Before being diagnosed with gestational diabetes, Emirati businesswoman Nashwa Al Ruwaini was a stressed workaholic with an insatiable sweet tooth.
While her unhealthy lifestyle did not impact her first pregnancy, she had an alarming fasting blood sugar level of 195mg/dL in the second trimester of her second pregnancy in 2010.
This was a signal to doctors that she had gestational diabetes, a type of diabetes that is most common in the second or third trimesters among pregnant women who did not have diabetes before pregnancy.
Being diagnosed with gestational diabetes at Mubadala Health's Imperial College London Diabetes Centre (ICLDC) was a wake-up call for Al Nuaimi, the founder and CEO of the Abu Dhabi-based media production and consultancy firm Pyramedia Group.
"I always had bad eating habits, skipped meals and would have a big dinner right before bedtime," she said. "When I was told that I had gestational diabetes, I changed my ways because I was worried that the baby would have diabetes or be affected by my high blood sugar levels."
After her third child, Al Ruwaini developed type 2 diabetes, but she said following the ICLDC clinical team's instructions on diabetes management helped her immensely.
"I learned that a workaholic like me, who is stressed and neglects her body's need for good nutrition and exercise, can easily fall into the vicious trap of diabetes," she said.
The risk factors for gestational diabetes include being overweight and obese, lack of physical activity, pre-diabetes, family history, polycystic ovary syndrome and previously delivering a baby weighing more than 4kg.
The World Health Organisation estimates that gestational diabetes affects about seven to 10 per cent of all pregnancies worldwide.
For most women with gestational diabetes, the diabetes resolves itself soon after delivery. When it does not go away, the diabetes is deemed type 2 diabetes.
Even if the diabetes does go away after the baby is born, half of all women who had gestational diabetes develop type 2 diabetes later. Their children are also at risk of developing childhood obesity and are six times more likely to develop type 2 diabetes.
Dr Tarig Abdalla, a consultant endocrinologist and diabetologist at ICLDC, has been helping Al Ruwaini manage her diabetes since the second pregnancy.
With the help of a diabetes educator and dietitian, Dr Abdalla said the team at ICLDC were able to help Al Ruwaini reduce her blood sugar levels to the target range of 70 – 120 mg/dL for an uncomplicated pregnancy.
“Al Ruwaini’s blood sugar level was quite high when she came to us, so we had to start her on insulin therapy and advised her on dietary and lifestyle measures. She managed quite well, and her baby was born the right size, which shows that she had good control of her blood sugar," he said.
Risks for mother and baby
Dr Abdalla also noted that there is a high risk to the mother and baby if gestational diabetes is not in check during a pregnancy.
“If it is uncontrolled, the baby is exposed to very high maternal glucose levels, so his or her pancreas will try to deal with this by producing insulin. This causes the child to grow in size and weight, making the delivery difficult, necessitating a C-section.
"Also, when babies produce too much insulin, sometimes they are born with hypoglycaemia (low blood sugar). This can cause seizures and requires immediate intervention with feeding or an intravenous glucose solution," he said.
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