×
A. Diabetes that develops during pregnancy is known as gestational diabetes. It occurs because your body cannot produce enough insulin (a hormone important in controlling blood glucose) to meet its extra needs in pregnancy. This results in high blood glucose levels.
Gestational diabetes usually starts in the middle or towards the end of pregnancy.
A. Gestational diabetes is very common.
It may affect up to 18 in 100 women during pregnancy.
You are more likely to develop gestational diabetes if you have any of the following risk factors:
A. If you have any of the above risk factors, you should be offered a glucose test during your pregnancy.
This may be a simple blood test in early pregnancy and/or a glucose tolerance test (GTT) when you are between 24 and 28 weeks pregnant.
A GTT involves fasting overnight (not eating or drinking anything apart from water):
If you have had gestational diabetes in a previous pregnancy, you may be offered a glucose test, or a kit to check your own blood glucose levels, early in pregnancy as well as a GTT at 24–28 weeks.
A. Most women who develop diabetes in pregnancy have healthy pregnancies and healthy babies but occasionally gestational diabetes can cause serious problems, especially if it goes unrecognised. Diagnosing and treating gestational diabetes reduces these risks.
It is important to control the level of glucose in your blood during pregnancy.
If your blood glucose is too high, your baby will produce more insulin, which can make your baby grow bigger and increases the likelihood of having your labour induced, caesarean section, serious birth problems and stillbirth.
These risks are higher if gestational diabetes is not detected and controlled.
A baby that is making extra insulin may have low blood glucose levels after birth and is more likely to need additional care in a neonatal unit.
Your baby may also be at greater risk of developing obesity and/or diabetes in later life.
Controlling your levels of blood glucose during pregnancy and labour reduces the risks of all these complications for you and your baby.
A. If you are diagnosed with gestational diabetes, you will be advised to have your baby in a unit that has a neonatal unit.
Your healthcare team will usually include an obstetrician, a doctor specialising in diabetes and a dietician. You should start receiving extra antenatal care as soon as your gestational diabetes is diagnosed. Having gestational diabetes will mean more clinic visits at the hospital.
Healthy eating and exercise:
The most important treatment for gestational diabetes is a healthy eating plan and exercise. Gestational diabetes usually improves with these changes although some women, despite their best efforts, need to take tablets and/or give themselves insulin injections. You should have an opportunity to talk to a dietician about choosing foods that will help to keep your blood glucose at a healthy and stable level.
Monitoring your blood glucose:
After you have been diagnosed with gestational diabetes, you will be shown how to check your blood glucose levels and told what your ideal level should be.
If it does not reach a satisfactory level after 1–2 weeks, or if an ultrasound scan shows that your baby is larger than expected, you may need to take tablets or give yourself insulin injections.
Monitoring your baby:
You would be offered extra ultrasound scans to monitor your baby’s growth more closely.
Advice and information:
During your pregnancy, your doctors and midwives will give you information and advice about:
A. Up to one in five women with gestational diabetes will need to take tablets and/or have insulin injections to control their blood glucose during pregnancy. Your healthcare team will advise you what treatment is best for you.
If you do need insulin, your physician will explain exactly what you need to do. This will include showing you how to inject yourself with insulin, how often to do it and when you should check your blood glucose levels.
A. Ideally you should have your baby between at 38 and 40 weeks of pregnancy, depending on your individual circumstances.
A. If your ultrasound scans have shown that your baby is large, your obstetrician will discuss the risks and benefits of vaginal birth, induced labour and caesarean section with you.
A. It is important that your blood glucose level is controlled during labour and birth and it should be monitored during labour to ensure it stays at a satisfactory level.
You may be advised to have an insulin drip to help control your blood glucose level.
During labour, your baby’s heart rate should be continuously monitored.
A. Your baby will stay with you unless he or she needs extra care.
A. You should be offered a postnatal appointment during which the result of your blood glucose test or GTT will be discussed with you. If your blood glucose levels are still high, you will be referred to a doctor specialising in diabetes.
You should be given information about your lifestyle, including diet, exercise and watching your weight, to reduce your chance of diabetes in the future.
Women who have had gestational diabetes have a one in three chance of developing type 2 diabetes within the following 5 years. You will be advised to have a fasting blood glucose test once a year.
A. Being the right weight for your height (having a normal BMI), eating a healthy diet and taking regular physical exercise before you become pregnant reduces your risk of developing gestational diabetes again.
If you are planning to become pregnant, you should start taking a high dose (5 mg) of folic acid daily before you stop contraception.
As soon as you find out you’re pregnant, contact your obstetrician for advice about your antenatal care.