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:
- Anyone in your family has diabetes or has had gestational diabetes.
- You’ve already had a large baby, weighing over 4.5kg (9lb).
- You’re obese or overweight.
- 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