For pregnant mothers, gestational diabetes is one of the pregnancy complications that they should be worried about as it would affect both mother and baby.
Here, we have Dr. Muhammad Azrai Abu, Obstetrician and Gynaecologist from UKM Medical Centre to help us understand more about gestational diabetes in this episode of AskMeDoctor! Season 2.
Q1: What is gestational diabetes?
Dr Muhammad Azrai Abu: Gestational diabetes means diabetes diagnosed during pregnancy. So, what happens to every pregnant woman is that they go through a series of hormonal changes.
These changes will lead to insulin resistance, whereby this insulin is needed, in order for the glucose to be stable in your body.
When you are pregnant, the possibility of developing diabetes is high. In 2014, National Data found that around 10%–15% of pregnant women are at a higher risk of being diagnosed with diabetes mellitus.
Q2: What are the causes of gestational diabetes?
Dr Muhammad Azrai Abu: Hormonal changes. Because the main hormone that most pregnant women will discrete is human placental lactogen.
So, this hormone will create an environment that causes women to be diabetic during pregnancy.
Women with gestational diabetes will need more monitoring, and may need medications to control it.
The occurrence of gestational diabetes is during the 2nd and 3rd trimester – around 24 weeks to 28 weeks. That is why the process is called ‘minum air gula‘ or the glucose test screening.
Q3: Who is at risk of diabetes during pregnancy?
Dr Muhammad Azrai Abu: This glucose testing will be conducted on pregnant ladies who fit one of the criteria below:
- Over 25 years of age
- Pre-pregnancy obesity
- High levels of glucose in the urine
- Maternally-inherited diabetes
- Diabetes during a previous pregnancy
- Previously delivered a baby weighing 4kg
These are all risk factors, which we would need to know upfront for an early screening programme of gestational diabetes.
So, we can actually intervene before any problem arises like macrosomia, baby’s weight gain, and glucose levels becoming out of control.
So, is it important to diagnose early and be prepared for it? Yes!
Q4: What are the complications that may affect the mother?
Dr Muhammad Azrai Abu: The mother is at a higher risk of developing hypertension as well, especially because these two come together. These diseases always come in a package. Therefore, we need to conduct screening tests.
That is why nowadays, diabetic mothers are given Aspirin or Antiplatelets to prevent the occurrence of hypertension.
This is one of the prophylaxis measurements that the majority of clinicians and doctors are currently giving to pregnant women with diabetes.
Also, when you have diabetes, you are prone to get infections; a majority of these pregnant women develop urinary tract infections, vaginal infections, and are prone to experience preterm birth.
Risks and Effects of Gestational Diabetes include:
- Prone to get infections
- UTIs (Urinary Tract Infections)
- Vaginal Infections
- Preterm birth
What’s more, when the baby is overweight, the mother is more prone to get a cesarean section operative delivery.
In the long term, pregnant women with gestational diabetes will eventually develop diabetes type two or other kinds of diabetes subsequently and also, cardiovascular disease.
Q5: What can one do to prevent this health issue?
Dr Muhammad Azrai Abu: There is no exact mechanism that can prevent gestational diabetes mellitus. But, we definitely know that obesity in pregnancy is one of the risk factors.
So, for the majority of pregnant women who are at risk of gestational diabetes mellitus, they will need to have individualised medical nutritional therapy with a nutritionist, which includes close monitoring of gestational weight gain.
Initiatives Pregnant Women Can Do to Prevent GDM:
- Practise healthy eating habits
- Consume the appropriate amount of calories
- Manage sugar intake
- Exercise regularly
- Around 20–30 minutes daily
First of all, the diet recommended by a nutritionist is already a nutritional diet, and we will advise on the types of exercises you can do, too.
When you are pregnant, it is normal that you are encouraged to exercise for at least 20–30 minutes every day.
So, these are some of the ways that you can try to make sure that you do not fall in the obese group.
Pregnancy Weight:
- Underweight – 13kg–15kg
- Ideal Weight – 11kg–16kg
- Overweight – 7kg–11kg
- Obese – ≤7kg
There is a certain limit of weight gain that needs to be achieved. If you are obese, then you will need to only gain a maximum of 7kg throughout your pregnancy journey.
But if you exceed the recommended weight gain during your pregnancy, one of the complications that your body will develop is diabetes mellitus or hypertension itself. So, watch your weight, mums-to-be!
Q7: If one is already diagnosed with diabetes even before getting pregnant, what should she do?
Dr Muhammad Azrai Abu: For this category, the majority of them are under a proper follow-up. Before you embark on your pregnancy journey, someone who is known as an endocrinologist will need to monitor you first.
You will also be on specific medications, in which your glucose levels are adjusted accordingly with the medications.
Once you have gone through this pre-pregnancy counselling session and also, if the endocrinologist or the doctor from your medical side approves it, then only can we allow you to continue to embark on this beautiful journey with your partner.
Many unwanted complications can happen if there is an overload of glucose during the early phase of your pregnancy, which is when the development of your baby’s brain, spine, and cardiovascular system is most crucial.
Because you may just end up giving birth to a baby with birth defects. Therefore, the easiest way to avoid all these from happening is to control pregnancy diabetes beforehand.
Another problem we usually have with the majority of pregnant women diagnosed with diabetes is that they would always stop their medications because they think the medications will make their babies turn out abnormal.
This is wrong because the uncontrolled glucose overload in their bodies is actually the cause of the problem; not because of the medications that they take.
So, continue to take the prescribed medications that you have been taking and please have proper pre-pregnancy counselling sessions.
And, do not stop taking any medications on your own just because you think it is the right move for your baby.
Always seek doctor’s advice before you stop any medications or even start new ones.
Again, I will always advise every pregnant woman to enjoy every moment of her pregnancy journey. Do not stress yourself too much.
Do not make yourself anxious unnecessarily. Just enjoy the moment.
As advised byDr Muhammad Azrai Abu, one of the many ways to have a healthy pregnancy is by practising healthy eating habits.
For pregnant mothers, it is good for you to supplement yourself with a good maternal milk like Similac® Mom to help support your pregnancy journey.
Certain nutrients, particularly during the early stages of pregnancy, provide a strong foundation for better growth and brain development of your child.
Why Similac® Mom?
Similac® Mom is a low-fat maternal supplement designed for mothers who are pregnant or breastfeeding.
It is made with Eye-Q® Nutrition System, Natural Vitamin E, and Lutein to keep DHA from oxidising, while supporting your little one’s growth and brain development before birth.
- Contains 23 vitamins and minerals to help meet increased nutritional needs.
- Supports better sugar management during pregnancy.
- Has the lowest fat content to support better weight management during pregnancy and post-delivery weight loss for breastfeeding mothers.
Similac® Mom meets your daily calcium and folic acid requirements with only two servings! It also gives your child the nutrients he or she needs to grow and develop properly.
Stay tuned for our next episode of Ask Me Doctor! regarding your pregnancy journey with Similac® Mom. Meanwhile, don’t forget to visit Similac® Mom‘s official website and Facebook!