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Gestational
Diabetes
by Anne Cavicchi
There
are so many things to think about when you are pregnant -- and,
if you are anything like me, obsess over! At some time during
your pregnancy, your doctor or midwife will likely order a test
for gestational diabetes.
Some
of the risk factors for developing gestational diabetes include:
- A
strong family history of diabetes.
-
A previous stillbirth.
- A
previous large baby (over nine pounds or 4 kilograms).
- A
mother who is overweight.
- Gestational
diabetes in a previous pregnancy.
- Pregnancy
over thirty years of age.
Some
women will have none of these risk factors and have gestational
diabetes anyways.
Usually
at about 24 - 28 weeks, you will be sent to the lab to drink a
glucose (sugar) drink (often called "the one hour test").
One hour later a blood test will be taken. If it is within the
acceptable range, that's all there is to it! You more than likely
won't require any further testing. However, if your blood sugar
level is above the acceptable range, a second test is taken.
The
second test is similar and called a Glucose Tolerance Test (often
called "the three hour test"). You will be given another
glucose drink but this one is higher in sugar. Blood tests will
be taken one and three hours later. If the test readings are above
the acceptable level, your doctor may tell you "You have gestational
diabetes.".
Gestational
diabetes affects about 4% of all pregnant women. Essentially,
gestational diabetes starts when your body is not able to make
and use all the insulin it needs for pregnancy. Without enough
insulin, glucose cannot leave the blood and be changed to energy.
Glucose builds up in the blood to high levels.
The extra blood glucose goes through the placenta, giving the
baby high blood glucose levels. This causes the baby's pancreas
to make extra insulin to get rid of the blood glucose. Because
of the extra insulin made by the baby's pancreas, newborns may
have very low blood glucose levels at birth and are also at higher
risk for breathing problems. Babies with excess insulin become
children who are at risk for obesity and adults who are at risk
for type 2 diabetes. Since the baby is getting more energy than
it needs to grow and develop, the extra energy is stored as fat,
possibly causing a high birth weight.
Because
untreated or poorly managed gestational diabetes can hurt you
and your baby, you need to start treatment quickly. Gestational
diabetes will require that you take extra care of yorself. While
gestational diabetes is a cause for concern, the good news is
that you and your health care providers can work together to lower
your high blood glucose levels so that you can be rewarded by
a healthy baby! You will need to follow a special meal plan, increase
your activity, monitor your blood sugars and test your urine for
ketones. If your meal plan and increased activity cannot control
your blood sugar levels, it may be necessary to take insulin.
The
good news is that in almost every case, gestational diabetes disappears
after the baby is born and your baby will not be born with diabetes.
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