Download Glucose Testing - Karen Baker Midwife

Glucose Metabolism in Pregnancy
All our food is converted into glucose in our bodies. Glucose is the
fuel for all the work our cells do to keep us alive and well. Insulin is a
hormone that helps the glucose enter the cells so that cellular work can be
performed. When our production of insulin looses efficiency or our bodies
become resistant to our own insulin (weird, but it happens), too much
glucose floats around in our blood causing trouble. In pregnancy, even a
little extra glucose can be a problem. The baby’s pancreas attempts to make
the mother’s blood sugar levels normal. The baby’s pancreas produces more
insulin in order to lower the blood sugar. Insulin stimulates the baby to
grow large and the extra insulin can have other harmful effects on the baby.
In brief, other possible problems for the baby can be increased infections,
increased fetal distress in labor, hypoglycemia at birth (low blood sugar,
which can be very serious), and other problems with calcium and
magnesium. The negative consequences of this problem in a pregnancy are a
complex issue. The information in this paper is a simplistic explanation
designed to give a very basic understanding of glucose metabolism in
pregnancy.
More and more people in our society are having a problem with
glucose metabolism and may eventually be diagnosed with Type 2 Diabetes.
We know there are genetic factors and environmental factors which
predispose a person to the problem. It tends to become a problem with
increased weight and decreased activity. It often goes along with increased
age (as we age, we usually slow down and gain weight) It also tends to
show up in pregnancy. Many women who are found to have “gestational
diabetes” do not have a problem at all when they are not pregnant; however,
most of these women are “predisposed” to Type 2 Diabetes and may show
symptoms as they grow older.
Some women have risk factors that are obvious: obesity, sedimentary
lifestyle, a diet high in refined carbohydrates, a history of large babies, and
frequent yeast infections. Many women do not have symptoms or risk
factors, and chances are, if they do have a glucose metabolism problem, it
may not be recognized as a problem. It is possible for a woman to have a
blood sugar-related problem and not have symptoms.
It is up to each pregnant woman to prevent a blood sugar problem
and/or to detect and treat a problem before it can cause harm to her and her
baby during the pregnancy and the newborn period.
Prevention/Management of Impaired Glucose Metabolism in Pregnancy
Basic Principles:
Reduce or eliminate “refined” carbohydrates and starchy foods that raise
your blood sugar quickly. (sugar (even natural sugars and its cousins), white
flour products, such as pasta and breads and cereals, white rice products, and
potatoes.)
Healthy carbohydrates like orange juice may be too concentrated for
pregnancy. There is a lot of sugar in juice! (fructose) ½ and orange would
be a better choice than a large glass of juice. Water is a better beverage.
Juice can also be diluted down to reduce the amount of carbohydrate.
Select complex carbohydrates that are more slowly absorbed by your body.
(Whole vegetables, whole fruits, whole grains.)
If you are having a problem with glucose metabolism, it is especially helpful
to start your day with a protein meal, not a carbohydrate meal.
Make protein the base of your meals and use healthy complex carbohydrates
to round the meals out.
High fiber foods (whole grains and fibrous fruits and vegetables) slow down
the absorption of carbohydrates that you eat. This means your pancreas is
not worked so hard producing insulin in reaction to the carbs. Your blood
sugar metabolism will be more efficient.
Physical activity greatly improves your glucose metabolism in pregnancy.
Moving your skeletal muscles will lower your blood sugar levels. Your
muscles will use the glucose for fuel. Regular exercise will keep your
glucose metabolism balanced. If you do eat a meal that is too high in
“carbs” get up and move your body! Take a 20-minute walk in order to
bring the blood sugar levels down to normal.
Glucose Testing
Write down what you eat for meals and what time you eat and test.
Write down when you do significant exercise.
Don’t be afraid to experiment!
Target Glucose Scores
Fasting or before meals: 70-100 mg./dl
One hour after eating: Under 140 mg./dl.
Two hours after eating: Under 120 mg./dl.