Expert advice

Leah Hechtman: fertility expert

Leah is the Director of The Natural Health and Fertility Centre in Sydney , where she specialises in male and female fertility and reproductive health. She is passionate about helping couples make healthy babies.

Gestational diabetes

Lean Hechtman
Tuesday, April 19, 2011
"if you're monitored properly and you adjust your diet and lifestyle as directed then your bub shouldn't have any problems."
Lean Hechtman

Question:

I'm almost 28 weeks pregnant and have only gained 4kg. It's my third child and I am going through a stressful period but I'm concerned about my baby. I have also been diagnosed with gestational diabetes at 17 weeks. My midwife said it's okay to lose some weight as long as the baby is growing. I'm eating well and my only exercise is running after my three-year-old son and general housework. Should I be more concerned for my baby's health? I gained 14kg with my first and 13kg with my second child.

Answer:
I replied to a similar query regarding weight gain in pregnancy recently. Please have a read through it as I'm sure you'll find it interesting. The most important aspect is that each woman and each pregnancy is different. Provided that you stay healthy during your pregnancy generally things work out well.

What I'd like to focus on here is management of gestational diabetes. Gestational diabetes mellitus (GDM) is a unique form of diabetes that occurs during pregnancy in some women. It typically goes away once the bub is born and is directly related to your genetics, weight, diet, age, lifestyle and ethnicity. A few examples of typical women that may develop the disease include:

  • women who are sedentary (don't exercise);
  • women who eat a carbohydrate rich diet (to excess) with a high percentage of refined carbohydrates (white flours, sugar, processed foods, junk food);
  • women who start the pregnancy overweight;
  • women with a family history of type 2 diabetes or women whose mum's had gestational diabetes (especially when they was pregnant with them);
  • women of Aboriginal or Pacific Islander descent, for whom incidence of GDM is as high as 20 percent;
  • women over the age of 30;
  • women with high blood sugar or have formally been diagnosed GDM in previous pregnancies; and
  • women who have had previous pregnancy issues, including miscarriage, high blood pressure during pregnancy or large bubs at birth (greater than 4.5kg).

There are some things you can do and some things you can't change. For example, you can't do anything about your age or your mum's medical history but you can exercise and eat well.

GDM is picked up commonly in women during their routine screens and health checks during pregnancy. It poses limited health risk to the mum. There is an increased chance that you will experience high blood pressure or you may need a caesarean section for delivery of your bub. Additionally, it's important to watch for urinary tract infections or thrush (yeast infections).

With regards to your baby, if you're monitored properly and you adjust your diet and lifestyle as directed then your bub shouldn't have any problems. If you are negligent and continue to eat poorly (for example) then your baby is at a greater risk of being a higher birth weight (called macrosomia). This in turn increases your risk of needing to delivery by caesarean section, or increases the bub's risk of developing jaundice, having breathing problems, long-term sugar issues or insufficient calcium levels.

Overall, make sure you focus on healthy eating, work with your diabetes educator (nutritionist) and regularly monitor your sugars. Additionally, daily gentle exercise should be encouraged and above all be sure to rest and get an adequate amount of sleep. Remember that glucose naturally rises when we're stressed.

For more information please visit Leah Hechtman's website.


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