Pregnancy brings about numerous physiological changes, including shifts in hormonal levels. One significant aspect influenced by these hormonal fluctuations is the body's insulin sensitivity and function within its cells. Insulin, a vital hormone responsible for regulating blood sugar levels, can experience alterations during pregnancy due to the presence of hormones such as estrogen, progesterone, and human placental lactogen (HPL).
The intricate interplay of these hormones creates a dynamic scenario where insulin sensitivity can vary across different tissues and stages of pregnancy. As a result, gestational diabetes—a condition characterized by elevated blood sugar levels—can develop in some women who experience challenges in adapting to these hormonal changes.
Gestational diabetes doesn't usually cause noticeable symptoms, which is why regular prenatal check-ups and glucose testing are crucial. If left unmanaged, it can increase the risk of complications for both you and your baby. This condition is typically diagnosed around the 24th to 28th week of pregnancy through a glucose tolerance test. However, if you are considered a high-risk pregnancy, a pre-screening glucose tolerance test maybe performed as early as 12-16 weeks.
How Can You Prepare for the Glucose Screening?
There are two levels of testing. The first is called the glucose challenge test (screening) and it is usually performed in your OBGYN’s office. You do not need to fast for this test. When you arrive to your appointment, you will be asked to drink a sugary drink (50 grams of flavored syrup water) within a short amount of time, usually 5 minutes. After an hour, your blood will be drawn and analyzed to determine your body's response to glucose. Typically, you’ll know your test results within 24 hours. Elevated levels are generally considered any reading over the 130-140 mg/dL range.
Should your screening results indicate elevated levels, your OBGYN may recommend a second test, an oral glucose tolerance test, which typically involves an 8-hour fasting period. During the test, your healthcare provider will first measure your fasting blood sugar level. Then, you'll consume a drink containing glucose, and blood samples will be drawn every hour for 2-3 hours. A diagnosis of gestational diabetes is made if two or more blood test results reveal elevated blood glucose levels.
It's possible for the initial screening to indicate elevated glucose levels, while the subsequent glucose tolerance test (which is more precise) might reveal results within the normal range. Therefore, failing the first screen does not necessarily mean you have gestational diabetes. If, however, you are diagnosed with diabetes, it is important to take the necessary steps to manage your condition to prevent any possible complications.
What Steps Can You Take if You are Diagnosed?
Many of these suggestions resemble those to prevent this diagnosis: adopting a healthy diet with controlled intake of sugary foods and complex carbs, engaging in 30 minutes of exercise five times a week, and maintaining hydration. Additionally, attending prenatal appointments, self-education, and using stress-reducing methods are helpful. Gentle yoga, stretching, and deep breathing exercises can positively influence your blood sugar levels.
What are the Risks to Your Baby?
If you have been diagnosed with gestational diabetes, your baby may be at increased risk of:
- Excessive birth weight (increased cause for birth injury or C-section birth)
- Pre-term birth & respiratory distress syndrome
- Low blood sugar (severe cases may cause seizures in baby)
- Higher risk of obesity and type 2 diabetes later in your child’s life
How Can You Prevent Gestational Diabetes?
According to the Centers for Disease Control and Prevention (CDC), every year, an estimated 2% to 10% of pregnancies in the United States are affected by gestational diabetes. While some women are more likely to develop GD, there are preventative measures you can take for the health of you and your baby. Guidelines issued by The American College of Obstetrics and Gynecology (ACOG) on gestational diabetes recommend women do the following:
- Maintain a healthy diet: Focus on a balanced diet rich in whole grains, lean proteins, fruits, vegetables, and healthy fats. Avoid excessive sugar and refined carbohydrates. Be mindful of portion sizes and eat light snacks to stabilize blood sugar levels. (A classic favorite is apple slices with almond butter spread. Yum!)
- Keep an active lifestyle: Exercising during pregnancy can improve insulin sensitivity and regulate blood sugar levels. Strive for 30 minutes of moderate activity, like a brisk walk, at least five days a week. Be sure to consult with your OBGYN about an exercise program that will work best for you.
- Establish a healthy weight before pregnancy: If you are planning to conceive, aim to achieve a healthy weight before pregnancy. Being overweight increases the risk of gestational diabetes.
- Drink water: Staying well-hydrated helps regulate blood sugar levels and aids in digestion and proper nutrient absorption. Dehydration can lead to elevated blood sugar levels.
For most women, gestational diabetes goes away after birth. Women with a history of gestational diabetes during pregnancy, who have not been previously diagnosed with type 2 diabetes mellitus, are encouraged to be screened for it after birth. According to The Women’s Preventive Services Initiative, initial testing should ideally occur within the first year postpartum and can be done as early as 4–6 weeks postpartum. Women diagnosed with gestational diabetes are more likely to develop type 2 diabetes later in life.
How Can Cord Blood Banking Play a Part in Treating Diabetes?
The stem cells found within the umbilical cord of babies have been used in clinical trials worldwide for the treatment of both types of diabetes. Many of these trials explore mesenchymal stem cells (MSCs) sourced from umbilical cord tissue. A meta-analysis looking at patients’ data among 154 participants, between ages 17 and 27, from 2012 onwards, suggests stem cell therapy in patients with type 1 diabetes may reduce hemoglobin A1c, positively affect C-peptide secretion, and improve cells (islet β cells) responsible for diabetes autoimmunity function and regeneration. What does this mean? Essentially, the stem cells found within your baby’s umbilical cord are packed with beneficial properties capable of countering some of the harmful effects of diabetes. Additionally, cord blood is an FDA-approved treatment for nearly 80 diseases, including numerous other types of metabolic disorders and immune system deficiencies.
To learn more about research involving umbilical cord-derived stem cells in treating diabetes, visit our other article. If you have found value in our blog, and we really hope that you have, we invite you to learn more about these stem cells' potential in treating other conditions and why banking them for your family’s future use is so important.