Gestational diabetes

Gestational Diabetes affects some mums-to-be but with the correct care from our incredible NHS, this can be treated to reduce the risks to both baby and you and usually disappears after baby is born. Diabetes mellitus (the technical name) is when your body doesn’t have enough insulin to cope with the amount of sugar in your blood. There are three types of diabetes which can affect you during pregnancy: Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes. If you have either Type 1 or Type 2 then you will already be speaking to your doctor or midwife about the implications, and so we will focus on the third type Gestational Diabetes here. Who is most at risk? During your first appointment (booking appointment) with your midwife (between weeks 8 to 12), you will have been asked a number of questions which will help determine if you are at risk of Gestational Diabetes. These will include: You’ve had Gestational Diabetes during a previous pregnancy. You’re BMI is above 30. Your ethnicity has a high prevalence of diabetes. You have a strong family history of diabetes. If you’ve had a previously large baby, over 9.9lbs. Gestational Diabetes affects 5% of pregnancies and it will also put you at a slightly higher risk (30%) of developing diabetes later in life. If your midwife feels you are at risk of having Gestational Diabetes, then you will be invited to have a screening between 24 – 28 weeks. This test is called an oral glucose tolerance test (ORTT) which takes about 2 hours and involves a blood test in the morning when you haven’t eaten or drunk anything for 8-10 hours. It is likely that you will be expected to wait at the hospital during this time and may not even be able to leave the waiting room, so take a good book or some work with you. If you do have Gestational Diabetes, then you will be more closely monitored during your pregnancy and labour as well as given plenty of help and advice to keep everything in check. It is also recommended that you give birth before 41 weeks and so your midwife or consultant may talk through these options with you if you do not go into labour naturally. Treatment Every mum is different and so is the treatment. For some it can be managed by diet alone. Your midwife or consultant will talk to you about the glycaemic index (GI), this shows you how quickly carbohydrate foods affect your glucose levels and which foods to avoid.

Switching high GI carbohydrate foods and drinks like white bread, white rice, confectionery and fruit juices for low to medium GI foods like wholegrains, pulses and some fruit and vegetables may be all that is needed to manage your levels. Others will need additional help including tablets or insulin and this will all be discussed with you at your appointment. The Risks Most of the risks connected to Gestational Diabetes are due to having high blood sugar levels and so it is important to manage these, through diet or medication, and attend all your antenatal appointments to ensure you are getting all the right information for you and your baby. Fetal abnormality – this tends to be linked to those mums with pre-existing diabetes and can put your baby at a higher risk if your diabetes wasn’t controlled well prior to getting pregnant. It can also increase your chances of having a miscarriage. Stillbirth – The risk is higher if you don’t control your sugar levels, it is important to monitor your baby’s movement and let your midwife or consultant know if you notice any changes or reduction in movement. Large Baby – High sugar levels in your blood can be passed to baby resulting in them having high insulin levels which makes them grow bigger, so management is key. High Blood Pressure – Pre-Eclampsia is more common in mums with diabetes, especially if you are overweight, have pre-existing high blood pressure or kidney problems. Labour problems – If you struggle to manage your diabetes during pregnancy then your baby is more likely to be large which can lead to complications and an increase chance of having an emergency c-section. The above information at first glance may seem a little scary, but we are very lucky to have our NHS & with the right care you can have a perfectly healthy pregnancy and baby. The best thing you can do for you and your baby is stay as healthy as possible and follow the advice available and if you have any questions or worries then ask. Once baby arrives you will then receive another blood test 6 to 13 weeks after birth to check your blood sugar levels and then every year after.