Diabetes that develops during pregnancy is also known as gestational diabetes. Gestational diabetes, like “regular” diabetes, is a disorder that disrupts the way one’s body uses sugar during pregnancy. All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. If there is not enough insulin, or if the body stops responding to insulin, sugar builds up in the blood. That is what happens to people with diabetes. Gestational diabetes is a form of diabetes that affects some women when they are pregnant. It happens because pregnancy increases the body’s need for insulin, but the body cannot always make enough. Gestational diabetes affects between two and 10 per cent of women during pregnancy. It is hard to predict which women will get gestational diabetes. But some women are more likely to get it than others. One is more likely to get gestational diabetes if they had gestational diabetes before, are overweight, have diabetes in the family or are above 25. It is important to recognise and treat gestational diabetes as soon as possible to minimise the risk of complications in the baby. In addition, it is important for women with a history of gestational diabetes to be tested for diabetes after pregnancy because of an increased risk of developing type two diabetes in the years following delivery. It is recommended that all pregnant women be screened for gestational diabetes. Identifying and treating gestational diabetes can reduce the risk of pregnancy complications, such as having a large baby (weighing more than 4.1 kgs) which can increase the risk of injury to the mother or baby during delivery and increase the chance of needing a cesarean section, or a life-threatening problem during pregnancy called preeclampsia (preeclampsia causes high blood pressure, among other things). Most women should be tested when they are about six or seven months pregnant. That’s the same as 24 to 28 weeks pregnant. But women at high risk for diabetes may need to be tested earlier in pregnancy. There are a few ways to test for diabetes. A common way is to have you drink a special, sweet drink. Then, after about two hours, one’s blood sugar level is measured. That way, he or she can see how high your blood sugar gets after you eat sugar. To treat ones gestational diabetes, one needs to check their blood sugar often. This is something one can learn to do on their own, with an easy-to-use machine. Most women can control their blood sugar level by changing their diet. Some women also need insulin shots or other diabetes medicines. Watching one’s diet is essential in dealing with gestational diabetes and one will need to see a dietician and be educated on the proper diet to have during their pregnancy. Avoid high-calorie snacks and desserts, including soda with sugar, fruit punch, candy, chips, cookies, cakes, and full-fat ice cream. Eat a lot of vegetables and fruits, at least five servings a day. Some fruits (like grapes, dried fruit) can increase your blood sugar level excessively and should be eaten in limited amounts. If you eat red meat, eat a small amount and only a few times during the week. Remove skin from chicken and turkey before eating. Choose low- or fat-free dairy products, such as skim milk, nonfat yoghurt, and low-fat cheese. Use liquid oils (olive, canola) instead of solid fats (butter, margarine) for cooking. Although exercises have limited effect on treating gestational diabetes, being active helps to control ones blood sugar. If you already exercise, keep doing what you have been doing. If you have not been exercising and want to start, ask your doctor or nurse what kind of activity is safe for you If ones blood sugar levels have been close to normal, chances are good that they will have a normal delivery. During delivery, your doctor or nurse will keep checking your blood sugar to make sure that it does not get too high. After delivery, this form of diabetes will most times go away and one’s blood sugar will probably go back to normal. If one was taking insulin or any medication for the diabetes, they most probably will not need it anymore. Even so, your doctor or nurse should check your blood sugar to make sure your levels get back to normal and stay that way. Women who have gestational diabetes are at very high risk of getting “regular” diabetes later in life, and need to get checked for diabetes every few years for the rest of their lives. Dr. Ian Shyaka is a General Practitioner at Rwanda Military Hospitaliangashugi@gmail.com
