Ges­ta­tional Di­a­betes

Ev­ery­thing you need to know for a safe and healthy preg­nancy

Raise Vegan - - Contents - By Dr. Re­becca Jones

The Ve­gan Doc­tor is a UK GP, a prac­tic­ing ve­gan and health writer. She is a med­i­cal ad­vo­cate for the ve­gan life­style, break­ing down bar­ri­ers be­tween ve­g­ans and the med­i­cal pro­fes­sion.

Ges­ta­tional Di­a­betes Mel­li­tus ( GDM) is a type of di­a­betes that ei­ther de­vel­ops or be­comes ap­par­ent dur­ing preg­nancy. Be­fore we get into the finer de­tails of GDM, let’s take a quick tour of di­a­betes in gen­eral, to give you a bet­ter un­der­stand­ing.

Di­a­betes Mel­li­tus ( DM) is a group of con­di­tions where there is ei­ther re­duced in­sulin pro­duc­tion, re­duced ef­fi­cacy of in­sulin in the tis­sues, or a com­bi­na­tion of the two. In­sulin is a hor­mone pro­duced by the pan­creas in re­sponse to an in­crease in blood sugar lev­els. It works by al­low­ing glu­cose ( a type of sugar) to en­ter cells so they can pro­vide en­ergy for the nor­mal func­tions of those cells. Type 1 di­a­betes is usu­ally di­ag­nosed early in life, and is a fail­ure of the pan­creas to pro­duce in­sulin, whereas type 2 di­a­betes re­sults from in­sulin re­sis­tance; in­sulin is pro­duced but the body’s tis­sues don’t re­spond ad­e­quately to it. If in­sulin is ei­ther not be­ing pro­duced or not be­ing re­sponded to, then blood glu­cose lev­els rise. Raised blood sugar lev­els are con­cern­ing for sev­eral rea­sons; in the short term they can re­sult in se­vere de­hy­dra­tion, and, when chron­i­cally raised, they may cause dam­age to or­gans, such as the eyes and kid­neys, and to the ner­vous and car­dio­vas­cu­lar sys­tems. De­pend­ing on which type of di­a­betes has been di­ag­nosed, it can be treated with di­etary changes, oral med­i­ca­tions, or in­jec­tions of in­sulin.

GDM is di­ag­nosed in preg­nancy, but some who are di­ag­nosed dur­ing their ges­ta­tional pe­riod will ac­tu­ally have been di­a­betic, or at least pre- di­a­betic, be­fore­hand, but not yet di­ag­nosed. Rates of GDM are on the rise with the in­creas­ing rates of obe­sity. The rea­son preg­nancy puts peo­ple at higher risk of di­a­betes is that some of the hor­mones that are re­leased have anti- in­sulin ef­fects in or­der to make glu­cose more avail­able to the de­vel­op­ing fe­tus. Most preg­nant peo­ple will be able to deal with these ef­fects, how­ever, around 5% will ei­ther de­velop GDM or be di­ag­nosed with pre- ex­ist­ing di­a­betes dur­ing their preg­nancy. There are cer­tain fac­tors that can in­crease the risk of be­ing in this 5%, in­clud­ing: a BMI of over 30kg/ m ² , a prior his­tory of GDM or fam­ily his­tory of DM, a pre­vi­ous de­liv­ery where the baby weighed 4.5kg ( 9.92 lbs) or more, and eth­nic ori­gin from a coun­try with a high preva­lence of DM, in­clud­ing some African and South Asian coun­tries. In the US, it is rec­om­mended to take a glu­cose tol­er­ance test with all preg­nan­cies, how­ever, in the UK, the test is gen­er­ally only ad­min­is­tered to those con­sid­ered to be high- risk. The glu­cose tol­er­ance test in­volves hav­ing one’s blood sugar level checked be­fore and af­ter con­sum­ing a glu­cose- rich drink. This test is car­ried out be­tween 24 and 28 weeks of preg­nancy. If di­ag­nosed with GDM, the mother might be at risk of pre- eclamp­sia, poly­hy­dram­nios ( too much am­ni­otic fluid around the baby) and pre­ma­ture la­bor. The baby might be at risk of con­gen­i­tal ab­nor­mal­i­ties, be­ing too large and still­birth. There are also some com­pli­ca­tions that can af­fect both mom and baby dur­ing de­liv­ery such as fail­ure to progress be­cause baby is too big, and shoul­der dys­to­cia, where the baby’s shoul­ders get stuck in the birth canal, again, be­cause they are too big. This is why it is so im­por­tant to test for and ap­pro­pri­ately man­age GDM. Even if the in­di­vid­ual is not at risk of GDM, they will still have some screen­ing for it when their urine sam­ple is checked at reg­u­lar in­ter­vals dur­ing the preg­nancy.

Af­ter di­ag­no­sis, if the blood sugar is only marginally raised, GDM can be man­aged with diet and ex­er­cise. How­ever, if blood sug­ars re­main high, then a med­i­ca­tion called Met­formin might be pre­scribed; there are mul­ti­ple for­mu­la­tions of this drug that do not con­tain any an­i­mal prod­ucts. If blood sugar lev­els are high at di­ag­no­sis, or re­main high af­ter the above mea­sures have been taken, then in­sulin will be pre­scribed. The in­sulin is in­jected with a very fine nee­dle into the layer of fat un­der the skin, and this can be done at home. Most in­sulin pre­scribed to­day is not de­rived from an­i­mals, but make sure to dou­ble check.

In the same way that a healthy, plant- based diet can lower the risk of type 2 di­a­betes, it can also have pro­tec­tive fac­tors for GDM. Healthy, non- over­weight ve­g­ans will be at a lower risk of GDM, but reg­u­lar an­te­na­tal checks are ex­tremely im­por­tant in case you de­velop this con­di­tion, so that it can be prop­erly man­aged to keep mom and baby safe dur­ing preg­nancy and de­liv­ery. It is also im­por­tant to re­mem­ber that any­one who is di­ag­nosed with GDM dur­ing their preg­nancy will be at a higher risk of de­vel­op­ing type 2 di­a­betes later in life, so yearly blood tests should be car­ried out to screen for it.

Photo: Chom­poo Suriyo

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.