Gestational Diabetes

Gestational Diabetes
What is gestational diabetes?
Gestational diabetes develops when you have too much sugar (glucose) in your blood during pregnancy.
Your blood sugar levels can increase when your body is not producing enough of the hormone called insulin.
Insulin is needed for:
The muscle and tissues in your body to use blood sugar for energy
And
Your body to store any blood sugar that isn’t needed.

What causes gestational diabetes?
While you are pregnant your body needs to make extra insulin especially from mid pregnancy onwards.
You need extra insulin because hormones from the placenta make your body less responsive to insulin.
If your body cannot meet this extra demand, your blood sugar levels will rise and you may develop gestational diabetes.
Gestational diabetes is common but the good news is, it usually goes away after your baby is born. It is different to type 1 and type 2 diabetes which lasts a lifetime.

Who is more at risk of developing gestational diabetes?
Women are more likely to develop gestational diabetes if they:
Have a family history diabetes
Are over the age of 35 years
Are obese
Had a previous large baby
Had a previous late stillbirth

How will I know I have gestational diabetes?
The symptoms of gestational diabetes are tiredness and excessive urination. However, both of these symptoms are experienced by most pregnant women and gestational diabetes may go undiagnosed.
Urine is routinely tested for sugar at every antenatal visit and if you are more at risk of developing gestational diabetes you will be offered a glucose tolerance test between 24 and 28 weeks.
The only way to confirm gestational diabetes is with a glucose tolerance test. You will need to fast from 12 midnight, you will be allowed to drink water. At the clinic your midwife will take a blood sample from you to get a baseline blood sugar measurement. Then she will give you a sugary drink. After 2 hours she will take another blood sample to see how your body has responded to the sugar.

Will gestational diabetes affect my baby?
Most women with gestational diabetes have healthy babies because it is diagnosed and treated.
If it is not controlled and you have too much sugar in your blood it will cross the placenta to the baby. This can cause your baby to grow larger than normal.
A big baby can make labour and birth more difficult.
Uncontrolled diabetes can result in too much amniotic fluid around baby, this is called polyhydramnios.

What is the treatment for gestational diabetes?
The most important part of treatment is to control blood sugar levels and you may need to attend a diabetic clinic where you will get expert guidance.
This means regular testing of blood sugar / glucose levels, a carefully planned diet and regular exercises.
Some women will require insulin injections and this extra insulin will not cross the placenta and will not affect the baby.
You will be offered extra ultrasound scans to check how your baby is growing and how much amniotic fluid there is around your baby.

Will gestational diabetes affect my baby?
While your baby adjusts to making the right amount of insulin, your baby may have low blood sugar, which is called hypoglycaemia.
Your baby’s blood sugars may need to be monitored for a while in the special care baby unit.

Does gestational diabetes go away?
Usually gestational diabetes will go away after your pregnancy.
You will have your blood sugar levels checked after the baby is born and again 6 weeks post natal.

Will I get gestational diabetes in my next pregnancy?
You may do.
If you had gestational diabetes before you may be asked to monitor your blood sugar levels or you may be offered a glucose tolerance test at 16-18 weeks, and if it is normal it may be repeated later in pregnancy.
If you had gestational diabetes where you had to receive insulin injections as part of your treatment you are more likely to get it in the next pregnancy