New mum Natacha Tinker has spoken for the first time about her ‘roller coaster’ ride with gestational diabetes hoping that by shining a spotlight on her ordeal she will help raise more awareness about the condition.
The Brit, a former Amwaj Islands resident who lived in the kingdom for 16 years, has stepped forward to support GDN Media’s Annual Ramadan Community Campaign in support of Bahrain Diabetes Society.
In her first week back in the UK she found out that she was pregnant. Her happiness, sadly, was interrupted when at 26 weeks, during a routine appointment with her doctor, she discovered that things were not going to plan.
“I had no health problems prior to getting pregnant so it was never a concern, however, my bump was measuring two to three weeks ahead, which is a sign of gestational diabetes,” explained the former flight attendant and air crew trainer, who currently lives with her ‘little buddy’ Amari James Fletcher in the English city of Newcastle.
She underwent an urgent test, which came out positive for gestational diabetes – a case of high blood sugar (glucose) that develops during pregnancy, most commonly in the second or third trimester. Women with the condition are at an increased risk of complications during pregnancy and at delivery.
A series of global studies have indicated that the prevalence of gestational diabetes mellitus worldwide is around 14 per cent, with one latest research paper focused on the Middle East and North Africa region, dating to 2021, highlighting that sub regionally, prevalence was highest in Gulf countries.
“While the causes for gestational diabetes are unknown, there is a theory that the placenta produces pregnancy-supporting hormones, which interfere with insulin,” King Hamad American Mission Hospital (KHAMH) consultant obstetrician gynaecologist and maternal-foetal medicine expert Dr Hana Akleh told the GDN.
Dr Akleh
“This usually occurs around the 24th week of pregnancy, leading to high sugar levels or gestational diabetes. Other factors could include having a family history of diabetes, gestational diabetes in a previous pregnancy, obesity, advanced maternal age, race – African-American and Asian women have higher chances – or a pre-diabetic condition.
“If the patient is on medication, we have to induce her at 38 weeks to prevent any possible problems but if she is controlling her blood sugar levels through diet, then we deliver her at term,” she explained, adding that in either case, patients are advised to follow a healthy lifestyle and balanced diet.
Ms Tinker was placed on a special diet for two weeks but still couldn’t maintain a healthy blood sugar level despite her best efforts. She was given medication and had to monitor her glucose readings using a regular finger-prick test kit.
“I was put on six units of insulin a night, and it was really hard pricking my finger up to eight times a day, sometimes more,” she explained. “I would eat and then test my blood after an hour. Walking helped me lower my levels after meals if I was slightly over my limit.
“I also had to have regular growth scans to ensure the baby wasn’t growing too rapidly and the placenta was still working as it should. Any lack of movement, I was to go to the hospital and get on the monitor to check baby’s vitals. This happened quite frequently and can be very scary,” the customer service professional revealed.
Dr Akleh highlighted that fetal macrosomia (bigger than normal foetus i.e. around four kilograms) is common with those having gestational diabetes, which could lead to complications like traumatic vaginal deliveries, instrumental (vacuum) delivery, shoulder dystocia which increases chances of birth asphyxia or even death, intrauterine foetal death.
She warned about rebound hypoglycemia, a situation where blood sugar drops usually within four hours after eating, likely the result of the body making too much insulin after a large, carb-heavy meal.
“Three meals and three snacks are advised to avoid a sudden shooting up of blood sugar levels or rebound hypoglycemia. A diet rich in vegetables and salads, protein and one-third carbohydrates is recommended, accompanied by regular check-up for blood sugar before and after meals,” she advised.
Dr Akleh noted that at KHAMH, while the test for diabetes is routinely carried out between 24 and 28 weeks of pregnancy, those who have the pre-disposed conditions are tested at around 12 weeks. If the results come out negative, then the test is carried out again at routine times.
“It’s worth mentioning that if they have diabetes at 12 weeks, they are not labelled as ‘gestational’ but ‘type two’,” Ms Akleh added.
Type two diabetes affects how your body uses sugar for energy and stops the body from properly using insulin – the hormone that regulates blood sugar. Women with gestational diabetes and possibly their children are at increased risk of the disease in the future.
Ms Tinker gave birth to her bouncing boy in May last year and has since registered a few hypoglycemia readings that needed treatment.
“I’m currently nine and a half months postpartum and have had three diabetes tests and there’s one happening this month. My last in December wasn’t great but I don’t have diabetes,” she said.
While Dr Akleh maintained that in general, patients with gestational diabetes do well and in the majority cases end up with a healthy foetus and good outcome for both mother and baby, it is important to have regular postpartum checks for diabetes.
“Testing at six to 12 weeks, and then, every three years is important as there is a 50 per cent higher chance of getting diabetes after having gestational diabetes. Regular check-up for sugar levels for the baby is also mandatory. Some postnatal risks for the baby include hypoglycemia, hypocalcemia, hypomagnesemia and higher chances of having type two diabetes and obesity in adulthood,” she warned.
melissa@gdnmedia.bh
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