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Table of Contents What is gestational diabetes? In pregnancy, gestational diabetes occurs as a result of elevated blood sugar levels or diabetes. Approximately 4% of all pregnancies are affected by this condition. A woman’s first diagnosis of gestational diabetes is usually made in the late stages of pregnancy. What causes gestational diabetes? During pregnancy, the body undergoes several hormonal and non-hormonal changes that predispose certain women to becoming insulin resistant. In addition to insulin, the pancreas produces several hormones that help the body digest glucose for subsequent use as fuel (energy). A increase in blood glucose occurs when insulin levels are low or the body cannot properly utilise insulin (insulin resistance). What blood tests diagnose gestational diabetes? Gestational diabetes is diagnosed with blood tests. Most pregnant women are tested between the 24th and 28th weeks of pregnancy, but if you have risk factors, your doctor may decide to test earlier in the pregnancy. Testing of the patient’s blood confirms the diagnosis. Testing your blood sugar levels an hour after consuming a sugary beverage is part of a glucose tolerance screening screening test. If the results of the screening test are not normal, you may need to undergo further tests. It is also possible to do a glucose challenge test using oral glucose (OGTT). After eating a sugary beverage, your baseline blood glucose level is examined, and then your blood glucose level is assessed 1, 2, and occasionally 3 hours later. This test will identify 80 percent of women with gestational diabetes if their blood glucose level is 140mg/dl or above. 90 percent of patients are identified when the threshold is reduced to 130mg/dL. In most cases, women with a blood glucose level more than 130 mg/dL are advised to undergo a second diabetes screening test that requires them to fast (not consume anything) before the examination. Another test that may be conducted is hemoglobin A1c, which is glycosylated. Test for long-term monitoring of blood glucose levels in diabetics. Blood glucose is measured by hemoglobin A1c, which is a measure of the average blood glucose during the last few months. Related> Diabetes and High Blood Pressure: Understanding the Relationship Should all pregnant women get tested for gestational diabetes? All pregnant women should be screened for gestational diabetes during their pregnancy. Most pregnant women are tested between the 24th and 28th weeks of pregnancy. What is the treatment for gestational diabetes? When blood glucose levels are stabilized, issues and complications are less likely to occur. Maintaining a good diet is an important part of treating gestational diabetes. Glucose control can be achieved by following a dietary plan for many women with diabetes. It has been shown that regular exercise can also help to maintain a tight glycemic control system. Testing your blood glucose levels at home at specific times or after meals will be recommended to determine if your glucose levels are within acceptable limits. Testing at least four times per day is typical. You may also be asked to test your urine for ketones, substances that are produced when your body metabolizes fat. Ketones are elevated when the body is unable to use glucose for energy. If diet and exercise alone are not enough to keep your blood glucose levels under strict control, insulin treatment may be essential. However, many doctors utilize oral medicines to manage blood sugar levels in women with gestational diabetes who are not using insulin. It is possible that insulin requirements will alter as the pregnancy continues, and that insulin dosages would need to be adjusted accordingly. Related> Do’s and Don’ts of Diabetes Is there a special diet plan for women with diabetes during pregnancy? While there is no one specific diet that is recommended for all women with gestational diabetes, following a meal plan can help keep your blood sugar levels under control and avoid complications. - A nutritionist may be helpful in designing a meal plan that takes into account individual schedules and preferences. - Eating a variety of foods is recommended, and it is better to eat smaller portions throughout the day (e.g. 3 small to moderate meals and 2-4 snacks) rather than just a few large meals. - Many women with gestational diabetes will be advised to eat fewer carbohydrates than in their normal diet and to eat complex carbohydrates that contain fiber. It’s important to limit consumption of foods containing large amounts of simple sugars. - High-fiber foods like fresh fruits and vegetables, as well as whole-grain products, are not only nutritious but also effective in keeping blood sugar levels stable. - Skipping meals is not recommended because this leads to undesirable fluctuations in blood sugar levels. Can you prevent diabetes during pregnancy? Gestational diabetes cannot always be prevented; however, obesity is a prime determinant for developing the disease. Maintaining a healthy weight and following a good nutritional plan both before and during pregnancy can decrease your chances of developing gestational diabetes. Maintaining a healthy weight can also decrease your chances of developing type 2 diabetes following pregnancy. Can gestational diabetes be cured? Most women with gestational diabetes who receive treatment go on to deliver healthy babies. The risk of complications increases when blood glucose levels are not properly controlled. While some women with gestational diabetes will develop type 2 diabetes following delivery, this risk can be reduced by following a good nutritional plan, exercising, and maintaining a healthy weight. FACTS ABOUT DIABETES - Risk factors for gestational diabetes include - obesity, - a history of gestational diabetes in a previous pregnancy, - a family history of type 2 diabetes, and - having prediabetes. - There are typically no noticeable signs or symptoms associated with gestational diabetes. - Gestational diabetes can cause the fetus to be larger than normal. Delivery of the baby may be more complicated as a result. The baby is also at risk for developing low blood glucose (hypoglycemia) immediately after birth. - Following a nutrition plan is the typical treatment for gestational diabetes. - Maintaining a healthy weight and following a healthy eating plan may be able to help prevent or minimize the risks of gestational diabetes. Get new content delivered directly to your inbox. NURSING TV Follow Us
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काठमाडौं– गर्भावस्था एक संवेदनशील अवस्था हो। गर्भावस्थामा महिलालाई विशेष हेरचाहको आवश्यकता पर्छ। गर्भावस्थामा कतिपय महिलालाई ‘मधुमेह’को समस्या देखिन सक्छ। जसलाई चिकित्सकीय भाषामा ‘जेस्टेशनल डायबिटिज’ भनिन्छ। जेस्टेशनल डायबिटिज हुनुको विभिन्न कारणहरु छन्। ३५ वर्ष माथिका, मोटापन, पहिलेदेखि रक्तचाप भएको र गर्भ खेर गएका महिलामा जेस्टेशनल डायबिटिज हुने जोखिम बढी रहने प्रसूति तथा स्त्री रोग विशेषज्ञ डा सन्देश पौडेल बताउँछन्। जेस्टेशनल डायबिटिज भनेको के हो? यो समस्या किन हुन्छ? कसरी बच्ने लगायत विषयमा हामीले डा पौडेलसँग कुराकानी गरेका छौँ। उनीसँग गरिएको भिडियो कुराकानी यहाँ प्रस्तुत गरिएको छः गर्भावस्थामा किन मधुमेह रोगको समस्या देखिन्छ? – गर्भावस्थामा देखिने मधुमेह दुई किसिमको हुन्छ। एक, पहिले नै मधुमेह भएको र दोस्रो, गर्भावस्थामा हुने। – सामान्यतया गर्भावस्थामा शरीरमा ग्लुकोजको मात्रा धेरै उत्पादन हुन्छ। – गर्भावस्थामा ग्लुकोजको मात्रा धेरै भए पनि सबै महिलामा मधुमेह हुने जोखिम भने हुँदैन। – ३५ वर्ष माथिका, मोटापन, पहिलेदेखि रक्तचाप भएको र गर्भ खेर गएका महिलामा मधुमेहको समस्या हुन सक्छ। – यी जोखिम कारकको आधारमा जेस्टेशनल डायबिटिज भए/नभएको थाहा पाउन परीक्षण समेत गर्छौ। गर्भावस्थामा पहिलो पटक देखिने मधुमेहले बच्चा र आमालाई कस्तो असर गर्न सक्छ? – पहिले नै मधुमेह भएका महिला र पछि देखिएको महिलामा असर फरक हुन सक्छ। – पहिले मधुमेह भएका महिलाको रक्तचाप बढ्न सक्छ भने बच्चाको वृद्धि विकास राम्रोसँग हुँदैन। – शिशु जन्मिएपछि चिनी कम हुने, क्याल्सियम, म्याग्नेशियमको कमी हुनुका साथै जण्डिस हुन सक्छ। – गर्भमा रहेको शिशु अपांग हुने पनि जोखिम हुन्छ। – गर्भावस्थामा देखिएको मधुमेहले शल्यक्रिया गर्नुपर्ने संभावना बढेर जान्छ। – डेलिभरीपछि बढी रक्तश्राव हुने, संक्रमणको सम्भावना पनि धेरै हुन्छ। – बच्चा धेरै ठूलो भएपछि सुत्केरी हुने क्रममा असर गर्छ। – गर्भावस्थामा देखिएको मधुमेह सुत्केरी भएपछि घट्छ भने ५० प्रतिशत महिलामा ५ देखि १० वर्षमा मधुमेह देखिन सक्छ। शिशु जन्मिएपछि पनि उनीहरुलाई पुनः मधुमेह देखिने संभावना बढेर जाने भयो? – हो, ती महिलाको उमेर अनुसार पछि पनि मधुमेह देखिने सम्भावना हुन्छ। – केही महिलालाई मधुमेह निको हुँदैन भने धेरैको पछि देखिने संभावना धेरै हुन्छ। गर्भावस्थामा पहिलोपटक मधुमेह हुँदा खानपान र जीवनशैलीमा कसरी ध्यान दिने? – यो बेलामा खानपान मात्र नभई शारीरिक व्यायाम पनि गर्नुपर्छ। – ४०–५० कार्बोहाइड्रेट, २५–३० प्रोटिन र बाँकी प्रतिशत फ्याट शरीरलाई आवश्यक पर्छ। – हामीले निश्चित सुझाव दिए पनि पोषणविद्सँगको सल्लाहअनुसार खानपान गर्नुपर्छ। – दुई हप्तादेखि एक महिनासम्म पनि मधुमेह नियन्त्रण भएन भने मात्र अवस्था हेरेर औषधिको प्रयोग गर्छौं। गर्भावस्थामा देखिने मधुमेहको पहिचान कसरी गर्ने? – यो अवस्थामा केही लक्षण नदेखिन पनि सक्छ। – बच्चा बस्ने भागमा धेरै पानी भए, आमाको तौल एक्कासी बढ्दै गए शंका गर्नुपर्छ। – धेरै तिखा तथा पिसाब लाग्नु पनि यसको लक्षणहरु हुन्। – यकिन तथ्याङ्क नभए पनि एसियनहरु जेस्टेशनल डायबिटिजको बढी जोखिममा हुने विभिन्न अध्ययनले देखाएको छ। गर्भावस्थामा देखिने मधुमेहको समस्याबाट कसरी बच्न सकिन्छ? – यो समस्या निम्त्याउने सबै जोखिमका कारकलाई परिवर्तन गर्न सकिँदैन। – गर्भभन्दा अगाडिको शरीरको तौल मात्र नियन्त्रण गर्न सकिन्छ। – समस्याको प्रारम्भिक पहिचान गर्न सके यसले निम्त्याउने जटिलतालाई कम गर्न सकिन्छ। – रोगको प्रारम्भिक पहिचान गर्न नियमित परीक्षण गराउनुपर्छ।