Managing Diabetes During Pregnancy: Understanding and Preventing Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM)

Gestational diabetes mellitus (GDM) is a form of glucose intolerance that occurs during pregnancy, with incidence generally occurring between the 10th and 14th weeks of gestation. This condition is often linked to impaired glucose tolerance and inadequate insulin secretion from the pancreas. During pregnancy, a woman's body undergoes numerous physiological and hormonal changes, which can sometimes interfere with the body's ability to use insulin effectively. This leads to high blood glucose levels, also known as hyperglycemia. Control of risk factors and early diagnosis are essential to reduce morbidity for both the mother and the baby. Some of the major risk factors associated with GDM include obesity, a condition in which excess body fat can interfere with glucose regulation. Another significant risk factor is a family history of diabetes mellitus: having first-degree relatives with diabetes increases the likelihood of developing GDM. Glycosuria, or the presence of glucose in the urine, can indicate high blood sugar levels, acting as a warning sign. Women who have had gestational diabetes in a previous pregnancy are also at increased risk of developing it again. Finally, maternal age over 25 is also a major risk factor. Diagnosis is made through specific blood sugar tests, including the oral glucose tolerance test (OGTT). In this test, the pregnant woman drinks a glucose solution, followed by a series of blood sugar measurements at regular intervals. The results of these tests allow doctors to evaluate how the woman's body handles glucose. If the blood sugar levels are higher than normal, GDM may be diagnosed. Early diagnosis allows preventive measures to be taken to control blood glucose levels, thus improving the outcome of the pregnancy. These measures include dietary changes, regular physical activity, and in some cases, the administration of insulin or other medications. Appropriate management of GDM is crucial to prevent complications such as fetal macrosomia, preeclampsia, cesarean section, and, in the long term, the risk of developing type 2 diabetes for the mother and baby. With careful monitoring and appropriate medical guidance, many women with GDM are able to carry healthy pregnancies to term without significant complications.

Diet

### Diet To prevent gestational diabetes mellitus (GDM), it is essential to have a conscious nutritional approach both before and during pregnancy. One of the most important initial steps is to maintain a normal body weight before conception. A healthy weight can significantly reduce the risk of developing GDM and other pregnancy-related complications. However, reaching and maintaining an ideal weight is not simply about reducing caloric intake; it requires a proper nutritional balance that provides all the essential nutrients to the body. During pregnancy, calorie needs vary considerably depending on the nutritional status of the mother-to-be. In general, you may see an increase in energy needs as the pregnancy progresses, but it is important to ensure that these additional calories come from nutrient-dense sources. The diet should be well-balanced, avoiding drastic reductions in carbohydrates, as a deficiency could lead to ketosis, a potentially dangerous condition for both the mother and the fetus. Carbohydrates should make up a significant portion of the daily diet, but it is essential to choose the right ones. Eating foods with a low glycemic index can help maintain stable blood sugar levels. Foods such as legumes, green leafy vegetables, low-sugar fruits, and whole grains are great options. Avoiding simple carbohydrates, such as those found in sweets, sugary drinks, and refined baked goods, can help avoid dangerous blood sugar spikes. At the same time, protein intake should be adequate to support the growing fetus and the increased needs of the mother's body. High-quality protein sources such as lean meat, fish, eggs, legumes, and dairy products can provide the essential amino acids needed for proper fetal development and maternal health. Lipids also play a crucial role. It is important to monitor fat intake, but do not eliminate it from your diet. Healthy fats, such as those found in vegetable oils, avocados, nuts, and seeds, can contribute to a healthy pregnancy. On the other hand, it is advisable to reduce saturated and trans fats, found in fried and processed foods, which can be harmful to cardiovascular health. Despite these general guidelines, every pregnancy is unique and may have specific nutritional needs. For this reason, it is always advisable to consult a dietitian or nutritionist for a personalized meal plan. A professional can provide precise indications based on individual needs, medical tests and other variables, offering the support necessary to ensure a healthy and balanced diet throughout the entire pregnancy. Adopting these precautions not only helps prevent gestational diabetes, but also promotes a healthier pregnancy and better well-being for mother and baby.