Gestational diabetes and diabetes in pregnancy
Gestational diabetes is a form of diabetes that develops or is discovered during pregnancy and then usually disappears when the pregnancy is over. Gestational diabetes occurs in approximately 1 in 20 pregnancies.
What causes gestational diabetes?
Gestational diabetes can develop during pregnancy, because the pregnancy hormones make it harder for your body to use insulin sufficiently. In addition to this your body may need 3 times as much insulin than what it did before you were pregnant. Gestational diabetes usually occurs between 24 and 28 weeks but can develop anytime.
What are the symptoms of gestational diabetes?
Gestational diabetes is routinely tested for during pregnancy and so it is usually picked up before symptoms develop. If symptoms are present they might include the following:
- Increased thirst
- Needing to wee more than normal
- Dry mouth
- Tiredness
- Headaches
- Recurrent thrush or urine infections.
Most of these symptoms are common in pregnancy anyway so if you are experiencing them it is not necessary a sign of diabetes.
Am I at risk of gestational diabetes?
You will be at an increased risk of gestational diabetes if you are overweight, you have previously had a large baby (over 9.9lb), you have a parent or sibling with diabetes or if you have had gestational diabetes before. All pregnant women should be tested for gestational diabetes between their 24th and 28th week of pregnancy. Gestational diabetes normally affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is growing.
How is gestational diabetes diagnosed?
At your first antenatal appointment, usually around 8-12 weeks you will be asked many questions and your risk for diabetes will be assessed. If you are at risk of diabetes you may be recommended to have an oral glucose tolerance test. This involves a blood test carried out before and after drinking a glucose drink to see how your body deals with the glucose. This test is usually carried out around 24 weeks though this might be earlier if you are at high risk. You might also be recommended to regularly test yourself at home to monitor your glucose levels. Click here to buy or read more about the glucose tests available on this website.
How is gestational diabetes treated?
If you are diagnosed with gestational diabetes you will be referred to a joint diabetes and antenatal clinic. The team in here will be experienced in dealing with pregnant women with diabetes. The aim of treatment is to keep blood glucose levels low. You might just have to change your diet and increase the amount of exercise. If lifestyle changes fail to lower your blood glucose levels then medicines might be required, your doctor might also need to prescribe insulin injections.
What are the risks of gestational diabetes?
If treated and monitored the risks to mother and baby can be reduced and most women will have a normal pregnancy and healthy babies. Risks from this type of diabetes includes the following:
- The baby being too large, due to the extra sugar being passed to your baby.
- Too much amniotic fluid (polyhydramnios) this increases the risk of premature birth
- An increase risk of pre-eclampsia
- Risk of baby suffering from respiratory distress when born
- Risk of jaundice for the baby
- Stillbirth though this is very rare.
You will be monitored very closely and have plenty of check ups as well as additional scans to ensure the baby is doing well. If you have gestational diabetes and all is going well you may be able to go into labour naturally, however you will be advised not to go over your due date. You will usually be offered to have an induced labour at 38-40 weeks. For most women gestational diabetes will go away after birth, however, about half of women will go on and develop type 2 diabetes within 10 years. Your doctor will carry out a blood test about 6-12 weeks after birth to ensure your glucose levels have returned to normal. The doctor will also advise you on ways to prevent you from developing type 2 diabetes.
Diabetes and pregnancy
Most women with diabetes have healthy babies, but if you have gestational, type 1 or 2 diabetes you will need to be looked after carefully during pregnancy so expect to have a lot of additional medical care, scans and regular blood sugar checks are essential.
If you have diabetes and are planning on having a baby you should discuss this with your diabetic nurse so they can carry out tests and give you guidance. The risks of complications above are the same if you had diabetes type 1 or 2 before becoming pregnant. It is likely that your current treatment regime may need to be changed as some diabetic medication is not safe to take during pregnancy. You will be prescribed a high dose folic acid treatment and you will have to monitor your levels much more. Pregnancy can make diabetes complications worse and so you will be recommended to have eye screening and kidney checks.
You and the baby will both have your blood glucose levels shortly after birth to make sure they are in a normal range.
