Gestational Diabetes
Gestational diabetes (GDM) is a condition where high blood glucose (sugar) levels develop during pregnancy, in a person without pre-existing diabetes. It can happen at any stage of pregnancy, but is more common in the 2nd or 3rd trimesters.
“In Singapore, GDM occurs in one in four to five pregnancies.”
Insulin is a hormone secreted by your pancreas in response to rising glucose levels in your bloodstream.
After a meal, the carbohydrate you have consumed will be broken down into glucose, resulting in an increase in your blood glucose levels. The pancreas detects this rise in blood glucose and will start to secrete insulin, to allow blood sugar to enter the body’s cells, where it is converted into energy (see Figure 1). Insulin thus helps to lower your blood sugar levels.
Figure 1
During pregnancy, the placenta (which connects your baby to your blood supply) produces high levels of other hormones. These hormones can impair the action of insulin on your cells, giving rise to a condition known as insulin resistance, causing blood glucose levels to increase.
All pregnant women have some degree of insulin resistance during late pregnancy. Many pregnant women can produce enough insulin to overcome insulin resistance, but those who cannot will develop gestational diabetes.
Risks of uncontrolled GDM
Pre-eclampsia (a condition characterised by high blood pressure and leakage of protein into the urine)
Pre-term delivery
Macrosomia (large baby)
Increased risk of baby becoming overweight or obese during childhood or adolescence
What can I do?
Effective management of GDM can reduce the risk of complications during pregnancy and the birth of your baby.
If you have gestational diabetes, your doctor and health coach / dietitian will help to develop an appropriate care plan for you, but typical recommendations include the following:
Eat a healthy balanced diet
Pay attention to portion control, so that you do not consume more calories than necessary. Recommended serving portions are shown in Figure 2 below.
Figure 2
Choose wholegrain foods (e.g. brown rice, wholemeal bread) instead of processed grains (e.g. white rice and white bread). The bran and fibre in wholegrains slow the break down of starches into glucose, resulting in a lower and slower increase in blood sugar levels, which improves blood sugar control.
Replace sweetened drinks with water or non-sweetened drinks. Sugary drinks can result in excess calorie intake, leading to weight gain. Sugary drinks also cause rapid spikes in blood glucose.
Exercise
Aim for 150 minutes of moderate intensity physical activity (e.g. brisk walking) each week. Your doctor can advise you on a safe level of activity for you and your baby throughout your pregnancy.