Gestational diabetes mellitus (often referred to as GDM or just gestational diabetes) is a type of diabetes that occurs during pregnancy and usually goes away after childbirth.
Here’s a look at gestational diabetes mellitus (gestational diabetes) – the risks involved, symptoms, and how it can affect your baby.
When you have diabetes, the process of the hormone insulin moving glucose or sugar from your blood and into your body’s cells is blocked, making your cells ‘insulin resistant’ and causing too much insulin to be present in your blood.
When you are pregnant, your body produces extra insulin to meet your baby’s needs, causing your cells to become naturally insulin resistant. For most women this is compensated by increased insulin production, however, this doesn’t happen for some, resulting in gestational diabetes.
This usually occurs between 24th to 28th week of pregnancy and is quite common, affecting thousands of women in Australia every year. Thus all women are routinely tested for gestational diabetes around this time of their pregnancy term by their obstetrician or doctor.
Risks of Developing Gestational Diabetes
Gestational diabetes usually goes away once the baby is born. However, during pregnancy, it can lead to a number of complications.
Increased blood sugar can have an effect on a baby’s growth, usually making them bigger. This can lead to complications during birth, and may require induced labour or a caesarean section.
Gestational diabetes can also lead to health problems after the birth such as low blood sugar (hypoglycaemia) and jaundice for the baby, as well as increased increased risk of type 2 diabetes and obesity in later life for both the mother and baby.
Symptoms of Gestational Diabetes
Gestational diabetes usually presents no obvious symptoms, but if they do occur they can include:
• Excessive thirst
• Excessive urination
• Yeast infections
It should be emphasised however, that the overwhelming majority of women presenting with these symptoms do not have gestational diabetes.
Risk Factors For Developing Gestational Diabetes
Women are thought to be at higher risk of developing gestational diabetes if they:
• Have a family history of type 2 diabetes or gestational diabetes
• Are overweight
• Are over 25
• Are from an Indigenous Australian or Torres Strait Islander, Vietnamese, Chinese, Middle Eastern, Polynesian or Melanesian background
• Have had gestational diabetes during previous pregnancies
• Have previously had polycystic ovary syndrome
Treating and Managing Gestational Diabetes
Your obstetrician will advise you on how to manage your blood sugar levels, usually by tailoring a plan for healthy eating and regular physical activity. For some women, this will not be effective in controlling blood sugar levels, so insulin injections are necessary for the rest of the pregnancy.
Cutting down on foods and drinks that are high in sugar, saturated fat and simple carbohydrates, and ensuring a healthy and balanced diet is kept is very important for controlling blood sugar levels. Plenty of light to moderate exercise is also important, especially for overweight women.
If you have gestational diabetes, your doctor will show you how to monitor your blood sugar levels. This is very important for discerning whether the lifestyle changes above are effective or whether further treatment is necessary. Insulin injections may be required if diet and exercise is ineffective in keeping blood sugar levels under control.
Gestational Diabetes and Your Baby
Babies of mothers with uncontrolled gestational diabetes are at risk of several problems.
Firstly, they may grow much larger than babies of mothers without GDM. This can create difficulties at the time of delivery.
Secondly, after delivery they may have trouble maintaining their blood sugar levels. This may lead to them needing to be admitted to a special care nursery for feeding to bring their sugar safely up.
Thirdly, babies of mums with GDM may have lungs which mature more slowly than other babies of a similar gestational age. If they are born too early, they may require admission to a special care nursery for a short stay to help maintain their oxygen levels.
Fourthly, the placenta in pregnancies where mothers are affected by GDM can age more rapidly than in other pregnancies. This is even more likely if insulin is required to bring a mother’s blood sugar under control. This means that these babies will need to be born earlier than babies of unaffected mothers.
Testing for Gestational Diabetes
Most women are diagnosed for gestational diabetes between the 24th and 28th week of pregnancy through a blood test to measure glucose levels. These tests may be performed earlier for high risk women.
We understand that no two pregnancies are the same, so we’re there for you every step of the way, before, during and after. Personalised care and strong relationships with our patients is of utmost importance to us!