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Gestational Diabetes  What is gestational diabetes? Gestational diabetes is a condition that sometimes develops during pregnancy. The mother has an abnormally large amount of sugar in her blood. It usually resolves itself after the baby is born - unlike other types of diabetes which are lifelong conditions.
Diabetes develops when the body can't produce enough insulin, a hormone made by the pancreas. Insulin regulates the amount of sugar available in the blood for energy, and enables any sugar that isn't immediately required to be stored.
Your body has to produce extra insulin to meet your baby's growing energy needs - especially from mid-pregnancy onwards. If your body can't manage this, you may develop gestational diabetes. Your blood sugar levels may also rise because the hormonal changes of pregnancy interfere with insulin function.
If you have sugar in your urine when you attend your antenatal clinic, your GP or midwife will probably suggest that you have what is called a random blood glucose test to get a more accurate estimate of the amount of sugar in your blood. If the result is high, you will be referred for a glucose tolerance test. You may be asked to attend a special diabetic clinic to have this test done.
How will having diabetes affect my pregnancy?
This really depends on how well you look after yourself. If you can control your diabetes carefully, you will be doing the best that you can for your baby.
The main problem with having too much sugar in your blood is that it crosses the placenta to your baby, which means that he can grow very large. A big baby may make labour and delivery more difficult and your chances of needing a caesarian section are increased. There is more likelihood of your baby being jaundiced or having breathing problems if he has to be born surgically.
Some researchers believe large babies are more prone to obesity later in life. As adults, they are also more likely to develop Type 2 diabetes (also known as non-insulin dependent diabetes or adult-onset diabetes).
Babies born to women who were diabetic before they became pregnant - especially women with poorly controlled diabetes - have a greater risk of health problems.
Who is at risk of developing gestational diabetes? Women who have had gestational diabetes in a previous pregnancy, or who have previously given birth to one or more large babies are at risk of gestational diabetes. Obese women are also at greater risk, and women who have had pregnancy-related problems, such as a miscarriage or pre eclampsia. Other women at risk include:
o Older mothers (everyone's tendency to develop diabetes increases with age)
o Women with hypertension (high blood pressure)
o Women who were large babies themselves (weighing more than nine pounds at birth)
o Women with a parent or sibling who is an insulin-dependent diabetic.
Will I know if I have gestational diabetes? You probably won't know until the problem is picked up at your antenatal clinic. A few women experience extreme thirst or abnormal fatigue which are signs of diabetes.
How is gestational diabetes treated? Your midwife or the specialist you see at the diabetic clinic will give you advice on how to control your blood sugar level by cutting down on sugary foods and drinks that contain caffeine such as coffee and cola. You will be helped to look at your eating pattern, and think about eating frequent small snacks rather than a few large meals which put a strain on your body.
A few women with very severe gestational diabetes that can't be controlled by diet and exercise may be prescribed insulin injections. You will be taught how to give these to yourself. Whether you need insulin injections or have a milder form of gestational diabetes, your baby will be monitored closely and you will probably be advised to have frequent ultrasound scans to check on how he is growing. Some experts feel that this kind of surveillance is unnecessary and there is no doubt that it tends to make some women feel anxious rather than reassured.
I've heard that exercise can help. Is that true?
Yes. Getting enough exercise is important, and your midwife will discuss with you how you can include exercise in your everyday life. Research shows that exercise helps keep blood sugar levels in check and other evidence suggests that exercising before you get pregnant helps prevent gestational diabetes.
What can I do if I am already diabetic?
If you have diabetes and are planning to become pregnant, try to make sure that your blood sugar levels are well under control before you conceive. High blood sugar in the first three months of pregnancy increases the risk of your baby not developing properly. Your pregnancy will probably be considered high-risk, but that doesn't necessarily mean that you will have problems, especially if you continue to keep your blood sugar levels as close to normal as possible.
Will I continue to have diabetes after my baby is born?
You will be offered a glucose tolerance test approximately three months after your baby is born and it is very probable that your blood sugar levels will have returned to normal. Nonetheless, if you have had gestational diabetes, it is more likely that you will develop diabetes later in life. Women who were obese before and during pregnancy often remain diabetic after pregnancy.
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