Your gestational diabetes questions, answered

Your gestational diabetes questions, answered


The Canadian guidelines recommend
that all pregnant women be screened for gestational diabetes between 24 and 28
weeks gestation. However if a woman has additional risk factors for Type 2
diabetes such as a previous history of gestational diabetes, strong family
history of Type 2 diabetes or overweight or obesity then it’s recommended that
they may be screened earlier in pregnancy and the main reason for that
is to make sure they don’t have Type 2 diabetes, which would show up right away. Generally what you eat leading up to the
tests for gestational diabetes does not have an effect on the results of the
tests. We recommend for the first glucose screening tests that women don’t need to
fast and that we’re just interested in knowing what happens to their blood
sugar after we give them a large glucose drink. Having said that though, if a woman
decides to also have a large carb or sweet snack prior just before taking the
test that could likely increase the blood sugar result further but earlier in the pregnancy the results should not – and whatever they eat earlier
in the pregnancy should not have a substantial effect on the actual test
results. Gestational diabetes can be very stressful for women because pregnancy is supposed to be a hopeful time a time of anticipation and
and a happy time for women and then they get this diagnosis, which has
implications for both them and the baby so we definitely know that it can make
women feel somewhat negative about the pregnancy and anxious about what it
means for them and their baby. However we know that here in Canada we have really
great diabetes teams that are able to help women manage their diabetes and make it as convenient as possible for them so the pregnancy is
not so that they have a better experience. For example they do
need to have some extra appointments and they do need to check their blood
sugar during pregnancy several times a day and they do need to make
modifications to their diet but with those changes actually their
chances of having a healthy pregnancy are very high. So if gestational diabetes
is not well controlled and the blood sugars are high then there is a higher
risk that the baby will over grow. Overgrowth if the baby can lead to large
sized babies and that can lead to birth complications those birth complications
can include prematurity and early delivery can increase risk of need for
c-section and if a woman does undergo a vaginal delivery then that can increase
the risk of birth trauma and complications of labour. So a lot of women
once they’re diagnosed with gestational diabetes and they start testing their
blood sugars and start seeing how what they eat is affecting the blood sugars
they ask us whether cutting out the carbs in their diet is a way a good way
of actually keeping those blood sugars normal and what we tell them is that
while cutting out carbs does keep your blood sugars low it’s at the expense of
the health of the your baby. So we know that when with very low carb diets
we make ketones and those ketones have been shown to have adverse effects on
the baby and so for that reason we actually don’t recommend that women cut
out their carbs completely in pregnancy. We recommend that they have a healthy
amount of carbs and that they spread them throughout the day and that they
choose carbs that are healthier for them – lower glycemic index
complex carbohydrates as opposed to high glycemic index simple carbohydrates.

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