What is gestational diabetes?
Gestational diabetes can affect anyone and is usually diagnosed in the second or third trimester. It is caused when your body cannot produce enough insulin which means you have high blood sugar levels. It can be managed easily with help from your midwife and usually disappears after the birth of your baby.
It is important it is diagnosed early on because it can cause problems for your baby such as large birth weight, premature birth and jaundice.
The danger to a mother is the risk of pre-eclampsia and a higher chance of developing Type 2 diabetes in the future. You may also have gestational diabetes in subsequent pregnancies.
What are the risk factors for getting gestational diabetes?
• A BMI greater than 30
• Previously having a baby weighing 4.5kg (10lb) or more at birth
• A history of diabetes in your family
• Having gestational diabetes in a previous pregnancy
• You are of south Asian, Black, African-Caribbean or Middle Eastern origin
You may not know if you have gestational diabetes because the symptoms are not always obvious. If your blood sugar levels get too high you may become more thirsty, need to pee more and feel tired. However, these are also general pregnancy symptoms so you will need to speak to your midwife and be screened for gestational diabetes to know for sure if you have it.
You should seek urgent medical advice if you are hyperglycaemic (very high blood sugar) or unwell. Symptoms of hyperglycaemia include blurred vision, weight loss, thirst, tiredness, nausea and sickness and breath that smells fruity.
Screening for gestational diabetes
Your midwife will ask you some questions during your booking appointment at 8-12 weeks to find out if you are at an increased risk of gestational diabetes. If you have one or more of the risk factors above you will be offered a screening test. This is called an oral glucose tolerance test (OGTT). Your blood will be taken then you will have to drink a glucose drink and then have another blood test two hours later to determine how your body is coping with the sugar.
The screening test usually happens between 24-28 weeks but if you have had gestational diabetes before you will be offered it earlier in your pregnancy.
You may also be offered extra scans to check on the baby’s weight and to make sure you don’t have too much fluid in the womb.
Treatment for gestational diabetes
Treatment for this condition will involve you making changes to your diet and exercise regime and sometimes medication such as tablets or insulin injections. You can usually stop taking these medicines after you have given birth.
Starchy, low glycemic index (GI) foods such as wholewheat pasta, brown rice, lentils, pulses and beans are recommended because they release sugar slowly. Avoid sugary foods and drinks and eat plenty of fruit, vegetables and protein.
You may be given a glucose testing kit to take home with you so you can check your levels by pricking your finger and putting the drop of blood on a testing strip. Your midwife will advise you on how to do this properly and what level you should be aiming for.
Your medical team will discuss with you how your gestational diabetes may influence the decisions you make around birth. Your team will discuss the option of an induction of labour if your blood sugar levels cannot be easily controlled. Your baby’s blood sugar level will be tested in the first few hours after it is born.
Gestational diabetes should go away once your baby has arrived but you should have another blood test 6-12 weeks after the birth, even if you feel well. If it is normal you will be advised to have a test once a year because you are still at risk of developing Type 2 diabetes.
If you are planning to have another baby make sure you get checked for diabetes by your GP beforehand.
:: For more information about gestational diabetes speak to your midwife or go to the NHS website.
