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Gestational diabetes

Gestational diabetes

Pregnancy does lots of weird (and not always wonderful!) things to your body, and even if they’ve never had a problem before, around one in 20 mums-to-be develops pregnancy diabetes, known as gestational diabetes.

What is gestational diabetes?

Gestational diabetes essentially means your blood sugar level is too high. When you eat, the sugar in the food goes into your blood. Your body then produces insulin to break down the sugar so it can be used as energy.

During pregnancy, hormones interfere with the insulin and you need to produce more to bring your blood sugar down to the right level. If your body can’t keep up, you develop gestational diabetes.

It’s most likely to start during the second and third trimesters, and usually goes away naturally once your baby is born.

What causes it?

No one knows for sure, but you’re more likely to be at risk if:

  1. Anyone in your family has diabetes or has had gestational diabetes.
  2. You’ve already had a large baby, weighing over 4.5kg (9lb).
  3. You’re obese or overweight.
  4. You’re from South Asia, the Middle East or the Caribbean.

What are the signs of gestational diabetes?

You may feel very thirsty, constantly tired and you might need to wee more often. However, most mums-to-be experience these symptoms in a normal pregnancy, so it’s hard to tell if it’s actually gestational diabetes.

How is it diagnosed?

In some areas, midwives test a sample of your urine at your antenatal appointment. If they find sugar, you may then have a blood glucose test. If that result is high, you’ll be referred for a glucose tolerance test to confirm the diagnosis.

If you don’t have routine urine tests but are concerned about gestational diabetes, ask your midwife for advice.

If your midwife or GP feels you’re at risk of developing pregnancy diabetes, you’ll be offered a glucose tolerance test. You’ll have to fast from 10pm the night before, then give a blood sample, which shows the normal level of sugar in your blood.

You’ll then be asked to drink a sugary mixture, and give another blood sample two hours later. The two different results will be compared and will show how your body deals with sugar, which will indicate whether or not you have, or may develop, gestational diabetes.

What does it mean for my baby?

If the level of sugar in your blood is high, your baby can grow very big, which in turn can lead to complications during delivery.

Your baby also needs to make extra insulin while in the womb. Once they’re born, this exra insulin can cause their blood sugar level to drop too low (hypoglycaemia), as the supply of sugar from you is cut off.

To counteract hypoglycaemia, your baby may need additional feeds or may need to be given a sugar solution through a drip. It’s recommended that you breastfeed your baby within 30 minutes of delivery, then every two to three hours, to help keep their blood sugar levels at a safe level. They’ll be closely monitored to make sure everything’s OK.

How is it treated?

Most mums-to-be will be able to control their gestational diabetes through diet and exercise.

You’ll need to cut out junk food, cut down on sugar and eat plenty of wholegrain foods. Eating little and often also helps keep your blood sugar levels steady.

Around one to two women out of 10 will need insulin injections or tablets.

What lifestyle changes to I need to make?

You’ll need to eat plenty of carbohydrates with a low GI (glycaemic index), such as wholemeal bread and pasta, oats, brown rice, potatoes, lentils and beans. Include at least five portions of fruit and vegetables each day, and some lean protein, such as chicken and oily fish.

It’s recommended that you do at least 30 minutes of exercise a day that leaves you slightly breathless, such as cycling or fast-paced walking, as it can help reduce blood sugar levels.

Will it affect how I give birth?

If your baby is big you may either be induced early, or may need a caesarean section.

What happens after my baby is born?

You’ll both be monitored until your blood sugar levels have returned to normal.

You should be able to stop taking any diabetes medication once your baby has been born, and will have another test at your six-week check-up.

The expert view

"Most mums who are diagnosed with gestational diabetes shouldn’t need insulin injections or any other treatment, but they will be referred to a dietician to be advised on a healthy diet and exercise. Following this advice will minimise the risk of needing insulin injections but occasionally diet alone does not correct the problem and insulin injections will be needed." Sharon Broad, Midwife.

Will I always have it?

Gestational diabetes should simply fade away after you give birth. However, there is a higher risk of you getting it if you get pregnant again, and there’s also a risk of you developing Type 2 diabetes in the future, which is a lifelong condition.

To protect yourself, keep up with the healthy lifestyle; eat a balanced diet and exercise regularly

A mum says

"I was quite shocked and upset when I found out I’d got gestational diabetes. (I think you worry about every tiny thing when it’s your first pregnancy, let alone the big things!) But I actually found it very easy to control through what I ate, and by exercising regularly. In fact, with a healthier lifestyle, I actually felt a lot better for it! And I’ve kept it up since Olivia was born, to help protect myself in the future; especially now she’s asking for a baby sister!"
Jane, mum of Olivia, 3

Comments

I'm 18 years old and on my 20 week scan they told me there was too much amniotic fluid around the baby which then I had to see a consultant straight after about it which she told me it was fine I then get told I have to have a GD test at 28 weeks as they think theres a risk of diabetes, has anyone had this?
i have to have the test around 28 weeks purely because of my weight at start of pregnancy, so far my little girl is spot on average size and ive had no indicators what so ever. sometimes it is just a precaution. im really not too worried, still not looking forward to 2 blood tests in 1 day though.
Hiya I've been to midwife today at 25 weeks pregnant n they measured my belly and I was measuring 27 & half weeks and there sending me for a glucose tolerance test but there were no glucose in my urine but worrying like mad
I was diagnosed at week 12 with Gestational Diabetes, as I have Crohns disease so was deemed a higher hisk. I tried to diet control it and failed as it reacted to every bit of Carbs I ate. I am known as an anonmaly as no matter what I eat or do it doesn't settle down, we have a very healthy and active lifestyle so was a massive kick in the teeth as well. So I just wanted to say it can develop in anyone and sometimes won't be controlled via diet or insulin. I am due a growth scan in two weeks for the Dr's to decide an inducement at 37 or 38 weeks, I am currently measuring 2cms bigger than I should be, but in the circumstances, I am quite pleased with that. But don't give up it will all be worth it. x
I'm 30 weeks and have gestational diabetes. It got me really down at first, but the consultants and dieticians were really helpful and now I'm dealing with it a lot better. The best advice I got is don't look it up online, or if you have to, remember the problems listed are worst case scenario, and really unlikely to happen with the extra monitoring. Also remember that its not just sugar, but carbs you have to watch with the diet!
Hi I'm 30 weeks and have just had a GTT test done. I'm really scared as I'm finding hard to eat as I'm so thirsty all the time. Also people keep making comments on how big my tummy is and is getting me down. This is my first baby and I can't help but feel like I'm failing now the doctors say I may have to be induced early. How early do they induce people with GD?
i'm a bit worried as i have seen my consultant today after my 31.5 week scan to see if my placenta had moved, that has which is great, baby is extended breach at the moment but my concern is that at 24 weeks his est weight was 1lb 12oz, now it's 4lb 6oz so i have to have an urgent gtt tomorrow, can't believe how much he seems to have grown, they are also talking about inducing me early now too. this is my third although i have a large gap and am 44 now. guess i'll just have to see what tomorrow brings.
hi i am having a gd test on thursday but i did not have it with my other two children which r 7 and 11 i am a bit worry about this are help out there will b nice
I'm gutted, being tested tomorrow at 28 weeks, also am polyhydramic and have double the surrounding fluid I should have. Anyone wake had this? It's pretty terrifying. I am now assuming I had this in previous pregnancy but it was undetected and resulted in 6 day labour and then a c section x
Had GD with my first (almost 3 years ago) now at 25 weeks with no.2, had a GTT at 16 weeks but that was negative - got another on new years eve! Is it strange that i want the results to be positive as then i know it will be monitored - worried if it is negative i may develop it later on and it not get picked up (i was only just over the borderline with my first-ended up injecting for last 2 months though)
I had it with my first and she is now 10 months. I swapped hosptial care at 28 weeks so missed the test and the new hospital found sugar in my urine on a routine test. I didnt go on insuline or metformine but found it hard to cope with diet control. My bubba was 10Ib and born by emergency c-section after being induced at 40weeks. She was fine but I never go tested at my 6 week check - should I ask my Doc to do it now or is it not worth it? I put on a lot of weirght really quickly so think thats why I got it. I have lost 4 stone and really want antoher but am so scared ill get it again. If you are correct weight does this make a difference or could I still get it?
I had it from 30 weeks with my 1st who is 22 months, and was on insulin. To be honest, it's nothing to worry about, as I'd rather have had the injections 3 times a day with a needle as thin as a hair, than have had poorly baby. I'm 21 weeks pregnant now, and have been on monitoring since 6 weeks, as they are expecting me to get it again. At least I don't have to have the GTT, as they will be able to see if and when the blood sugars go haywire. It does go away straight away after birth, and you have a GTT 6 weeks post birth to confirm that it has gone away.
Hi, I was diagnosed with GD at 28 wks after the GTT, it was a bit of a shock & took some time to get my head around! I'm 37 wks now & have managed so far just thru diet but have had to be ruthless- didnt eat much junk anyway before but now I'm on natural yoghurt, no added sugar alpen, sweetener in porridge, lots of fruit and one tiny square of dark choc per day for the chocolate fix! I found the advice from diabetic nurse quite vague, I recommend Nigel Denby's GL diet books & he has a website too I think called diet freedom. On the plus side, my hubby keeps telling me how little weight I've put on compared with last time :-) hoping it will be worth it in the end! Good luck to all coping with this x
I had gestational diabetes with my twins twelve years ago, it wasn't a surprise when I found out that I have it again with my second pregnancy, can any one suggest a site with a decent diet plan for those with GD???
does any one have any excerise tips? I go swimming once a week but other than houseowkr I dont really do that much. I've just been told i've got G D which was a shock.
this is my 3rd pregnancy and have been told totay that i will need a glucose test as measuring 29 wks and im only 25, i have had 2 big babies, i was worried it was me not eating a healthy diet so will be watching carefully what im doing just hope its no bigger than my last at 10lbs!! Laura, mum of Pippa 5 and Izzi 3
My dad has diabetes so i've been booked in for the blood test. Having gestational diabetes doesn't worry me as i'm used to knowing how its controlled. This is my first pregnsncy and after 18 weeks i'm still getting morning sickness, especially if i don't eat first thing when i wake up. I'm concerned that the sickness wil effect the test, any advice?
need more advice on what to snack on when you are hungrey
I have gestational diabeties for the second time and i am injecting insulin 4 times a day as i was with my first baby, it did disapear afterwards thank goodness so i have my fingers crossed for this time as well!! Once you get your head around it and get into a routine it does become easier and the diabetic team i'm under have been great. Anna-marie
I'm 35 weeks (first pregnancy), and was told by my midwife yesterday that I need to go for an urgent Glucose Tolerance Test -booked in for tomorrow. Am quite nervous, and surprised as no concerns have been mentioned before!
I have had gestational diabetes in both my pregnacies and required Insulin for both. after my first the diabetes just went away and i am waiting for delivery of my second. In both pregnancies the baby was growing big and I have had to be induced early. It can be controlled by diet and exercise but in odd cases like me you might need Insulin
im 8wkz pregnant wid my 4th baby,my first baby was 11lb 4oz,2nd baby i got diabetes n injected insulin n was induced at 37 wks baby weighed 9lb 8oz,my 3rd baby same happend n induced at 37wks n again weighed 9lb 8oz,now on baby no.4 n last week had sugar test n already i hav diabetes,just to let other mums no there nuffin to b scared of injecting urself isnt that bad n doesnt hurt,lil tip pinch ur fat up on ur leg b4 injectin n i promise ur feel nuffin,pratice on oranges cos itz same thickness as skin lol well close,soon as baby born it goez away n u can eat again lol yay! n ur hav a beautiful chubby baby xx
Hello there, I had gd with my previous 3 pregnancies, and I could control it by diet, however this pregnancy and I'm also over 39 I can't get a hold on it and started insulin 6 weeks ago. It's fine i'n monitoring sugars 7x a day and injection morning and tea time, the insulin started at 6 units once a day and now is up to 16 units 2x a day and I've been told it will get worse through the pregnancy, i'n only 17 weeks now! But, the insulin keeps my sugar levels relatively normal which means babys not working so hard and anything that helps baby is fine by me. After all anything for a healthy baby, the diabetes just makes me feel a bit tired sometimes, and I have to eat regulary as my levels drop rapidly and I get really grouchy and almost cry tired, but they're fine after I've eaten xxxx don't panic about the insulin just take it as it comes, it's not forever, good luck x
I am 9+3 weeks pregnant with my 3rd child and had gestational diabetes with my 2nd child after being tested because my 1st child birth weight was 9lb 10. Im worried whether I will have it again with this baby...
I am 14 weeks pregnant with my second child (last one was 20 years ago) so I am the wrong side of 40 and over weight and have been diagnosed with gestational diabetes. I have been monitoring for the last 4 days with high readings and I have until Monday when they say insulin will be the plan. Does anyone have any experience of insulin in pregnancy as I am so upset by this. I have cut out all sugar, I am eating the correct foods and doing exercise but to no avail!
i need this test as my last baby was over 11lb. but i dont think i have it as big babas run in my family. fingers crossed i dont! xxx
Hey tinkerbee, i had exact same problem you had with face ut i had the whole left side, arm legs couldnt move none of it went for mri and tests like you, and in the end took migraine tablets and they solved it the problem all along was migraines and i didnt realise i was having headaches hope this helps if you see this x
Hi all. I was told yesterday I have gestational diabetes. I am 26 weeks pregnant now with a baby boy. It has come as a big shock for me as I have 5 other children also and never had diabetes before. So far I only have to monitor my blood sugar levels and change my diet. Because I have a few problems with my pregnancy including dizzyness and faintness the midwife I saw yesterday advised me against the exercise. I also have had another worrying problem but noone knows what it is. In December 2010 I had a facial weakness affecting my speech and I couldn't move the left sidde of my face at all including blinking on the left side. It was ruled out about a stroke and Bell's Pausy and ct and Mri scans aswell as blood tests were all normal. After around 10 days I made a 95% recovery but then last week it happened again although not as severe. ENT said it's nothing to worry about but it is something that can keep reocurring. The midwife I saw wasn't happy bout the way I have been left to basically deal with this problem myself and has made me an appointment with a pregnancy consultant for Friday. I have been feeling really down during the pregnancy because of how ill I have been with other probs besides the ones mentioned and am considering counselling to help reduce the possibilty of post natal depression when baby has arrived.
I am quite surprised that I have developed this aswell, but also feel like I have let down my baby and myself. Work is very stressful, so hope that I can find some time for the exercise and being good...and it's xmas! Does anyone have any tips?
I have had gestational diabetes 3 times now. It is monitored so well now. My 2nd baby was induced at 37 weeks and was a massive 9lb 6. 12 years later my LO was induced at 38 weeks and was a tiny 6lb 7. I get tested annually. 2 years later Im still ok.