11/3/2009 5:00:00 AM
Physicians Corner: Gestational Diabetes
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By Dr. Craig Hanson
Gestational diabetes starts when your body is not able to make or use all the insulin it needs during pregnancy. About one in every twenty women develops gestational diabetes, making it one of the most common problems in pregnancy. The diabetes usually disappears after the baby is born. Also, it is the mother who has the diabetes, not the baby. Having gestational diabetes can also increase your risk on having diabetes later in life.
There are usually no apparent symptoms for gestational diabetes. A prenatal examination may find a fetus that is larger than normal for that particular stage in pregnancy. The diagnosis is based on glucose testing done between the 24th and 28th week of pregnancy or possibly sooner is the mother is already a diabetic.
Risks for gestational diabetes increase with obesity, family history of diabetes, previous history of gestational diabetes, mother's older than 25 years of age, five or more previous pregnancies and a history of an unexplained fetal death or stillbirth. While there are no specific preventative measures, pre-pregnancy weight loss in overweight women and pre-pregnancy evaluation for women considered borderline diabetic or who have a history of gestational diabetes may help reduce maternal and fetal risks.
The key to successful treatment and a healthy baby is determined by the mother's motivation and ability to change her lifestyle. For some, dietary control is sufficient, while for others, insulin may be required for treatment. Normal labor and delivery usually occurs, although, a cesarean section may be necessary if the baby is too large for a vaginal birth.
Treatment for gestational diabetes would include diet changes and a moderate exercise program. Patients learn how to monitor their glucose levels. Medications are usually not necessary unless diet and exercise are unsuccessful. Nonweight-bearing exercise is usually recommended, even if it is only for small amounts at a time. Diet changes are an important aspect of treatment with specific diet instructions being provided by the physician. These diet changes involve increasing fiber, restricting fat intake, elimination of concentrated sweets and monitoring calorie intake. Consultation with a dietitian is often recommended and very helpful.
For more information or questions on gestational diabetes, call Van Wert Ob-Gyn at 419-238-6047.
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