By Catherine McCormack
What is gestational diabetes?
Maintaining neutral blood sugar levels is crucial to our general wellbeing, and diabetes occurs when the body no longer has the ability to remove excess glucose from the bloodstream. Why would this happen? In simple terms, the food we eat is broken down into glucose that ultimately serves as our primary energy source. Moving glucose from our blood stream to our cells is the job of insulin, and in a healthy body, the pancreas will produce exactly as much insulin as is required. In an unhealthy body, or one that is genetically predisposed, the insulin response is hampered to the point where high blood sugar levels go unmanaged for sustained periods of time, ultimately resulting in diabetes.
During pregnancy, even healthy people, who ordinarily have no blood sugar problems, have a compromised ability to produce and respond to insulin, and in susceptible women, this can lead to gestational diabetes.
When can you test for gestational diabetes?
“The ideal time to test for gestational diabetes is between 24 and 28 weeks, and if it’s detected, it’s usually very easily managed with little to no risk for either mom or child,” says Sandton-based gynaecologist and obstetrician, Dr Peter Koll. “But in SA we tend to under-test for diabetes in general, and for gestational diabetes in particular.”
According to Razana Allie, Diabetes Nurse Educator from Diabetes SA, gestational diabetes is affecting more and more women in South Africa, due in part to lifestyle choices we make before and during our pregnancies. In some cases, however, there’s simply an insulin resistance which pregnancy exacerbates, and which is very hard to avoid. “As with so many of these diseases, your genes load the gun, but your environment pulls the trigger,” says Dr Koll. “If you have a family history of diabetes or are obese yourself, then you’re probably at a higher risk. But there are no hard and fast rules, and I would advise that everyone be tested.”
Undiagnosed or poorly managed, gestational diabetes can lead to a variety of complications for both the mother and the child, including putting both at risk of becoming obese and developing type 2 diabetes later in life.
Early diagnosis on the other hand usually means that the disease can be managed through lifestyle changes that include following a low-glycemic (low-GI) diet and increasing levels of appropriate exercise, which is sometimes easier said than done.
Can it be cured?
Gestational Diabetes is controlled rather than cured, and in a true case, the condition will usually disappear after birth. Awareness of blood sugar levels through self-testing and following an appropriate low sugar diet, is the best way to manage the disease without medication, but this is only usually possible if diagnosis happens early in the pregnancy.
In extreme cases, or in the case of a late diagnosis, doctors may prescribe insulin or one or more drugs capable of controlling glucose levels artificially.
Who is at risk?
You’re at an increased risk for gestational diabetes if you:
- Are obese
- Have a strong family history of diabetes
- Have sugar present in your urine
- Have previously given birth to a large baby
- Are over 35
- Have high blood pressure
- Have suffered unexplained miscarriages
Foods you should avoid
Nutritional therapist Hannah Kaye advises her patients to follow a low-GI diet by avoiding foods that release energy too quickly. “A good rule of thumb is to avoid white food and focus rather on leafy vegetables and no-carb snacks like chicken pieces, hummus, avocados and lentil spread. Avoid sugar-laden snacks masquerading as healthy alternatives, and become an expert at reading labels to identify hidden sugar in all its many forms.”
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