Gestational Diabetes: How To Control High Blood Sugar In Pregnant Women - Know Risks And More

During pregnancy, women's bodies get insulin resistance, meaning they use insulin less effectively to digest sugars or can’t make enough insulin because of hormonal changes. While this condition reverses back to normal after delivery, some women go on to develop Type 2 diabetes later in life.

Keep tab of blood sugar levels during pregnancy (Image by Freepik)

Gestational diabetes is a type of high blood sugar or diabetes that develops during the second half of pregnancy in women who don’t already have diabetes. Women who develop gestational diabetes are usually at higher risk of developing type 2 diabetes later in life. Dr Astha Dayal, Lead Consultant, Obstetrics and Gynaecology, CK Birla Hospital, Gurugram, shares, "In the world, about 2% to 10% of pregnant women could get gestational diabetes, but the incidence is much higher in Asians. During pregnancy, our bodies get insulin resistance, meaning we use insulin less effectively to digest sugars or we can’t make enough insulin because of hormonal changes, and this condition reverses back to normal after delivery. But about 50% of women with gestational diabetes go on to develop type 2 diabetes later in life."

Gestational Diabetes: Diagnosis And Risks

So how does gestational diabetes get diagnosed? "We diagnose gestational diabetes with the glucose challenge test, where 75 grams of glucose is given and sugar levels checked in 2 hours to ascertain if the woman can digest the sugar load. A value above 140g/dl indicates gestational diabetes," says Dr Astha Dayal.

Talking about the risks, Dr Dayal says, "If you have gestational diabetes, there is a high chance of increased birth weight of the baby, leading to difficult delivery, or higher chance of cesarean sections. There is also a higher risk of breathing problems to the baby at birth, low sugar, or hypoglycemia to the baby, jaundice, premature birth, and childhood obesity."

How To Manage Gestational Diabetes

Managing gestational diabetes starts with lifestyle changes, involving supervised diet and exercise. Dr Dayal lists the following ways in which one can manage gestational diabetes:

1. Balanced Diet: Follow a balanced diet low in sugary foods and refined carbohydrates but rich in fruits, vegetables, whole grains, and lean proteins. Take small frequent meals and spread your carbohydrate intake throughout the day to help maintain stable blood sugar levels. One could also meet a dietician for a supervised diet plan.

2. Work Out, But With Caution: Regular Exercise also helps improve insulin sensitivity and control sugar levels. If there is no other high-risk factors in pregnancy, one can engage in moderate physical activity regularly, like walking, swimming, or prenatal yoga under guidance.

3. Monitor Blood Sugar Levels: It is very important to monitor blood sugar levels regularly (weekly or biweekly if well controlled or more frequently if uncontrolled) as advised by your doctor till delivery, as the sugar levels keep increasing with pregnancy. Keeping track of your levels can help you understand how different foods and activities affect your blood sugar and allow you to make necessary adjustments.

4. Weight Management: Try maintaining a healthy weight during pregnancy and not gaining more than 1-2 kg per month. Weight loss during pregnancy is not recommended, but if you are overweight, you can still reduce the weight gain, under medical supervision, to manage gestational diabetes. 

5. Control Stress Levels: Stress Management is also important, as high stress levels can affect blood sugar levels. One should practice relaxation techniques such as deep breathing, meditation, or prenatal massage to help reduce stress.

6. Be Aware: You should also read about gestational diabetes, talk about it, educate yourself about gestational diabetes and seek support from your doctor, support groups, or other pregnant women who have experienced gestational diabetes.

"About 90% of pregnant women can manage their sugars with lifestyle modification but about 10% do need medication or insulin to manage blood sugar levels effectively.  Following your doctor's advice carefully and attending all prenatal appointments is important. You may need multidisciplinary care with an endocrinologist along with your obstetrician to monitor your condition closely and provide guidance. You should also plan delivery in a tertiary care birthing centre with facilities of a good NICU and endocrinologist available," says Astha Dayal.