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Sugar Mommies

Posted on December 8, 2017 | No Comments on Sugar Mommies

Motherhood is often illustrated by images of a woman cuddling an infant or holding a child. But motherhood actually starts with conception while the baby is inside the womb. It is the mother’s duty to nurture the infant by taking care of her body throughout pregnancy. Sadly though, there are some diseases that are brought about by the changes that occur during pregnancy and these can affect both maternal and fetal well-being.

Diabetes is one such disease. Any woman who has elevated blood sugar or blood “glucose” first detected during pregnancy is said to have the type of diabetes we call “Gestational Diabetes Mellitus” (GDM). There are a lot of changes in the hormones of the body during pregnancy. In some women, these changes during gestation lead to difficulties on how their bodies handle the sugar from the food they eat, making their blood glucose levels go higher than expected – and we can aptly call them “sugar mommies”.

Who are likely to develop diabetes during pregnancy?
Researches have been done worldwide to come up with a list of factors that puts a woman at greater risk for developing gestational diabetes, and the presence of any one element confers higher risk. First is the presence of diabetes mellitus in a first-degree relative. Second is the presence of obesity before pregnancy, or having a pre-pregnant weight that is 110% of ideal body weight. A previous history of elevated blood sugar, even if it was only a mild elevation, is also contributory. Another criterion is the age – a woman 25 years old and above is more likely to get GDM. The outcome of past pregnancies is also relevant: such as recurrent miscarriage, giving birth to a malformed or dead baby, or delivering a large infant weighing more than 8 or 9 pounds. Women who belong to a race with a high rate of type 2 diabetes mellitus are also at high risk for GDM – these include Hispanics, Africans, South and East Asians, and Asian-Pacific Islanders.

Even the mother’s own birth weight is important – women who weighed less than 6 pounds or more than 9 pounds at birth are also at risk for GDM. Certain diseases and drugs such as steroids can also trigger diabetes during pregnancy.

How do we diagnose gestational diabetes?
After identifying the risk factors in an expectant mother’s medical history and physical examination, the doctor requests for laboratory examinations that measure the blood glucose after fasting and after taking a slurry of glucose solution in specified amounts. This includes a series of hourly blood extractions that the doctor interprets based on the recommended values for pregnant patients. The lab tests may be interpreted in three ways: negative for diabetes, positive for diabetes, or borderline results.

What can be done to control the blood sugar in GDM?
The most important step is to get a prescription for the proper diet. When most people hear the word “diet”, it gives the idea of drastic restriction in the amount of food; this is why the term “medical nutrition therapy” is preferred. Pregnancy is a state where severe and drastic reduction in food intake is harmful. Prescribing proper nutrition includes specifying the total amount, the right proportion of nutrients (proteins, carbohydrates, fats, fiber) and the distribution of daily calories. When the endocrinologist computes for the caloric prescription, several information is considered: the patient’s weight before and during pregnancy, the daily activities, food preferences, schedule of meals, status of the baby, etc. The bottom line is that it needs to be individualized for each case. Counseling and food guides are then provided by the nutritionist based on the doctor’s prescription.

It is also very essential that the mother monitors her capillary blood glucose (CBG) closely to catch the variations throughout the day. The CBG record is like a diary that helps the doctors decide on how to best manage patients. If the blood sugar remains elevated even after medical nutrition therapy is started, then insulin is prescribed. There are studies on the use of tablets for gestational diabetes, but these are not yet recommended.

What will happen if gestational diabetes is neglected?
Both the mother and the fetus can have complications at all stages – from conception to delivery, if GDM is neglected. The mother becomes prone to other diseases like frequent infections, high blood pressure, difficult labor and delivery and other lifethreatening metabolic emergencies. The baby may develop congenital malformations, abnormal birth weight and detrimental metabolic problems during and even after delivery.

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