After Pregnancy with Gestational Diabetes

Your blood sugar will most likely return to normal after delivery. But gestational diabetes is a warning sign that you are at risk for getting diabetes later in life. You’re also more likely to have gestational diabetes with your next pregnancy. But you can take steps to reduce these risks.

Taking Care of Yourself

 

Even if your blood sugar goes back to normal, you still need to take care of yourself. This will help prevent diabetes later in life.

Keep your weight down. Eating food that is low in fat and sugar can help you control your weight. If you’re overweight, your risk of getting diabetes in 10 to 15 years more than doubles. Keeping your weight down also reduces your risk of having gestational diabetes with your next pregnancy.
Get regular exercise. Exercise helps lower your blood sugar. It can also help you control your weight.
Have your blood sugar checked. Make an appointment to have your blood sugar checked about 6 to 8 weeks after delivery.
Have regular diabetes screenings. Get checked every year, or as often as your healthcare provider advises.
Breastfeeding

Breast milk is the best food for your baby. Breastfeeding may also help lower your blood sugar. Your healthcare provider can show you how to breastfeed. Be sure to eat a good diet and drink extra fluids while you’re breastfeeding.

Planning Future Pregnancies

You need to be sure your blood sugar is back to normal before you get pregnant again. Have your blood sugar checked before you plan your next pregnancy. And remember that it’s possible to get pregnant again soon after delivery. Talk to your healthcare provider about the best method of birth control for you and your partner.

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Do Pregnant Women Exercise Enough?

Being physically active during and after pregnancy aids in the recovery from childbirth, postpartum weight maintenance, prevention of preeclampsia (1), gestational diabetes and severe complications of the musculoskeletal system (2).

The ACOG or American College of Obstetricians and Gynecologists endorses moderate-intensity exercise for at least 30 min on most, if not all days of the week for pregnant women. Examples of moderate-intensity exercise are brisk walking, low impact dance aerobics, and biking.

One of the study authors, in Petersen et al, Terry Leet, Ph.D. said, that pregnant women should exercise unless advised otherwise by their physician because of medical or obstetric complications observed during their pregnancy. Women beginning an exercise program during pregnancy should perform moderate, non-weight-bearing activities, such as brisk walking, swimming, or cycling. She said that women who exercised prior to their pregnancy should continue their activities, except for activities that might possibly cause abdominal distress such as contact sports and scuba diving.

In a study reported by Borodulin et al. (2008) 71.6% white, 17.3% African American, 11.1% other of 1,482 women, a majority of them reported some physical activity during the second (96.5%) and third (93.9%) trimester. The level of intensity and total volume of exercise decreased between the second and third trimester. The physical activity reported consists of care-related responsibilities, household indoor related and recreational activities.

Sadly, a majority of the women did not reach the activity recommendations set by ACOG. Age, lower-socioeconomic status, and those who smoked were all markers for a passive lifestyle during pregnancy. Pregnant women meeting the moderate to vigorous physical activity recommendations were more likely to be non-Hispanic white, more educated, younger, non-married, non-smokers, and with higher incomes.

What is surprising is that despite its benefits, exercise seems to be losing its appeal. Pregnant women who worked out at least three times a week declined from 9% in 1994 to 6% in 2000. The same goes for non-pregnant women. Activity levels decreased from 17% in 1996 to 14% in 2000. Worse, pregnant women who needed to exercise were the same ones who were not getting enough exercise when they were not pregnant. Therefore, they would be less likely to start exercising in the first place.

According to Dr. Raul Artal of the American College of Obstetrics and Gynecology, obstetricians are hesitant to recommend exercise to pregnant women. He believes that it is rooted in the old-fashioned notions of pregnancy as a time of rest and accouchement.

Fitness professionals, physicians and personal trainers should educate pregnant students and clients of the benefits of remaining physically activity during pregnancy. They should point out to pregnant patients that the American College of Obstetricians and Gynecologists has embraced the Center for Disease Control exercise guidelines. This guidelines states that every pregnant woman with uncomplicated pregnancies and who does not have a medical history or a history of obstetric complications should get at least 30 minutes of moderate physical activity every day for most days of the week.

References:

Borodulin, K.M., Evenson, K.R., Wen, F., Herring, A.H., and Benson, A.M. (2008). Physical activity patterns during pregnancy. Medicine & Science in Sports & Exercise, 40(11), 1901-1908.

Petersen et al, Correlate of Physical Activity among Pregnant Women in the United States, Medicine & Science in Sports & Exercise; Nov. 2005; p.1748-1753.

Definition of terms:

1) Preeclampsia – abnormal state of pregnancy identified by fluid retention and hypertension

2) Musculoskeletal complications – pain in the pelvis, back and weakness of the lower extremities.

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