What is Gestational Diabetes?
Diabetes occurs when your pancreas can’t produce enough insulin to meet your body’s demand, or when your cells become desensitised to insulin so insulin loses its effectiveness to transport glucose (sugar) into your cells. Gestational diabetes usually develops after the 24th week of gestation, and occurs in 8% of pregnancies in Australia.
During pregnancy the placenta releases hormones which aid the baby’s growth, however these hormones block the action of the mother’s insulin, creating insulin resistance. Due to insulin resistance the mother must release 2-3 times more insulin than usual. If the mother cannot release the required amount of insulin, gestational diabetes develops. During gestational diabetes the mother’s high blood glucose levels cross the placenta and create high blood glucose levels in her baby. The baby responds by releasing extra insulin from their pancreas. This leads to a bigger and fatter baby, which can lead to the baby needing to be delivered early and increases the risk of pre-eclampsia and caesarean delivery. It also stresses the baby’s immature pancreas and increases the risk of the baby developing type 2 diabetes later in life.
Baby’s exposed to high glucose levels in utero are also at risk of low blood glucose levels after birth. No matter how well controlled gestational diabetes is, there is a 50% chance the mother will develop type 2 diabetes within the next 15 years. In 90% of cases gestational diabetes resolves after delivery.
Modifying your diet and lifestyle can help control blood glucose levels. Exercise makes the cells in your body more receptive to insulin, resulting in improved insulin sensitivity for 48hours after exercise. When gestational diabetes is controlled the risks to both baby and mother are greatly reduced. The lifestyle changes made during pregnancy should be continued beyond birth to reduce the risk of you and your baby developing type 2 diabetes and obesity later in life.
When changing your diet or exercise habits you should always consult your obstetrician. Every pregnancy is unique. They can advise you of any extra precautions. You may be referred to a diabetes educator, dietician or your doctor may provide you with information on the optimal diet for managing gestational diabetes.
Beginning an exercise program after you have been diagnosed with gestational diabetes is generally safe if you have no other complications. The aim is to exercise on most days of the week with no more than 48hours between exercise sessions as the effects of exercise on insulin sensitivity only last 48hours after exercise. This should include an assortment of aerobic, resistance, and pelvic floor/core exercises.
It is best to have a program developed for you by our exercise pregnancy physiotherapist specific to your needs who can also help treat any conditions causing you pain, instability or concern.