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Gestational Diabetes: Everything You Should Know About It

Gestational diabetes is a type of diabetes that happens during pregnancy, commonly between 24 to 28 weeks. But it's probable to develop gestational diabetes after or before this period. Insulin is a hormone that lets your cells receive and use glucose as an energy source. Insulin maintains our blood sugar levels on target. But during pregnancy, the way that insulin is used changes. The placenta produces hormones that stop insulin from working as well as it should. Naturally, when you're pregnant, you'll become more resistant to insulin to give your baby more glucose. So, the need for insulin in pregnancy can be 2 or 3 times higher than usual. In some people, their body stops responding to insulin or doesn't make enough insulin to give them the glucose they need. So glucose level rises in the blood. That causes gestational diabetes. From 1 in 20 to 1 in 50 pregnant women experience gestational diabetes. A pregnant woman without gestational diabetes seldom has 100 mg/dl or more fasting blood sugar (FBS) in the morning before breakfast. The best blood sugar goal for a gestational diabetic is under 100mg/dl. If your blood sugar is higher than 100mg/dl, you may need more care about your gestational diabetes. During this period, the hormonal level keeps changing, and you should take care of consuming meals.
The good news is that physical activity, a good diet, and working closely with your dietitian and doctor can help you control your blood sugar.

Gestational Diabetes Symptoms

Some women may notice gestational diabetes symptoms before being tested by their doctor. Some of the typical symptoms are here: increased urinary frequency and urgency, frequent and increased thirst, fatigue and tiredness (which can be hidden by normal pregnancy tiredness), snoring, mood changes, bladder infections, thrush (yeast infections), nausea, vomiting, increased weight gain, and blurred vision. However, most women will not experience any observable gestational diabetes symptoms.

Who Is At Risk of Gestational Diabetes?

Anyone may develop gestational diabetes during pregnancy, but these factors increase the risk of gestational diabetes:
• Age (older than 25)
• Previous large for gestational age (LGA) (birth weight > 4500g or 90th percentile)
• Obesity or being overweight (BMI> 30 kg/m2 before pregnancy or when entering care)
• Gaining much weight during a current or prior pregnancy
• Heart disease like high blood pressure
• Inactivity
• Some conditions that cause insulin resistance, such as skin disorder acanthosis nigricans or polycystic ovarian syndrome (PCOS)
• Giving birth to a baby that weighed nine pounds or more in previous pregnancies.
• Race (Asian American, Native American, Asian, Black, Alaskan Native, or Hispanic).
• Rising maternal age (≥40 years)
• A first-degree relative (mother or sister) who had gestational diabetes or a family history of type 2 diabetes
• Having gestational diabetes during a previous pregnancy
• Multiple pregnancies
• Past perinatal loss
• Some medications (antipsychotics and corticosteroids)
• Eating low fiber diet

When Should I Test for Gestational Diabetes?

All women should be tested around 24–28 weeks of pregnancy (except those already diagnosed with diabetes or known to have gestational diabetes). Women with one or more above risk factors should be tested when their pregnancy is confirmed and then at 24 weeks if doctors don't diagnose diabetes earlier.

Reduce Risk of Gestational Diabetes

There are some things that you can do to reduce the risk of gestational diabetes:

Before Pregnancy:

If you aren't still pregnant and you are overweight, you can consider the following tips to reduce your risk of gestational diabetes:

1. Improve Your Diet and Eat Healthy Foods

Have a healthy diet that focuses on whole grains, vegetables, and fruits. Also, an increase of 10 grams per day in total fiber consumption decreases the risk of gestational diabetes by 26%. So the first thing you should do to reduce the risk of gestational diabetes is to readjust your diet plan with the consolation of a dietitian.

2. Make a Regular Exercise Routine Plan

Besides having a good diet plan, if you're inactive, whether you're overweight or not, you should have regular physical activity at least three times a week and for at least 30 minutes each time.
Several studies show that gestational diabetes was less common in women who exercised more – regardless of whether they had an average weight or were overweight.

3. Consider Weight Loss

Even a few pounds of weight loss can make a difference in your risk level for gestational diabetes. But for women who are at a good weight before pregnancy (BMI 18.5-24.9), weight loss doesn't help prevent gestational diabetes.

During Pregnancy

If during pregnancy you noticed that you have gestational diabetes, you shouldn't lose weight, but consider the below:

1. Have a Healthy Diet

A healthy pregnancy diet can help prevent gestational diabetes. Generally, for a pregnant woman, it is suitable to take about 2,200 to 2,500 calories per day; note that the exact amount of calories you should eat remarkably differs from person to person. If you are obese or overweight, you can lower your risk of gestational diabetes by making dietary changes. Suitable dietary changes hold your blood sugar levels normal and help you gain less weight throughout pregnancy. You still need to gain weight when you're pregnant. It is important to pay attention to what you eat and when you eat.

2. Exercising

Regular exercising from the start of pregnancy may lower your risk of gestational diabetes. You don't need to exercise heavily, do it light like walking, jogging, etc.

3. Manage Your Weight Gain During Pregnancy

Gaining too much weight in pregnancy can raise blood sugar, increase insulin resistance, and raise blood pressure. So, monitor your weight, and don't let it grow too much. However, you shouldn't follow a strict diet to lose weight during pregnancy because it can cause problems for you and your baby. The best way to manage your weight is to change your diet and increase your physical activity.
There are standard instructions based on pre-pregnancy weight concerning how much weight pregnant women can gain.
• 12.5 and 18 kilograms for underweight women (BMI of less than 18.5)
• 11.5 and 16 kilograms for women with an average weight (BMI of between 18.5 and 24.9)
• 7 and 11.5 kilograms for overweight women (BMI of between 25 and 29.9)
• 5 and 9 kilograms for obese women (BMI greater than 29.9)

Decreasing the Chance of Subsequent Gestational Diabetes Pregnancies

Suppose you had gestational diabetes during past pregnancies; better to pay more attention to your health if you want to prevent diabetes. We can't change something like age, ethnicity, insulin resistance, etc., in the past pregnancy, but there are some things that we can change. Do the following points to decrease the chance of subsequent gestational diabetes pregnancies:

• Lose weight (If you are overweight or obese) If your BMI is more than 29.9, losing weight will help you reduce the chance of gestational diabetes and will improve insulin resistance. But there is no guarantee of losing weight to avoid a second gestational diabetes pregnancy. Still, it is beneficial and will improve insulin resistance and decrease GD risk.
• Follow a healthy diet plan
• Have physical activity before and during pregnancy
• Take Myo-inositol supplement
Inositol (known as vitamin B8) is a natural product in nine different types found in various foods and produced by the body. Corn, cereals, green vegetables, and meat contain Myo-inositol. You can also take it as a supplement in tablet or powder form. Furthermore, Myo-inositol plays a part in insulin sensitivity. A meta-analysis of studies shows that using Myo-inositol supplementation may reduce the risk of gestational diabetes.

Is Myo-inositol Safe in Pregnancy?

Many studies show that Myo-inositol supplementation of 2g twice daily, besides 400μg folic acid daily, can reduce gestational diabetes. It has some other beneficial outcomes, like reduced rates of neonatal hypoglycemia. So taking it during pregnancy is safe.
But be sure to consult with your doctor before taking any supplement during pregnancy.

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