What is Gestational Diabetes?
If you have recently been diagnosed with Gestational Diabetes, you may have lots of questions. This blog is the first in a series on Gestational Diabetes. It was written with the help of obstetrician Victoria Medland, to help answer any queries you may have.
What is Gestational Diabetes?
Gestational diabetes, or GDM, is diabetes that occurs as a result of pregnancy, due to hormones produced by the placenta. It affects about 1 in 20 women, so it’s pretty common. The majority of women who have gestational diabetes have healthy pregnancies and healthy babies. GDM is a pregnancy condition where the body isn’t able to make enough insulin to make sugar (glucose) go out of the blood stream and into the body’s cells. This means that there is excess sugar in your blood, which travels through the placenta to baby. Gestational Diabetes can develop at any point during pregnancy. However, it is more common in the second or third trimester.
What are the risks factors for developing GDM?
There are some factors that increase your likelihood of having gestational diabetes. These are:
- If you have had GDM before
- If you have a strong family history of type 2 diabetes
- Anyone who is of South Asian, Chinese, African-Caribbean or Middle Eastern ancestry
- If you have had a baby weighing over 4.5kgs
- Anyone with a BMI over 30.
Despite this, we also see gestational diabetes in women without any risk factors. During your routine urine samples glucose is tested for. If glucose is repeatedly detected then the pregnant individual is offered screening for diabetes. Similarly, if a scan picks up a large amount of fluid around baby or baby seems unexpectedly large, this would also prompt GDM screening.
Why is it important to find out if I have Gestational Diabetes?
When a pregnant individual has gestational diabetes glucose crosses the placenta, but the insulin does not. This means that if blood sugar levels remain high in pregnancy because GDM is uncontrolled, it can cause the baby to grow too large. This is called macrosomia. On top of this, the baby’s shoulders and tummy can be disproportionately large. This increases the chances of having a complication called shoulder dystocia at birth. This is where the baby’s head is born, but the shoulders become stuck.
If you find out that you have GDM then it’s recommended to have additional monitoring in pregnancy because, sadly there is an increased risk of stillbirth in pregnancies affected by diabetes. That risk is increased if diabetes is not diagnosed or is poorly controlled.
For all the reasons above, women who have gestational diabetes have an increased chance of being offered an induction of labour or a cesarean birth. This is more likely to be advised if your blood sugars have been challenging to control or if your baby is looking on the larger side.
The good news is that controlling your blood sugar levels during pregnancy reduces the chances of all complications for you and your baby.
What to expect after birth for baby?
After birth, babies should be offered blood sugar monitoring. There is a possibility that they have been producing insulin at a higher rate as they have had a higher blood sugar level whilst in your womb. When they are born some baby’s can continue to produce this same amount of insulin, but without the higher amounts of sugar coming from your blood stream. This can cause their blood sugar levels to be lower than normal. Because of this, baby’s born to mothers who have GDM or pre existing diabetes should be fed early and frequently.
With this in mind, you should have access to information about antenatal expression of colostrum. Then you can have some ready to feed your baby, should you wish to breastfeed. It’s also a good idea to keep your newborn baby warm, skin to skin immediately after birth (or as soon as possible) will help keep your baby warm. Bring also hats and cardigans in your hospital bag too just incase your baby’s temperature on the cooler side at birth.
If you have any concerns that you may have GDM, consult your midwife. You may be wondering about the screening process for GDM. Head here to read about how GDM is tested for.
