Diabetes in pregnancy

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.Gestational diabetes affects more and more women in South Africa, due to lifestyle choices women make before and during their pregnancies. “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.”

What causes diabetes

Diabetes occurs when the body no longer has the ability to remove excess glucose from the bloodstream. What this means is that 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 the amount of insulin that 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 leading to diabetes. In some cases, however, there’s simply an insulin resistance which pregnancy worsens and is very hard to avoid.

You’re at an increased risk for gestational diabetes if you

 “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,” Dr Koli recommends, especially those

• 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

Complications to mother and child

Gestational diabetes can put mom and baby at risk especially if it goes undiagnosed or is poorly managed. It needs to be controlled until you give birth, where it is likely to disappear.Early diagnosis usually means that the disease can be managed through lifestyle changes which include following a low-glycaemic (low-GI) and low sugar diet and increasing levels of appropriate exercise. In extreme cases the doctor may have to prescribe insulin or drugs to control the glucose levels.

Foods you should avoid

When you are pregnant, you easily crave foods that may be detrimental to your health. Nutritional therapist Hannah Kaye advises that 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. “Read food labels to identify hidden sugar in all its many forms,” she advises.