Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Gestational Diabetes Mellitus

When diabetes is identified for the first-time during pregnancy, it is called Gestational Diabetes Mellitus (GDM) or simply Gestational Diabetes. It typically manifests between the 24th and 28th weeks of gestation.

Gestational Diabetes Mellitus impairs the body’s ability to regulate blood sugar, just like other types of diabetes. This leads to elevated glucose levels that can impact both maternal and foetal health.

This condition can be often managed by following a balanced diet and healthy lifestyle but in some cases, medication will be required. Unmanaged or improperly managed GDM can result in significant health complications for both the mother and the baby. Therefore, prompt diagnosis and treatment are crucial in these cases. Blood sugar levels generally normalize postpartum. This highlights the importance of monitoring and managing this condition throughout pregnancy.

Related Reading – ‘Gestational Diabetes Mellitus – causes, symptoms, prevention and treatment’

Gestational Diabetes Mellitus: Ayurveda Understanding and Management

Gestational Diabetes Mellitus vs Prameha

Ayurveda has not explained any condition which can be correlated with Gestational Diabetes Mellitus. Prameha / Madhumeha is a condition which has been popularly correlated with diabetes mellitus. The etiological factors, pathogenesis, symptoms, prognosis and treatment principles of Gestational Diabetes Mellitus should be understood on the lines of the nidana – causative factors, purvarupas – premonitory symptoms, samprapti – pathogenesis, lakshanas – symptoms, sadhyasadhyata – prognosis and chikitsa – treatment principles and treatment of Prameha itself.

Nidana Parivarjana: The golden principle

The golden principle of tackling any condition ‘avoid or keep away the causative or trigger factors’ is also applicable in dealing with gestational diabetes.

The previous memory of having undergone this problem will alert and remind the woman to take caution in the succeeding pregnancy. So, the natural caution light is on but she should see that she is not too stressed in taking care of the smallest of things. She needs to program a protocol for herself with the help of a doctor in terms of dos and don’ts based on previous experiences. The suspect foods and activities shall be kept away.

Prameha Chikitsa

Just like Diabetes Mellitus is treated on the lines of ‘Prameha Chiktisa’ or ‘Madhumeha Chikitsa’ considering Ayurveda approach, Gestational Diabetes too should be treated on the same lines.

General Ayurveda principles in dealing with Gestational Diabetes Mellitus

The basic principles of treating gestational diabetes mellitus will be the same as –

–        Prameha chikitsa
–        Medovaha sroto dushti chikitsa – treating contamination of fat conveying channels
–        Sthoulya Chikitsa – treating obesity
–        Medoroga Chikitsa – treating errors of fat metabolism
–        Agni Vikruti Chikitsa – treating imbalances of metabolic fire
–        Ama Chikitsa – treating ama if present
–        Garbhini vyadhi chikitsa – promptly treating any diseases which occur during pregnancy
–        Dealing with Kapha – though prameha can be caused by any dosha or doshas, kapha is the main culprit because all types of prameha have their origin from kapha. Therefore, it is important to keep a check on the balance of kapha and treat the same if any. At the same time any kapha disorders should also be treated.

Preventive measures

The principles will be the same as explained in the context of gestational diabetes.

If the woman has already experienced this condition during the previous pregnancy, she shall take all precautions to prevent the same from repeating in the current pregnancy. She needs to take care about her foods, lifestyle activities, habits, behaviours, stress, seasonal adaptation etc by talking to her consulting physician. The protocol will be based on experiences and memories carried from previous pregnancy. If there is a fixed and known protocol followed the previous time which has really worked in helping to keep things in balance, the same things shall be adopted in consent with the doctor.

If it is her first pregnancy, she may take caution if she has a family history of diabetes mellitus. She may also be the first person in her family to experience diabetes mellitus during pregnancy. In that case, if she suspects symptoms of diabetes, she can call the doctor. If the doctor finds out the condition first, then there should not be any issues. In either case, the consulting specialist / physician / obstetrician will guide the pregnant woman so as to how to effectively manage the condition. Here attempts can be put towards not allowing the disease or symptoms to progress and cause complications, by dealing with it effectively and also following preventive measures.

Can Panchakrama prevent gestational diabetes mellitus?

Yes. Panchakarma can definitely help in preventing gestational diabetes mellitus. Depending on the dosha predominance, vamana, virechana or vasti may be planned way ahead of conception. Vasti and Uttara Vasti are beneficial. These therapies, apart from providing a good detox, will also expel the morbid doshas which might cause diseases like diabetes mellitus and complications during pregnancy. They also help in treating any existing disorders and cleanse and prepare the womb for conception. They are also useful in comprehensive psychosomatic healing. They become essential tools for women with family history of diabetes mellitus or a previous history of her suffering from gestational diabetes and also if she herself is a patient of diabetes mellitus. The vastis mentioned in the garbhini paricharya – Ayurveda antenatal care, are curative in nature.

External therapies for prevention of gestational diabetes mellitus

Women planning conception can take external therapies under the direction of their consulting physician. Stress is an important component of many health issues encountered during the pregnancy and so are many other mental illnesses or psychosomatic disorders. The external therapies will not only de-stress the woman and calm the mind and senses, but will also deal with hormone imbalances. Combined with therapies like vamana – since kapha is the main dosha which would cause diabetes, mainly gestational diabetes and also virechana, these therapies would help in preventing gestational diabetes. Below mentioned therapies are highly beneficial –

–        Abhyanga
–        Swedana,
–        Udwarthana,
–        Shirodhara / Shiro Vasti
–        Sarvanga Dhara / Pizhichil

Garbhini Paricharya

Following the Garbhini Paricharya – the antenatal care principles explained in Ayurveda will help. Different Ayurveda Acharyas have given different kinds of tips to maintain good mother-baby health during pregnancy and lay the foundation for easy delivery of a healthy foetus.

Read here – ‘Garbhini Paricharya – Ayurveda Antenatal Care’

The Masanumasika Garbhini Paricharya i.e. month wise pregnancy care explained in Ayurveda grossly appears like a nourishing and satiating approach. One may think that they would cause or worsen diabetes in a pregnant woman. That is not the case. These are the general principles towards comprehensive care of mother and child. They can be customized according to the conditions like gestational diabetes etc present, occurring or recurring during pregnancy.

Other approaches

Sattvavajaya – The pregnant woman should find methods of overcoming stress and emotional highs or lows, either by herself or with help.

Vyayama – She should get indulged in the exercises which suit her, taking care of quality and quantity. She can customize exercise plans for her with the help of experts.

Dhyana / Meditation – Meditation calms the mind and controls the hormonal irregularities.

Nidra – She needs to sleep well. She should not wake up overnights and should not over-sleep during the day. The later one would cause kapha aggravation and can become one of the causes or triggers / risk factors of gestational diabetes mellitus.

Daiva Vyapashraya – This is yet another non-medicinal move which can be practiced. Getting indulged in religious and divine practices can be a part and parcel of daily regimen.

Yoga postures – One can practice Yoga under the guidance of an expert Yoga teacher / instructor. Modified Yoga is said to be the best form of Yoga practice. It involves adjusting traditional Yoga poses so as to accommodate a growing belly of pregnant women and also for other changing needs. This is an easy and effective way to maintain strength and flexibility during pregnancy.

Below mentioned are the best Yoga postures are beneficial in controlling and preventing the progression of gestational diabetes mellitus –

–        Supta Baddha Konasana – Reclining Bound Angle Pose
–        Viparita Karani – Legs Up the Wall Pose
–        Halasana – Plough Pose
–        Paschimottanasana – Seated Forward Bend Pose
–        Dhanurasana – Bow Pose
–        Bhujangasana – Cobra Pose
–        Ardha Matsyendrasana – Half Lord of the Fishes Pose