You’ve never had diabetes, so why have you developed the condition now that you’re expecting a baby? How does this affect your health, lifestyle and baby? Does it mean you have to give up bubble tea and other sweet treats?
Known as gestational diabetes, this condition is more common than you might think – occurring in one out of four to five women during pregnancy – according to Rddhi Naidu, senior dietitian and programme manager at Novi Health medical clinic.
You may be plagued by guilt and worry now, but try to turn off these anxious thoughts. When controlled well, many women with gestational diabetes go on to deliver healthy babies, Rddhi assures.
Here, Young Parents finds out more from her.
What is gestational diabetes?
This is a condition in which high blood glucose (sugar) develops during pregnancy, in a person without pre-existing diabetes. It can happen at any stage of pregnancy, but is more common in the second or third trimester.
How can I tell if I have gestational diabetes?
The condition usually doesn’t give rise to any symptoms. In Singapore, it is recommended that all pregnant women be screened for gestational diabetes at 24 to 28 weeks of gestation, unless they have a history of pre-existing diabetes or pre-diabetes.
The oral glucose tolerance test (OGTT) is used to screen for gestational diabetes. After a night of fasting, the pregnant woman will have a blood sample taken the next morning to check their fasting blood glucose level. They will then be given a 75g glucose drink, and a repeat blood test will be done at one- and two-hour intervals.
How does gestational diabetes affect my pregnancy?
If it is not properly controlled, it can increase the risk of complications for both mum and baby, such as:
- High blood pressure and pre-eclampsia
- Pre-term delivery
- Delivery complications due to large baby, which may necessitate C-section delivery
- Increased risk of developing Type 2 diabetes in future
- Excess growth (macrosomia)
- Pre-term delivery
- Low blood sugar at birth
- Breathing problems
Who is at higher risk of getting gestational diabetes?
Any woman can develop gestational diabetes, but some women may be at greater risk, such as those who:
- Have parents or siblings who have diabetes
- Are overweight or obese before pregnancy
- Are 40 years and older
- Had a child previously who weighed more than 4kg at birth
- Had a history of gestational diabetes in a previous pregnancy
I feel so guilty that I have gestational diabetes and how I’m hurting my baby. Why me?
You’re not alone. Gestational diabetes is a common condition and can affect up to one in four to five women in Singapore. Hormonal changes during the second and third trimesters can contribute to high blood glucose levels by impairing the action of insulin on cells.
Be assured that many women with gestational diabetes go on to deliver healthy babies. Managing the condition well and keeping the glucose levels within the desired target range will reduce the risk of any complications related to gestational diabetes, and contribute to a healthy pregnancy and a healthy baby.
The condition can be controlled through suitable lifestyle changes, such as having a healthy diet and incorporating physical activities, and if necessary, by adding medications.
Does this mean I can no longer eat ice cream?
You don’t have to completely deny yourself of sweet treats like ice cream. The key is to enjoy them in moderation, and to exercise portion control. For example, you can have a small scoop of ice cream once in a while.
But, it is always recommended that you do not have desserts like ice cream on an empty stomach, as the sugar gets absorbed faster into your bloodstream causing a spike in your glucose levels. Having frozen low-fat yoghurt is another good alternative to ice cream.
How about bubble tea?
Everyone – not just pregnant mums, or those with gestational diabetes – should limit their intake of drinks with added sugar, such as bubble tea or sodas. Such drinks are considered “empty calories” as they add significantly to your caloric intake, but do not contain any nutrients. All these excess calories you consume can lead to weight gain and adversely impact on your blood glucose levels.
The recommended amount of added sugar per day is no more than eight to 11 teaspoons. This includes sugar which may be found in different foods and drinks, such as cakes, pastries, spreads, coffee and cereals.
Regular bubble tea is quite high in added sugar, and you can easily hit or exceed your daily recommendation with just one drink! A medium-sized 500ml bubble milk tea with pearls and full amount of sugar has approximately eight teaspoons of sugar and 335 calories. The larger 700ml size has about 11 teaspoons of sugar and 470 calories.
Bubble teas and other sweetened drinks should thus be consumed in moderation. Here are some strategies you can try to cut down on your calorie consumption if you like to take bubble tea:
- Choose the smallest cup available and ask for less sugar (30 per cent or below)
- Go for no topping
- Limit to one drink per week
- Have only half the drink and share it with someone so you don’t feel compelled to finish all of it
What other diet changes should I make?
Choose high-fibre carbohydrate foods more often as these tend to be digested more slowly, causing a slower and lower rise in blood glucose levels. Some examples are wholegrain bread, brown rice, wholemeal pasta, oats and wholegrain cereals.
Control your intake of carbohydrate foods and spread them evenly throughout the day. Larger portions of carbohydrates will cause larger increases in blood glucose levels.
Instead of snacking on high-sugar or carbohydrate foods, have healthier protein- or calcium-based nutritive snacks in between meals. For example, you can take low-fat cheese slices, eight to 10 pieces of unsalted nuts, low-fat yoghurt, beancurd (without syrup), soybean milk (unsweetened, or with less sugar) and hard-boiled egg.
How about physical activities?
Try walking for 30 minutes after a meal, or doing low-impact exercises suitable for pregnancy, such as swimming. Regular exercise and physical activities can improve blood glucose levels by promoting muscle uptake of glucose and helping to maintain a healthy weight.
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