Diabetes during pregnancy
Hi Rose,
Note: This question would normally be beyond the realm of this forum, but I felt that due to its importance it should be addressed in its entirety. Exercise does play an important role in the management of this disorder so we weren’t totally off base by answering it!
Diabetes is a condition in which blood sugar or glucose levels are not regulated properly. It is related to the hormone insulin, which is responsible for controlling blood sugar levels. In Type I Diabetes (juvenile-onset or diabetes that develops before adulthood) the body does not produce enough insulin. In another form of diabetes, the insulin produced by the body is not used effectively. This is the case in both adult-onset diabetes and gestational diabetes.
Gestational diabetes, by definition, is diabetes that develops during pregnancy in a woman who did not have diabetes before she became pregnant. It is thought to result from metabolic changes brought on by the hormones of pregnancy and is only found in 1-5% of women who are tested for gestational diabetes during their pregnancies.
Although gestational diabetes is usually not a threat to the mother’s health, it should be taken as a warning sign that she is at a greater risk for developing adult-onset diabetes later in life. Also, gestational diabetes poses some real risks for the baby. However, when the problem is properly diagnosed and managed, the baby is put at no greater risk that it would have been had the mother not had the disorder.
The major risk for babies whose mothers have gestational diabetes is macrosomia or excessive birth weight. Macrosomia is defined as a birthweight of greater than 4500 grams or 9 pounds 14 ounces. Babies as big as this may have difficulty being born. Also the likelihood of a C-section is increased with these babies. Keeping blood sugar levels within the normal range is imperative in order to decrease the above risk.
Other problems that may develop as a result of gestational diabetes include hypoglycemia or low blood sugar shortly after birth. This may occur because the baby is used to getting high amounts of glucose across the placenta and once the umbilical cord is cut at birth, the source of this glucose is abruptly stopped. These babies are usually monitored after birth to prevent their blood sugar levels from becoming too low.
The key to managing gestational diabetes is to control mom’s blood sugar level. In most cases this can be done with careful diet planning, exercise and regular blood sugar testing. Home blood sugar testing may be recommended. Urine testing is not accurate as there is little correlation between urine sugar and blood sugar levels.
In almost all women who have the condition, diet, exercise and blood sugar monitoring can bring it under control. If diet and exercise do not seem to be controlling the condition, mom may require daily insulin injections.
Gestational diabetes almost always goes away after delivery. However, if mom has had gestational diabetes in one pregnancy, the likelihood that she will experience it in subsequent pregnancies is increased. Also as mentioned above, the likelihood that she will develop adult-onset diabetes in the future is increased. Therefore diet and exercise are especially important in the long term for moms who have had this condition during pregnancy.
I would suggest that your sister definitely be more assertive with her doctor regarding his management of her diabetes and also seek out the services of a registered dietitian to get her eating on track. IT IS EXTREMELY IMPORTANT THAT SHE GET HER DIET UNDER CONTROL!!! The American Diabetes Association says that “All women with gestational diabetes mellitus should receive nutritional counseling, by a registered dietitian when possible, consistent with the recommendations for calorie distribution proposed by the American Diabetes Association. Individualization of the diet depending on maternal weight and height is recommended. Diet therapy should include the provision of adequate calories and nutrients to meet the needs of pregnancy, and should be consistent with the maternal blood glucose goals that have been established. Intake of sucrose (sugar) and other caloric sweeteners should be limited.”
I cannot say whether her fatigue is related to the diabetes, which it very well could be, or just to her advancing pregnancy and her 50-pound weight gain. Please pass this information on to her quickly.
Please let me hear from you.