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It is American Diabetes Month and if you are pregnant or plan on becoming pregnant, it is important to know about gestational diabetes and the affects it can have on you during pregnancy.

Women who are pregnant have the possibility of developing gestational diabetes, which is elevated blood sugar levels occurring during pregnancy and typically ending at birth. Blount Memorial Diabetes Management Center program coordinator and registered nurse Dawn Hollaway says that due to hormonal changes during pregnancy, the cells in a woman's body may build up resistance to insulin, leading to an insulin-resistant state. The cells in a pregnant woman's body may not be able to utilize insulin effectively.

Women who are at high risk for gestational diabetes are those who are overweight or obese, have a personal history of gestational diabetes, a strong family history of diabetes, or are a member of an ethnic group with a high prevalence of type 2 diabetes, including Hispanic/Latino Americans, African Americans, Native Americans, Asian Americans and Pacific Islander Americans. The most common complication with gestational diabetes is delivering a large baby.

Gestational diabetes may not be present in every pregnancy a woman has, Hollaway says. "Some of our patients may experience gestational diabetes in only one pregnancy, while others may have it in every pregnancy. During pregnancy the blood sugar levels are in a much tighter parameter and women need to monitor blood sugar levels at least four times a day. The goal for a woman with gestational diabetes is to maintain levels between 60-90 while fasting, and 120 and below two hours after a meal."

The primary treatment for gestational diabetes is diet and exercise. "Our goal is to promote adequate nutrition for both mom and baby with appropriate weight gain," Hollaway says. If during pregnancy blood sugar levels cannot be controlled through diet and exercise, some physicians will prescribe an oral diabetes medication or insulin injections.

Holloway says that women with diabetes can breastfeed, as it gives nutrients the baby needs to stay healthy. "Since breastfeeding women typically need more calories daily, you should consult a dietitian to set up an individualized meal plan to ensure you obtain your needed calories." After you have given birth, breastfeeding can lower the amount of insulin needed. Giving birth can increase the risk of a low blood sugar, especially if breastfeeding. "Having a healthy snack before or after breastfeeding may be beneficial," she says.

If you are trying to prevent pregnancy, diabetic women should consult their physician regarding birth control pills. Progesterone and high estrogen doses may increase blood sugar levels. "Using birth control pills for longer than a year or two may increase your risk for complications. Non-diabetic women who take birth control pills are at a higher risk for heart attacks and strokes when compared to women not taking birth control pills," Hollaway says. Heart attacks and strokes are the number one long-term complication for type 2 diabetics; therefore women with diabetes taking birth control pills are at an even higher risk for cardiac complications.

For more information, call the Blount Memorial Diabetes Management Center at 865-977-5767.

The Women's Health column is provided by the staff and associates of Blount Memorial Hospital. It appears every Sunday in Women's Times. For more information on this column call 983-7211.