What Is The Treatment For Gestational Diabetes?
Gestational diabetes mellitus (GDM) is the hyperglycemia (high level of blood glucose) that occurs during pregnancy and usually disappears after delivery. Gestational diabetes mellitus is caused by insulin resistance; insulin is the body's hormone that regulates blood glucose. If your doctor has already made the diagnosis of gestational diabetes mellitus is important to start the treatment as soon as possible to avoid adverse consequences for you and for your baby.
The goal of treatment of gestational diabetes is to maintain the blood glucose at the desired level and this is achieved through the implementation of a diet plan and changes in lifestyle including physical activity and insulin treatment. The benefits of treating gestational diabetes mellitus are well documented in studies in several countries, where the majority of pregnant women have been treated with a dietary program and changes in lifestyle. For this reason, your doctor should refer you to a specialist in nutrition once he or she makes the diagnosis of gestational diabetes. During normal pregnancy weight gain of 25 to 35 pounds for women of normal weight is recommended; 25 to 29 pounds in women with overweight, and 11 to 20 pounds for obese women. If you have gestational diabetes you can only raise a maximum of 7 pounds according to some experts, which is impossible to achieve without professional help.
Regarding physical activity, moderate physical activity is recommended. Moderate physical activity include brisk walking, gardening, house walk and domestic chores, active involvement in games and sports with the children, moderate building tasks. This activity should be sufficient to significantly accelerate the heart rate for at least 30 minutes per day, but the appropriate duration frequency, intensity and type of exercise has not been determined. Some small studies suggest that exercise lowers fasting and after meal glucose concentrations and may reduce the number of women with GDM requiring insulin therapy.
Treating GDM is directed to maintain blood glucose at levels that will minimize risk of adverse outcomes during the period around birth but there is no evidence at which benefits of treatment clearly outweigh harms. The targets of glucose actually recommended are: fasting glucose equal or less than 95 mg, one hour after meal glucose equal or less than 140 mg, and two hours after meals glucose equal or less than 120 mg. If nutrition care and increased physical activity fail to maintain adequate glucose control, treatment should be intensified to include pharmacological therapy by an appropriate health professional. So if you do not want to take insulin during your pregnancy, you should faithfully stick to your diet and exercise program directed by your doctor. But you should not fear about the insulin, because insulin is the first-line treatment in GDM and your doctor will give you an individualized insulin regimen to achieve the target glucose levels.
In recent years experts are talking a lot about the use of oral medications (including glyburide and metformin) for the treatment of gestational diabetes mellitus due to the significant decrease in treatment costs. However, oral medications have not been approved by the Food and Drug Administration for use in pregnancy so far. Finally, before start in any treatment for gestational diabetes, the most important is to make the correct diagnosis of the disease with the most current diagnostic criteria.
By Orfa Reyes