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Gestational Diabetes

 

Diabetic pregnant woman

Gestational diabetes and diabetes in pregnancy

Gestational diabetes is a form of diabetes that develops or is discovered during pregnancy. It typically occurs between 24 and 28 weeks of pregnancy (but can develop anytime) after the baby’s body has been formed, but while the baby is growing. It usually disappears when the pregnancy is over.

What causes gestational diabetes?

Gestational diabetes can develop during pregnancy because pregnancy hormones make it harder for your body to use insulin sufficiently. In addition to this, your body may need three times as much insulin as it did before you were pregnant.

Symptoms of gestational diabetes

Gestational diabetes is routinely tested for during pregnancy and is usually picked up before symptoms develop. However, if symptoms do occur, they commonly include:

  • 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 do experience any of the above, it is not necessarily a sign of diabetes. Ask your GP to carry out a test if you are concerned.

Risk factors for gestational diabetes

Gestational diabetes occurs in approximately 1 in 20 pregnancies. You will be at an increased risk of getting gestational diabetes if:

  • you are overweight
  • you have previously had a large baby (over 9.9lb)
  • you have a parent or sibling with diabetes
  • if you have had gestational diabetes before.

How is gestational diabetes diagnosed?

At your first antenatal appointment, usually around 8-12 weeks, you will be asked questions which will help your health practitioner to assess your risk of diabetes.

If you are at risk of diabetes, they may recommend for you to have an oral glucose tolerance test. This is a blood test, which is carried out before and after drinking a glucose drink, to see how your body deals with glucose. The test is usually carried out around 24 weeks, though this might be earlier if you are at high risk.

You may also be advised to regularly test yourself at home with a glucose monitor

Treatment for gestational diabetes

If you are diagnosed with gestational diabetes you will be referred to a diabetes antenatal clinic. The specialist team here are experienced in helping pregnant women with diabetes. The aim of your treatment will be to keep blood glucose levels low.

Treatment may be as simple as changing your diet, increasing exercise and monitoring your blood sugar. If lifestyle changes fail to lower your blood glucose levels medicines might be required. Your doctor may also need to prescribe insulin injections for more serious cases.

Risks of gestational diabetes

Providing you regularly monitor your blood sugar and follow advice, risks to the mother and baby can be reduced. Most women will have a normal pregnancy and healthy babies.

However, there are some risks associated with gestational diabetes:

  • The baby may be larger due to the extra sugar being passed to your baby
  • Increased risk of premature birth due to too much amniotic fluid (polyhydramnios)
  • Increased risk of pre-eclampsia
  • Risk of baby suffering from respiratory distress when born
  • Risk of jaundice for the baby
  • Stillbirth – although this is very rare

Don’t worry. If you have gestational diabetes, 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 still be able to go into labour naturally, however you will be advised not to go over your due date.

You will usually be offered 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. They will also advise you on ways to prevent you from developing type 2 diabetes.

Read more about Type 2 diabetes

Diabetes and pregnancy

Most women with diabetes have healthy babies but, if you have gestational, type 1 or type 2 diabetes, you will need to be looked after carefully during pregnancy. Expect to receive additional medical care, scans and regular blood-sugar checks.

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. 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 will have to monitor your levels more frequently. Pregnancy can make diabetes complications worse so you will be advised to have eye screening and kidney checks.

You and the baby will both have your blood glucose levels tested shortly after birth to make sure they are in a normal range.

Learn more about diabetes:

Living with diabetes

Types of diabetes 

Understanding diabetes