What is gestational diabetes?
Around 7% to 8% of pregnant women in France have gestational diabetes. This complication of pregnancy is defined as a particular form of diabetes which specifically concerns future mothers.
Gestational Diabetes : what exactly is happening? During pregnancy, insulin (the hormone responsible for regulating blood sugar levels) loses its effectiveness, in particular because of the hormones produced by the placenta.
If, in most pregnant women, this phenomenon is naturally “compensated” by the pancreas (which begins to produce more insulin), in some women, the compensation is insufficient: pathological insulin resistance and chronic hyperglycemia then develop. . It’s gestational diabetes.
Gestational diabetes: is it serious?
Yes. If left untreated, gestational diabetes can cause potentially serious consequences for both the mother and the unborn child. This may include:
Gestational diabetes: what are the causes and how is it detected?
Gestational diabetes: risk factors.
Some pregnant women are at increased risk of gestational diabetes: these are in particular women who are overweight or obese (with a body mass index greater than 25), women aged over 35, women who have family history of diabetes, women with polycystic ovarian syndrome (PCOS)…
Gestational diabetes: screening.
Screening for gestational diabetes is not systematic: it is offered to pregnant women who have risk factors (who are over 35 years old, who are obese or overweight, etc.) and/or in the event of signs which may make us think of this pregnancy complication (a baby who seems “big” on the ultrasound, significant weight gain in the second or third trimester of pregnancy, excess amniotic fluid, etc.).
Screening for gestational diabetes begins with taking a blood test at the end of the third month of pregnancy. This must be done on an empty stomach and is used to measure blood sugar (i.e. blood sugar level). If blood sugar is above 0.92 g/L, gestational diabetes is confirmed.
If the first test is negative, a second screening can be carried out between the 24th and 28th week of amenorrhea (at the beginning of the 6th month of pregnancy): the OGTT – for Orally Induced Hyperglycemia. This involves taking a blood test before, 1 hour then 2 hours after ingestion of 75 g of glucose. With the OGTT test, we therefore measure 3 values: if only one of them is too high, diabetes is confirmed.
Gestational diabetes: what is the treatment?
As soon as the diagnosis of gestational diabetes is confirmed, treatment with a diabetologist/endocrinologist is implemented as well as follow-up with a dietitian-nutritionist.
During pregnancy, the use of oral antidiabetic medications is contraindicated; the control of gestational diabetes therefore essentially involves hygienic and dietary measures. If these fail, regular insulin injections may be prescribed.
To know. In the case of gestational diabetes, the pregnant woman must take her blood sugar level 6 times a day using a fingertip measure.
And also… Good news: in more than 90% of cases, gestational diabetes disappears after childbirth.
Gestational diabetes: nutritional advice from the dietician-nutritionist
“In the case of gestational diabetes, the health and diet recommendations are the same as for a Type 2 diabetes“ notes Nathalie Négro, dietitian-nutritionist. A few tips :
Avoid uncontrolled food intake.
Eat 3 meals a day (healthy but complete meals with starter + main course + dessert, especially during the third trimester of pregnancy when you tend to be more hungry), with possibly snacks during the day (this should be discussed with your dietitian-nutritionist).
Eat breakfasts that are low in sugar and balanced.
Favor savory breakfasts, avoiding fruit juice, honey, jam… The right formula? A hot unsweetened drink + a piece of bread (with a low glycemic index: rather rye bread or bran bread, bread with a compact crumb) + a portion of butter + a dairy product (a fromage blanc or a natural yogurt but not necessarily at 0% fat) + a fruit (opt instead for a juicy fruit which will give flavor to the dairy product: a peach, a pear, etc.).
Limit starchy foods (but don’t eliminate them completely).
The main course of lunch and dinner should consist of vegetables (raw or cooked) + a portion of meat or fish + starchy foods. Warning: don’t stock up on starchy foods! Furthermore, choose starchy foods with a low glycemic index: al dente pasta or dried vegetables rather than potatoes.
Treat yourself to small pleasures.
Want a pastry? Instead, take it as part of a meal, instead of dessert, and do not have starchy foods during this meal.
Keep an eye on the labels.
At the supermarket, are you hesitating between two packets of biscuits? Choose the reference whose “including sugars” value (in the “carbohydrates” section) is the lowest. The same goes for breakfast cereals. And if you like candy or chewing gum, take them without sugar.
Don’t forget to hydrate well every day.
To know. “If your blood sugar is not stable, remember to write down what you eat in a small notebook: this will help your dietitian-nutritionist to correct the situation if necessary. advises Nathalie Négro.
And also… “Physical activity improves blood sugar levels: ask your midwife or gynecologist for advice to find out which sport is best suited to your situation.” As for sports accessible to all, we can mention brisk walking and swimming – a medical green light remains necessary!
Thanks to Dr. Laure Abensur, general practitioner and ex-midwife.
Thanks to Nathalie Négro, dietician-nutritionist and head of the Nutritional Center of Brides-les-Bains thermal baths.
Read also :
⋙ Gestational diabetes: the list of foods to avoid
⋙ Gestational diabetes: it should not be taken lightly
⋙ Diabetes, cholesterol, pregnancy: the benefits of lupine seeds