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Monitoring Your Diet for Healthy Pregnancy: Read Juana's Story
A look at gestational diabetes
Date: 6/1/2012

For several months, Trenton resident Juana Hurtado monitored her

health in ways she never had to before. Juana kept a log of her daily food and beverage intake, as well as her blood sugar levels because her health — and her unborn baby’s health — depended on it.

During a routine prenatal laboratory visit prescribed by her physician, Christian Hoffman, MD, Juana completed a onehour glucose test to screen for gestational diabetes, a condition which develops during pregnancy. Juana’s results were abnormal so she was prescribed a three-hour follow-up test which confirmed she had developed the condition.

Like other forms of diabetes, gestational diabetes affects how one’s cells use sugar (glucose). According to the American Diabetes Association, 18 percent of pregnant women are affected by gestational diabetes. It is believed the condition is caused when essential hormones for baby development block insulin from doing its job.

The first step in managing gestational diabetes is typically diet modification. Juana was referred to an RWJ Hamilton registered dietician for a consultation.

“The dietician showed me that my sugar levels were ‘off’ because I was skipping meals and my drinks contained too much sugar. She encouraged me to eat five smaller meals throughout the day,” says Juana. “After I met with her, I started logging everything and counting calories. I checked my blood sugar levels before I ate, and three hours after.”

Juana brought these logs to subsequent prenatal appointments at RWJ OB/GYN Group Hamilton to share with her physician. By doing so, she helped her physician to understand how her body is responding to her diet.

“Monitoring diet and glucose levels is very important when someone is diagnosed with gestational diabetes,” says Dr. Hoffman. "These pregnancies are considered high-risk. When a mother goes untreated for gestational diabetes, the baby could experience low blood sugar or other illness, there is even increased risk of fetal death. Controlling blood sugar levels reduces these risks.”

In addition, women with gestational diabetes are at an increased risk for high blood pressure during pregnancy. Their babies also tend to be larger, which can increase the chance of complications at the time of delivery, including birth injury or trauma.

“In Juana’s case, and with anyone diagnosed with gestational diabetes, we carefully monitor the baby’s growth, movement and the amniotic fluid. We performed weekly ultrasounds on Juana later in her pregnancy and continued monitoring her blood sugar levels,” says Dr. Hoffman. In the weeks leading up to delivering her baby, Juana was prescribed medication for elevated blood sugars.

Baby Xander was delivered by cesarean section, weighing nine pounds, four ounces. Xander was born with low blood sugar levels, but his levels have since leveled out within normal range.

After delivery, Juana was taken off medication and her blood sugar levels returned to normal. She was advised to continue monitoring her levels at home and will have follow-up visits with Dr. Hoffman to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within five to 10 years after delivery.

“I had a wonderful experience at RWJ Hamilton. Not only did I learn how to take care of myself and my baby through proper diet, the way I eat is forever changed — for the better,” says Juana.

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