It’s not uncommon to hear a pregnant women talk about cravings during pregnancy – pickles, peanut butter, ice cream and the like. What moms-to-be may not realize is the nutrients, or lack of, in those cravings can put her at higher risk of developing gestational diabetes and delivering preterm.
Gestational diabetes happens when a woman’s body needs more insulin to keep the blood glucose (sugar) at a normal level during pregnancy. Without enough insulin, glucose can’t leave the blood and be changed to energy which can then negatively impact a pregnancy and the unborn baby’s blood glucose.
“Type 2 and gestational diabetes are similar in that it means the body is insulin resistant and needs more insulin to keep blood sugar at a normal level,” said Stacey Ehrenberg, MD, maternal fetal medicine specialist at Akron Children’s Hospital. “The symptoms of gestational diabetes are really difficult to recognize because they’re very similar to how a woman feels when she’s pregnant – intense thirst, frequent bathroom trips, constant fatigue…”
Most pregnant women get a glucose tolerance test at 24 to 28 weeks to test for gestational diabetes.
“Hormones made by the placenta during pregnancy naturally make mom more insulin resistant so diet and exercise become very important tools in preventing gestational diabetes,” said Dr. Ehrenberg. “Gestational diabetes can go away after pregnancy, but women who develop it have a 50% chance of developing Type 2 diabetes in the next 10 years.”
According to the March of Dimes, 7 out of every 100 pregnant women develop gestational diabetes. It can strike anyone, but women are more likely to get it if they’re obese (a BMI of 30 or higher), have a family history of Type 2, had gestational diabetes with prior pregnancies, have certain medical conditions or are older when they get pregnant.
For Alyssa Portwood, medical library manager at Akron Children’s Hospital, she fell into the later category.
“I had hypertension and was ‘advanced maternal age’ so I knew I was considered high-risk early on,” said Alyssa. “My doctor kept an eye on my blood sugar levels at each visit and when we saw the numbers creep up, I knew my baby and I would need extra care.”
Alyssa came to Akron Children’s Hospital’s Maternal Fetal Medicine department in her second trimester. She began meeting weekly with a team of high-risk specialists, nurses and dietitians who created a care plan specific to her needs.
“The dietitian was very confident she would find a dietary plan that worked for me,” said Alyssa. “She never questioned my ability and worked with me to figure out how I could still have my favorite foods, in moderation, which made a big difference in my numbers and with me sticking to the plan.”
Dietitians had Alyssa keep a food diary and log her glucose levels so they could determine how best to balance her diet with oral medications to regulate her blood glucose levels.
“We got my blood sugars in my target range right away with just a few tweaks here and there,” said Alyssa. “At the end of the day, if my baby needed me to get this right, I was determined to do it.”
A big worry about gestational diabetes is what it can do to a baby. Baby’s born to moms with gestational diabetes can have health complications including breathing problems, low blood sugar and jaundice after they’re born. Gestational diabetes can also cause mom to go into preterm labor and delivery.
“Most of the complications related to gestational diabetes are directly related to blood glucose control. Therefore, if blood glucose is well controlled, the risk of these complications is the same as someone who doesn’t have gestational diabetes,” said Dr. Ehrenberg. “If blood glucose isn’t well controlled, a baby can grow bigger and be surrounded by extra fluid. This stretches the uterus and makes the body thinks it’s farther along than it actually is, causing preterm labor.”
The good news is gestational diabetes can often be controlled by health and lifestyle changes.
Akron Children’s Hospital’s Maternal Fetal Medicine is working to offer 2 educational programs to help moms manage gestational diabetes.
- Sugar Mamas is a 2-hour group session for women with diabetes before pregnancy and counts as prenatal care. The group meets every 2 weeks for 24 weeks where high-risk specialists and dietitians discuss topics like safe sleep, nutrition, breast-feeding, diabetes management and labor preferences.
- The other program, Diabetes Bootcamp, is a 1-time, 3-hour group session where women recently diagnosed with gestational diabetes meet with a high-risk specialist to learn about gestational diabetes and what it means during pregnancy.
“Food is a big part of all our educational sessions,” said Dr. Ehrenberg. “It’s important moms learn about how the food pyramid, portion control, meal planning and access to food all play a role in managing blood glucose levels.”
They say it takes a village to raise a baby but, for Alyssa, it took a team of supportive high-risk specialists and a caring partner to help her deliver a healthy, full-term baby girl, Sara.
“We check mom for Type 2 diabetes 4 to 8 weeks after delivery. If the test is negative then we recommend her primary care physician test for diabetes every 1-3 years after delivery,” added Dr. Ehrenberg.
Alyssa is now a diabetes-free mom and loving every minute of it.
“A lot of the food strategies I learned during my pregnancy I use now while nursing Sara, which has also helped me lose pregnancy weight quickly,” said Alyssa. “I still have my blood checked regularly with my primary care physician and I’m happy to say I don’t have any long-term issues.”