One type of Diabetes Mellitus is known as gestational diabetes. Blood glucose levels become elevated in pregnancy, causing complications during labour, birth, and postpartum, for both the mother and baby.
High risk factors for developing gestational diabetes are:
Family history of diabetes
Previous history of diabetes
Asian, Middle Eastern, Aboriginal, Torres Strait Islander, and Pacific Islander background
PCOS (Polycystic ovary Syndrome)
Overweight, high BMI
Advance maternal age
Side effects from medication such as steroids and antipsychotics.
If you are at high risk of developing gestational diabetes, your GP or midwife may ask you to undertake an early 75g GTT (75g oral glucose test) as soon as you find out you’re pregnant. Normal pregnancy blood tests and repeat 75g GTT will occur around 26-28weeks.
However, if you are not high risk, you will have only one 75GTT around 26-28 weeks.
Blood Glucose Testing
If your glucose blood tests came back higher than normal at either fasting, 1 hour, and/or 2 hours after the oral glucose test, you are contacted by a hospital midwife to see a diabetes educator and dietician. They will give information on how to manage your blood glucose levels during pregnancy.
You may experience tiredness, cravings, and sweet smelling urination.
The diabetes educator will give you a glucometer to check your blood sugar level regularly at home between meals and ask you to record the results in your diary.
A Dietician will give you dietary recommendations to control your blood glucose levels.
If you can control your blood glucose levels with diet and exercise you are categorised as GDM with diet control, which means you don’t require any medication, just healthy life habits.
Some hospitals may ask you to have a foetal growth scan at 36 weeks to check your baby’s size, because diabetes causes a larger than normal baby on board.
Some hospitals may offer you to have an induction of labour around 40 weeks to minimise birthing a bigger baby.
If you can’t control your blood glucose levels with diet and exercise, your doctor will prescribe medication such as metformin tablets plus/minus insulin injections.
The hospital will keep an eye on your blood glucose levels, and any other complications such as developing high blood pressure, bigger than normal baby, hypoglycaemia from your medications etc.
Usually, the hospital offers you to have an induction of labour before 40 weeks.
Birthing with Gestational Diabetes
Once the baby is born from a diabetic mother, the baby has their blood glucose levels checked regularly to avoid hypoglycaemia postnatally.
The hospital may suggest you express your colostrum before your baby’s birth. If baby’s hypoglycaemia is suspected, the midwife can give your expressed colostrum to increase the baby’s blood glucose levels. Hypoglycaemia in newborns causes problems such as shakiness, jittery body, and breathing and feeding problems because of lack of sugar level for the brain and the body.
In severe cases, newborns may require NICU admission and IV glucose drips +/- formula top ups.
Chinese Medicine for Diabetes
Diabetes in TCM is categorised as “XIAOKE disease” (wasting and thirsting ) and diagnosed as “ Yin deficiency and dryness- heat”.
Three main factors contributing to this condition are improper diet, emotional disturbances, and a constitutional Yin deficiency.
Traditionally, Acupuncture and moxibustion have been used in the treatment of diabetes to reduce blood glucose levels and support endocrine (hormone) function. Studies have demonstrated that acupuncture has a beneficial effect on lowering blood glucose levels.
Chen DC, Gong DQ, Zhai Y: Diabetes acupuncture research. J Trad Chinese Med 14:163–166, 1994
Mao-liang Q: The treatment of diabetes by acupuncture. J Chinese Med 15:3–5, 1984
Some women want to avoid medications during pregnancy as much as possible. Others want to treat blood glucose levels with a combination of prescribed western medicine and gradually reduce the required dose.
The Chinese medicine approach offers you the option to optimise your body’s ability to function normally during pregnancy to minimise complications during birth and beyond.
Written by Chieko Kinoshita.