The saying
goes that a woman is ‘eating for two’ when she is pregnant however what she chooses
to eat has a drastic impact on her risk of gestational diabetes. There are the common cravings such as ice
cream and pickles but many find themselves also reaching more for bread,
crackers or comfort food and avoiding their normally healthy choices out of
convenience, nausea or sudden aversion to foods they once loved. These high carbohydrates, high sugar foods cause
a considerable amount of weight gain and fill the system with glucose leading
to hyperglycemia and insulin resistance.
It is well
known that everything changes with pregnancy.
Anatomically, the body shifts completely to accommodate a growing
fetus. Hormones sky rocket and the brain
seems to turn to mush (commonly called, mommy brain). A pregnant woman’s endocrine system also
changes as the body has to adapt to all of the shifts however if the output of
insulin by the pancreas cannot keep up with the increase in carbohydrate/sugar
heavy foods, she becomes diabetic.
Having gestational diabetes also increases a women’s risk for type 2
diabetes later in life and therefore should be monitored carefully both from a
screening glucose/insulin test and a
lifestyle stand point. It is also
important to note that given the current increasing trend in overweight and
obesity in the United States, research shows that 50-60% of women go into their
pregnancy already carrying too many extra pounds on their frame further
increasing the risk.
There is not
one set standard for diagnosing gestational diabetes however a woman is more at
risk if she has a body mass index (BMI) of 30 or more going into the pregnancy,
has had gestational diabetes in a prior pregnancy, or has a strong family
history of diabetes. The most common
test is the Oral Glucose Tolerance Test (OGTT) where a pregnant woman drinks a
very sweet drink then waits an hour and has her glucose tested. A normal result (depending on the lab) is
under 130-140 mg/dL. The drink is very
syrupy and often can cause vomiting, in which case the test must be repeated at
a later date. Follow up testing can include
the 3 hour Oral Glucose Tolerance Test where the same test is repeated however
glucose levels are drawn every hour for 3 hours. If 2 out of the 3 hours have abnormally high
levels of glucose, gestational diabetes is diagnosed.
As there are
considerable risks for the growing baby (heavy birth weight babies, early
delivery, and shoulder dystocia) it is important that gestational diabetes be
taken seriously. Pregnancy is not the
time to lose weight or go on a diet however routine glucose monitoring, changes
in diet and proper exercise can make a huge difference and possibly avert the
use of insulin in order to control glucose levels. Make sure to eat a variety of vegetables,
lean protein, good fats and fiber rich foods for the health of everyone
involved!
To learn more, read about the women's health website, Empowher, here!
References:
11) Mild Gestational Diabetes. Web.
20 January, 2013.
http://www.medscape.com/viewarticle/775396
22)
Gestational Diabetes. Web. 20 January, 2013.
33) The
Relative Contribution of Prepregnancy Overweight and Obesity, Gestational
Weight Gain, and IADPSG-Defined Gestational Diabetes Mellitus to Fetal
Overgrowth. Web. 20 January, 2013.
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