Gestational diabetes is something that could happen when you become pregnant sometimes without warning a women can develop systems of diabetes mellitus during pregnancy which is called gestational diabetes and this can be detected anywhere within the 24-28 week of pregnancy (sometimes earlier) the patient may present to her medical practitioner with symptoms of gestational diabetes which could include excessive thirst, urination, fatigue or thrush infections.  However symptoms of gestational diabetes mellitus are sometimes not obvious and the doctor will order a simple gestational diabetes test to check the sugar level. A diagnosis is usually apparent after the patient has performed a glucose challenge test (GCT) or commonly called a glucose test.

Gestational diabetes blood sugar levels are measured in the blood test one hour after a glucose drink. If results from this test are abnormal a further oral glucose tolerance test is performed where the pregnant patient will perform a 24 hour fast and a blood sample is then taken before, and two hours after, consuming a glucose drink.  Gestational diabetes is monitored continually throughout the pregnancy and treatment risks to the mother and baby are greatly reduced when gestational diabetes is well controlled. Working together with a doctor and health care team, can help lower a woman’s blood glucose levels and keep them within a normal range throughout pregnancy and also into her prenatal care.

What is gestational diabetes?

At the time of pregnancy the placenta produces certain hormones to help baby develop and grow but these hormones can also affect the mother’s insulin. When this happens it is called insulin resistance. Normally what happens as the pregnancy progresses, the mother’s energy needs increase and as such her insulin needs are also higher in demand. A few women are not able to produce the required extra insulin and as a consequence blood glucose levels rise.

Normally what happens when the pregnancy is over and the need for insulin returns to normal, the diabetes will normally disappear.

Who is at risk of gestational diabetes?

It is known eight per cent of women will develop gestational diabetes during their pregnancies some of the high-risk groups are:

• Those with a family history of type 2 diabetes
• Females over the age of 30 years of age
• Women who are obese or overweight
• Women who have a history of gestational diabetes from previous pregnancies

How does it affect baby?

Glucose crosses the placenta from mother to baby to meet the energy needs of the developing baby. When the mother’s blood glucose levels are raised, a greater amount of glucose will cross the placenta to the baby.

To help cope with this extra glucose the baby then produces more insulin, which promotes excessive growth and fat in the baby.

If untreated the mother’s blood glucose levels remain raised, the baby can be larger than normal at birth. After delivery, the baby could experience low blood glucose, especially if the mother’s blood glucose levels were raised before the delivery. The baby will not be born with diabetes. The risks mentioned are greatly reduced if gestational diabetes is well controlled through diet, exercise and monitoring throughout the pregnancy.

How Do I Manage Gestational Diabetes?

The management of this type of diabetes is with a closer look at both diet and exercise.  Looking at diet:

• A gestational diabetes diet plan can be of great importance. Eat a variety of foods high in fiber but rich in calcium, iron and folic acid but low in saturated fats.  The carbohydrates in grains, cereal, fruits rice and pasta provide all the necessary nutrients to provide energy.

Physical activity:

• Doing something that is as simple as walking will help control blood glucose levels and improve overall fitness.  As your pregnancy progresses in the later stages you might also consider non weight bearing fitness exercise such as aqua aerobic classes where you will be able to continue with exercise routine through to the last weeks of pregnancy with ease.

Monitoring blood glucose levels:

• Regular testing of blood glucose levels is an essential part of the treatment in order to be re-assessed and changed if required
• It may be also necessary for insulin injections as this maybe required to help control glucose levels. Overall insulin is safe to take during pregnancy, as this does not cross the placenta from the mother into the baby.

After baby is born:

As a general rule after the baby is born, the mother’s blood glucose levels usually return to normal. A simple follow-up blood test is recommended approximately six to eight weeks after the birth. Any woman that has had gestational diabetes has a greater chance of developing type 2 diabetes within twenty years.

Steps to reduce the risk of type 2 diabetes include:

• Keep eating a variety healthy high fiber diet
• Keep weight in a healthy weight range
• Ensure exercise becomes a habit
• Include in your annual check up an oral glucose tolerance test

To ensure that you have a safe pregnancy visit your doctor if you think you may have symptoms of gestational diabetes to ensure that you get the right treatment from the start.