What is gestational diabetes?When you're not pregnant, a hormone called insulin breaks down the sugar in your blood so your body can use it as energy or store it. When you're pregnant your body has to produce extra insulin so your baby gets enough sugar (glucose). Gestational diabetes occurs when your body can't make enough insulin to deal with the sugar, so you have too much sugar in your blood.
What are the signs of gestational diabetes?
But just because you have these signs, it doesn't automatically mean you have gestational diabetes as all these are also common pregnancy symptoms.
Can I be tested for gestational diabetes?
Some women are tested for gestational diabetes as part of their antenatal tests, but in some areas of the country you'll be only tested if you're showing symptoms or if you're considered to be higher risk. Those people include those who:
The most basic test is a dipstick test which shows up sugar in your urine, but it's not thought to be very reliable.
There is also the oral glucose tolerance test (OGTT) which you have between 24 and 28 weeks. The test involves fasting for a period of time, drinking a glucose solution such as Lucozade, then having a blood and urine test after a certain amount of time to see how your body has dealt with the excess sugar.
What if I have gestational diabetes?
If you've been diagnosed with gestational diabetes, don't panic. You'll be referred to a specialist and you'll have more appointments at the hospital or with your GP so they can keep an eye on you.
Diet is especially important in controlling diabetes, so you'll be given advice on what to eat.
Exercise is also important - aim for half-an-hour a day.
You may also have to monitor your blood sugar levels yourself and you'll be told what you should be aiming for. In some cases you might have to take medication to control your blood sugar levels or inject insulin.
Is gestational diabetes dangerous for me?Gestational diabetes can increase your risk of other pregnancy conditions such as:
Is gestational diabetes dangerous for the baby?If you have too much sugar in your blood, your baby may be getting too much sugar too, so it could grow very big. This could cause complications at birth and may increase the likelihood of a Caesarean section.
Can gestational diabetes be prevented?You can reduce the risk of getting gestational diabetes just by eating a balanced, healthy diet and doing regular exercise. Try not to have too many sugary drinks or snacks, even if you're craving them.
Does gestational diabetes last forever?Most women find that when they've given birth their blood sugar goes back to normal, but you'll be checked before you leave the hospital and offered subsequent check-ups until your GP's happy that you're not diabetic any more.
If I've had gestational diabetes once, will I get it again?There's no guarantee that you'll get it again if you've already had it,
although some women do get it more than once. It's best to keep a close
eye on your blood sugar levels through subsequent pregnancies and you
may be asked to do the OGTT test at 16 to 18 weeks.
One mother's experience of gestational diabetes
Jayne Crammond was diagnosed with gestational diabetes during her first pregnancy, then developed Type II after birth. Here's her story...
Pregnancy is a happy time for most couples, but there's always a chance of complications along the way, which can make pregnancy seem like the longest nine months of your life.
There are several ways diabetes can affect pregnancy, all of which can be maintained with the right combination of diet and medication, but it can still feel like the sheen has been taken off of what is supposed to be an exciting, life-affirming experience.
I was diagnosed with gestational diabetes during my first pregnancy, six years ago, and after giving birth I developed Type II diabetes. I'm currently expecting my second child and going into a pregnancy with an existing diabetes diagnosis provides a whole new set of issues to contend with.
Gestational diabetesGestational diabetes is usually diagnosed at around 24 weeks when you'll be invited for a glucose tolerance test.
Women who are overweight or have a family history (amongst other factors) have a higher risk of gestational diabetes and will need to control their blood sugars with diet or medication, depending on the severity of their resistance to insulin.
Untreated, gestational diabetes can lead to growth abnormalities in your unborn child and hyperhidrosis (excess fluid around the baby), although birth defects are not usually caused by GD as it usually develops later in pregnancy.
Pre-gestational diabetesWomen who are diagnosed with diabetes before they become pregnant will be managed in a slightly different way to straightforward GD patients.
Blood sugar levels will need to be monitored closely and medications adjusted accordingly - patients previously able to control their sugars with tablets, such as Metformin, may need to switch to injecting insulin to keep their blood sugars down, especially towards the end of the second trimester, when insulin resistance can increase.
Insulin-dependent patients may also need to increase their dose to accommodate the body's increased requirements.
Complications with pre-gestational diabetes are greater, with the development of the foetus's heart being of particular concern.
What to expectYou'll probably be asked to attend additional scans throughout your pregnancy, as well as an in-depth foetal cardiology scan which will be performed by a foetal cardiologist who will look in-depth at the ventricles of the baby's heart to make sure they're forming properly.
Although this may seem daunting, and it can be difficult at times, there are lots of minor changes which you can make to improve your blood sugar control.
It's likely that you'll be assigned a diabetic midwife and a consultant to monitor you, which usually means fortnightly appointments at your hospital or women's clinic. You may also see a dietician once or twice throughout the pregnancy who can give you useful tips about what you should be eating and when.
Following a low G.I. diet is the first step that you need to take. All food is given a number between one and 100 to indicate how quickly the body processes the sugars it contains.
High G.I. food, such as sweets, white bread, starchy food and sugary drinks, cause spikes in blood sugar and should be avoided. Low G.I. foods are broken down by the body over a longer period of time and release their sugars much more slowly, making them more suitable for a diabetic.
It's well worth investing in a pocket-sized book (they're easy to find online) with lists of Glycaemic Indexes in them, and you'll need to be aware that some foods may be surprisingly high on the G.I. - parsnips, for instance, score 97 out of 100!
In time, you'll come to know which foods affect your blood sugars more than others, and also what alternatives there are out there.
Another thing to consider is that 'No Added Sugar' does not always mean no sugar at all and I've been caught out many times by that neat little marketing gem.
Above all, try not to worry. As long as you listen to the advice of your healthcare professionals, eat sensibly and try to increase your exercise, diabetes during pregnancy can be well managed and does not mean complete avoidance of all the things that you like.
Guest post by Jayne Crammond of Mum's the Word.