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How to control diabetes during pregnancy

Diabetes that develops during pregnancy or diagnosed first during pregnancy is called gestational diabetes. However, it usually disappears after the birth of the baby. It usually starts from 24 to 28 weeks.

 In order to control gestational diabetes, it is imperative to understand what it is.

What is gestational diabetes?

Insulin is a hormone that is released from (beta) cells in the pancreas. It is released when the concentration of glucose (sugar) rises too high. It has a vital function; it lowers the concentration of glucose in the blood/blood glucose level back to the optimum level. Insulin causes the glucose to enter cells, thus reducing the concentration of glucose in the blood. During pregnancy, the body makes particular hormones which can cause changes. These result in insulin resistance. However, some women can produce enough insulin to overcome the insulin resistance, whereas others can’t. The women who cannot produce enough insulin then develop gestational diabetes.  

Gestational diabetes can have long-term impacts. Women are more likely to develop gestational diabetes again and type 2 diabetes. NHS has stated that women should have their blood tested to check for diabetes 6-13 weeks after birth, and then yearly if results are average. 

Risk Factors

Some factors can increase the likelihood of developing gestational diabetes. Some are controllable and can be altered like

  • Being overweight- a BMI of over 20kg/m2- You able to prevent the risk of developing gestational diabetes by losing weight before you are pregnant, not after. You can hear countless different methods of losing weight. However, the key is to lose weight safely and have a lifestyle that you can sustain in the future as well. Thus, not eating for a week or an only water diet may not be the best way to lose weight as they aren’t feasible as a way of life. You can make small changes that can have an enormous impact. Intermittent fasting can be a great way to lose weight. The principle is to eat within specific windows. A popular variation is the 16/8 intermittent fast. You only eat food from 12 to 8 pm. You cannot eat for the rest of the 16 hours. That can also have many other benefits, but most importantly, it is a convenient method to lose weight. Some people too, simultaneously, use a ketogenic diet. The ketogenic (keto) diet, allow foods that are low in carbs and high in fat to force your body to enter a metabolic state coined ketosis. This burns fat instead of carbohydrates as there is a limited reserve of glucose. 
  • Lack of exercise- Remember this is advice for before you are pregnant not after. Exercises for when you are pregnant is further below. To maximise your weight loss and make it more efficient, exercise while you diet. Walking is a fantastic form of exercise; not only does it require no equipment; it is also low impact. If you are more comfortable, then you can run or cycle. High-Intensity Interval Training, commonly known as HIIT, consists of intense exercise in a short period of time, around 30 seconds. Studies have shown that you burn more calories a minute than other activities. The great feature is that the whole workout is relatively short but consumes a tremendous amount of calories. A minimal impact exercise is a yoga. A study had shown that when 60 women with obesity tried yoga (they had two 1.5 hour sessions a week, for 12 weeks), they lost, on average, 1.5 inches around waistline more than other groups.

However, some cannot be influenced 

  • Your race- being African-Caribbean, black, middle eastern, or south Asian can increase the risk.
  • having gestational diabetes before 
  • another close family member (parents or siblings) having diabetes 
  • over the age of 25 
  • you have had a baby weighing more than 4.5kg 

Symptoms 

It must be noted that gestational diabetes does not typically have any associated symptoms, so it is only discovered when being tested for gestational diabetes. However, high blood sugar can have symptoms like:

  • thirst,
  •  dry mouth,
  •  tiredness.  

Oral Glucose Tolerance Test

If you have never had gestational diabetes before then, you may be offered a test when you are 24 to 28 weeks pregnant. Nonetheless, if you have had it before, then you may have one sooner. 

The test comprises of a blood test. Blood would be taken from a vein in your arm or (a drop) from your finger. You are required to keep a fast before the ORGTT for around 8 to 10 hours. You are allowed to drink water, no other kinds of drink are permitted. Then, on the morning of the test, you are given a drink comprising of glucose. If you have diabetes, then there will be another procedure.

Controlling your gestational diabtetes. 

Monitor your blood sugar levels, checking to see if they are within the optimum range. check at least four times daily 

We strongly urge you to seek medical advice, and you may be referred to a dietitian who can help you with your diet. 

What to eat: 

Before laying out what to eat, remember to eat around three or (five smaller) meals a day

  • Eat fruits and veg, aiming to get your five portions a day. 
  • Cut down on your sugary drinks and drink water instead. You can also drink plain skimmed, semi-skimmed, decaffeinated coffee/tea.
  • Eat foods with a low GI (glycaemic index). Foods that have carbohydrate have a GI associated with it. Remember, glucose is a carbohydrate and diabetes is when you cannot reverse high blood glucose level. The GI demonstrates how swiftly the food has an impact on your blood glucose level. High GI foods are broken down rapidly that dramatically causes a peak in your blood glucose. These food are sugar (sugary foods), white rice, white bread and more. In conclusion, eat food that releases sugar slower (with low GI) like brown rice, beans, lentils, wholewheat pasta and more.
  • There are also many foods you must not eat, NHS has a fantastic blog about food you should not eat. 
  • You mustn’t smoke or drink alcohol. 

If you are worried, you may be experiencing symptoms of gestational diabetes, speak to your GP. Your GP may also give you medicine/insulin injections to help control your blood glucose. 

Exercising 

Glucose is an energy source, and a great way to get rid of excess glucose is to burn it off. You can partake in physical activity to lower your blood glucose. NHS recommends aiming to achieve at least 150 minutes of moderate-intensity activity weekly and at least two days of strength exercise. Before diving into the exercises, remember that you must not over-exercise. You must be able to hold a conversation while exercising. Before you start, remember to warm-up. Whichever safe exercise you participate in, try to do it daily. People opt to go to exercise classes where the instructor is qualified to teach pregnant women. An easy and non-expensive way is to walk. Remember to drink plenty of fluid and don’t partake in strenuous exercise during hot weather. Choose a safe path as you should not exercise when there is a risk of falling, as it can harm your baby. Alternatively, you can swim as the water can support you and your baby. Lastly, always cool down at the end.

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