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Gestational diabetes (diabetes in pregnancy)

Key points

  • Gestational diabetes is a condition that can affect women during pregnancy.
  • If left untreated, high blood sugar levels can lead to problems for you and your baby.
  • Most women are able to control their diabetes successfully with diet and exercise changes.
     

FAQs

  • What is hypoglycaemia?
  • How will gestational diabetes affect the birth of my baby?
  • How long will it take for the gestational diabetes to go away once my baby is born?
     

Gestational diabetes is a type of diabetes that some women develop when they are pregnant. If you have gestational diabetes, your blood sugar (glucose) levels are higher than normal. It can lead to problems for you and your baby if the diabetes is uncontrolled. However, there are many treatment options that can help control the condition during your pregnancy and reduce the risks to you and your baby

About gestational diabetes

Gestational diabetes means you have a high blood sugar level that develops during pregnancy. The condition usually resolves after the birth of your baby. Around twenty two in 100 pregnancies are affected by gestational diabetes.

Normally, your body produces a hormone (a chemical messenger carried in your blood) called insulin to control the sugar level in your blood. Insulin causes the sugar in your blood to be taken up by your cells and stored to be later turned into energy.

During pregnancy, your hormones, such as oestrogen and progesterone, cause your cells to become less sensitive to insulin. This means your body needs to produce more insulin than normal to control your blood sugar. If you develop diabetes in pregnancy, it means that either your body isn’t releasing enough insulin, or your cells aren’t responding to it. The result is that your blood sugar level remains high. This can have a number of effects on you and your growing baby.

Gestational diabetes usually begins in the second trimester (after 13 weeks) of pregnancy. The condition often resolves after the birth of your baby. If you still have diabetes after your baby is born, it’s likely that you already had diabetes before you became pregnant. In this situation, you will need to have treatment for the condition.

Symptoms of gestational diabetes

Symptoms of gestational diabetes are uncommon. This is because the condition is usually diagnosed from screening tests before symptoms develop. However, if diabetes isn’t detected and or treated, you may develop symptoms such as:

  • feeling thirsty more often than usual
  • needing to urinate more often
  • having infections which affect your urinary tract

 These symptoms aren’t always caused by gestational diabetes. If you notice any of these symptoms, see your doctor.

Complications of gestational diabetes

Gestational diabetes can lead to a number of complications for you or your baby if it isn’t controlled. However, you can reduce your risk of many of these by carefully controlling your blood sugar level.

Complications affecting you

Complications that can affect you include the following.

  • Pre-eclampsia – You may develop dangerously high blood pressure during your pregnancy. Your doctor or midwife will measure your blood pressure to check for this. Severe headaches, swelling of the feet, ankles, face or hands, altered vision and abdominal (tummy) discomfort can all be symptoms of pre-eclampsia. If you have any of these symptoms, see your doctor or midwife immediately. If left untreated, you may develop a more serious condition called eclampsia. This can lead to serious complications and may even be fatal.
  • Too much amniotic fluid (the fluid around your baby in your womb). Having too much fluid around your baby can increase your risk of premature labour. This could also be a sign that your baby is in the wrong position for birth. If you have any discomfort in your abdomen, see your doctor or midwife for advice.
  • Premature labour – giving birth before 37 weeks of pregnancy.
  • Difficulties giving birth naturally. This is because your baby may grow larger than normal if you have diabetes during pregnancy. This means that you could need a caesarean.

You're also more likely to develop gestational diabetes in future pregnancies and have a higher risk of developing type 2 diabetes later in life. After you’ve had your baby, you should be checked for type 2 diabetes regularly so that treatment can be started if you need it.

Complications affecting your baby

Complications that may affect your baby include the following. Remember that your midwives and doctor will monitor you throughout your pregnancy and birth to reduce any risks to you and your baby.

  • Your baby can grow larger than normal. This can make labour and birth more difficult, and can increase the risk of shoulder dystocia (where your baby’s shoulders get stuck during birth). Your midwife or doctor will advise you on the best way for your baby to be born safely.
  • Your baby may have low blood sugar (hypoglycaemia) after birth. This will be monitored and only needs treating if your baby’s blood sugar drops below a certain level.
  • Your baby has a slightly higher risk of developing jaundice. This is a common condition in newborn babies that can cause your baby’s skin and eyes to have a yellow tinge. This will fade over a couple of weeks and doesn’t usually need treatment.
  • If born prematurely, there is a higher chance of your baby having respiratory distress syndrome. This is when your baby’s lungs haven’t fully developed at the time of birth. This can lead to serious complications for your baby, but he or she will be closely monitored to minimise their risk of these complications.
  • Your son or daughter will have a higher risk of being obese in later life.
  • Your child will also have a risk of developing type 2 diabetes when he or she is older.

Causes of gestational diabetes

There are a number of factors that can increase your risk of developing gestational diabetes. You’re more at risk if you:

  • are overweight or obese
  • have previously given birth to a large baby weighing 4.5kg or more
  • had gestational diabetes in a previous pregnancy
  • have a close relative with diabetes, such as a parent, brother or sister
  • have polycystic ovary syndrome

Your ethnic group may also increase your risk of getting gestational diabetes. The condition is more common in people with a South Asian (particularly India, Pakistan or Bangladesh), black Caribbean or Middle Eastern background.

Diagnosis of gestational diabetes

At your first antenatal appointment, your midwife will ask you a number of questions to assess your risk of gestational diabetes. Based on this, you may be offered a test later in your pregnancy to find out whether you have diabetes.

The test for gestational diabetes involves drinking a sugary drink and then having blood samples taken. This will measure how well your body processes sugar. You will usually be offered the test if you are thought to be at risk between 24 and 28 weeks of pregnancy. It may be offered to you earlier if you have previously had gestational diabetes.

Treatment of gestational diabetes

If you’re diagnosed with diabetes, you should be offered an appointment with a joint diabetes and antenatal clinic. The doctors and nurses here will be experienced in looking after pregnant women with diabetes. You will have more frequent antenatal appointments than women who don't have gestational diabetes.

Your treatment will be aimed at keeping your blood sugar lowered enough to help prevent complications. You will need to regularly test your blood sugar level. You will be given advice on how to test it, how often, and the level that you're aiming for.

Self-help

Your doctor or dietitian will advise you on ways to manage your gestational diabetes with diet and exercise changes. This may be all you need to do to keep your blood sugar level low enough to help prevent complications.

The following healthy eating ideas could help to keep your blood sugar level stable and within the ideal range.

  • Try to eat carbohydrates that release their energy slowly. Examples of these include cereals, wholemeal bread, pasta and potatoes.
  • Eat a variety of lean meat and fish.
  • Aim to eat up to (but not more than) two portions of oily fish each week, such as mackerel, sardines and salmon.
  • Try to eat at least five portions of fruit and vegetables every day.
  • Limit the amount of high sugar, salt and fatty food that you eat. An easy way to reduce the amount of sugar in your diet is to replace fizzy drinks and squashes with sugar-free versions. You could also try using herbs and spices to flavour your food, instead of using salt.
  • When cooking, aim to use unsaturated fats or oils such as olive oil and rapeseed oil instead of butter.

Keeping active during pregnancy can reduce your risk of developing gestational diabetes. Speak to your doctor or midwife if you have any concerns about exercising during pregnancy, or if you haven’t previously been doing any.

Medicines

Between one and two in 10 women won't be able to control their diabetes with lifestyle changes and will need medication. Your doctor will discuss different treatment options with you if you’re unable to control your diabetes after one to two weeks of diet and exercise changes.

You may be prescribed insulin, which you will need to take as an injection. You will be shown how to inject yourself and get advice on when to do this. Many tablet treatments for diabetes aren’t recommended during pregnancy. However, you may be prescribed metformin or glibenclamide which work in different ways to reduce the level of sugar in your blood.

After your baby is born

You and your baby will have your blood sugar levels tested shortly after delivery, to make sure these are back to normal.

Doctors recommend that it's best to breastfeed your baby soon after birth to keep your baby's blood sugar at a safe level.

You can usually stop taking medication for the condition immediately after birth. You will need to have a blood sugar test at your six-week check-up to ensure that your blood sugar has returned to the expected level. It’s important to keep your blood sugar level under control. Make sure that you make an appointment to get it checked once a year.

There is a chance that your blood sugar levels could remain high after the birth of your baby. This means that you could develop diabetes, even though you’re no longer pregnant. If you have high blood sugar after childbirth, your doctor will talk to you about some options to manage the condition.

 

Reviewed by Hemali Parekh, Bupa Health Information Team, December 2013.

 

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.

    Publication date: December 2011

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