDM at some point of their pregnancy journey. GDM is developed in a women’s second trimester of pregnancy, most commonly after week 24. All mothers are strongly encouraged to be tested for GDM after their 24th week of pregnancy. The test conducted is known as an Oral Glucose Tolerance Test (OGTT). It works like a normal blood test, where your blood sample is taken in the morning after fasting from 10pm the previous night. However, after that sample is taken, you will be asked to drink a sweet drink, and have your blood sample taken twice more, after one hour and two hours respectively. The doctors will then look at your blood glucose levels and how your body reacts to the glucose you consumed in the sweet drink.
GDM can affect any pregnant woman, but there are some traits that may cause you to be at a higher risk of developing it. Such traits are:
- Being aged over 35 years old
- If a family member had diabetes
- Personal history of having GDM (past pregnancies)
- Prediabetes (higher-than-normal levels of blood sugar)
What does Gestational Diabetes Mellitus mean for me and my foetus?
As mentioned, the lack of insulin processed by your body will cause the sugar levels in your blood to rise. In most cases, GDM will not be present any more after a woman gives birth to her child, and her insulin levels go back to their normal levels. However, there are a few cases of mothers whose blood sugar levels remain the same after childbirth, causing them to require continued follow-up in diabetes treatment. As for most of the ladies who have GDM resolved after childbirth, they would still have to be extra cautious about their sugar intake and blood sugar levels as they now have increased risk of developing type-2 diabetes. There is the same increased risk for the baby when he or she grows up.
GDM can be a life-threatening illness if serious, as both high blood pressure and preeclampsia have heightened risks, putting the lives of both mothers and baby under threat.
Regarding the foetus, the excess glucose in your blood can pass through the placenta but not the inulin. As such, the baby’s pancreas in turn will produce insulin to counter that, and it may cause the baby to grow too big and create a tough time for mothers during childbirth, as the baby may have difficulties passing through the birth canal, resulting in an inevitable c-section birth and even birth injuries.
Apart from the bigger baby, GDM may also cause women to go into early labour before the supposed the due date. It may also be possible that the recommendation is made by the doctor due to the expectation of a larger baby. Respiratory Distress Syndrome is also likely to affect your child if you have GDM and if he or she is born early, and such babies will require breathing aid to help them breathe until their lungs are matured and stronger.
Because of the blood sugar the baby received and the insulin production levels of the baby, it may cause the baby to develop hypoglycemia (low blood sugar) due to their higher insulin production. Severe cases of hypoglycemia could trigger seizures in your baby. This calls for timely feeding of the baby as well as the need for an intravenous glucose (dextrose) solution to bring the sugar levels back up, whenever necessary.
Types of treatment and cures for Gestational Diabetes Mellitus
Upon discovery of GDM in pregnant women, they will have been asked to make certain changes in their lives to improve them. Firstly, there will be changes in mummy’s diet in order to keep their blood sugar level in control. Normally, a dietician would be able to come up with a meal plan to follow. Next, the other way to suppress GDM is to get active and exercise. Types of exercises should be discussed beforehand with your doctor before getting some exercise in.
If the blood sugar level cannot be managed by diet alone, doctors may also prescribe insulin injections or diabetes medication that can help keep GDM suppressed for a healthy you and healthy baby.
Kate Shares About Her GDM Journey
Our interviewee Kate is 34 this year and when she was pregnant at 31, she found out that she had GDM after an Oral Glucose Tolerance Test.
“I was asked to do an OGTT in my second trimester, right around my 25th week, to check for GDM as I was told about the possibility. Many mothers go through this test too, and most of them will be relieved because their blood sugar levels were normal. Surprisingly, I was not one of them,” said Kate. She remembered the fear that almost completely overwhelmed her, not just for herself, but also for her precious first child.
However, it was through undying support that she found her positivity and motivation to stay strong. “It was quite overwhelming, but I kept telling myself I had to be strong because it was something that I could overcome. My parents, husband and doctor were very supportive of me in those times and I could never bear to let them down.”
After she was diagnosed with GDM, Kate was referred to a nutritionist who helped her to come up with a meal plan for each day. She was told to take blood sugar readings 6 times per day to monitor her blood sugar level. Kate recalled, “I was so depressed and scared as I was so afraid of needles but the thought that I am doing this all for the sake of my baby pushed my fears aside.”
Apart from that, Kate was also asked to do some light exercises like strolling which would help her in her journey to suppress her GDM. She jokingly added “I don’t remember any other time in my life when I had so much motivation to exercise!”
Kate told us it was quite challenging to commit to the meal plans that were set for her as she often felt light-headed when she had consumed less carbohydrates than required. At times, she had overlooked the added sugar in soup and other foods that caused her blood sugar readings to spike. However, she decided to overcome the challenges for the sake of her baby as well as her own health by researching more and experimenting with recipes and preparing her own meals. As she progressed further in her third trimester, she actually felt healthier and more energetic by eating healthily and most of all, she did not put on excessive weight throughout her pregnancy.
Kate gave birth to a healthy boy with slightly low birth rate at the 39th week. He is now a happy and healthy 3-year-old.
The family’s joy was doubled when our interviewee’s blood test 2 months after her birth showed normal blood glucose levels, meaning that she was free from diabetes. “I was obviously very happy because despite the complications, the pregnancy journey went by smoothly, and heaved a sigh of relieve knowing I was currently off the hook from diabetes.” she remembers. But she soon realized she still had more work to do even though GDM was no longer affecting her at that point. She was told by her doctor that she would be more likely to get Type 2 Diabetes later in her life, and that she might be at risk of getting GDM if she is pregnant again.
Tips for preventing gestational diabetes
Although it can happen to many mothers, there are some things women can do to lower the chances of being affected by GDM when they are pregnant.
Kate now leads a much more active lifestyle than in the past, saying: “I basically carried on with my changed lifestyle after pregnancy, knowing that I was also at higher risk of getting type 2 diabetes. Since I needed to lose the extra weight from pregnancy, and that now my belly was not as heavy, it was quite easy for me to get up in the morning for a walk or a jog. Currently, when I have the time to, I try to get some exercise done and keep myself active, through activities such as going to the gym or swimming.”
Regarding meals, she says: “I try to eat more balanced meals with more vegetables and less of the unhealthy fried foods, but I am able to have my cheat days occasionally! I also rarely take empty calories from sweet foods, to keep my blood sugar levels as well as my weight in check, all in preparation for the pregnancy journey with my second child.”
She also adds that it would be a good idea to make sure your children are active as well if you had GDM when carrying them, due to the increased risk of them getting diabetes in the future.
To sum it up, it may be a good idea to adopt a healthy lifestyle and good eating habits before pregnancy. Shedding some weight before pregnancy, especially if you are obese, will reduce your chances of getting GDM during your pregnancy.
GDM can happen to any mother on her pregnancy journey, but remember to stay positive even if you get it as it can definitely be managed by making positive lifestyle changes.