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Gestational diabetes: the risks, symptoms and treatment

20.03.2020

Gestational diabetes occurs during pregnancy, however, in many cases, once the baby is born, the diabetes usually disappears.

Whether you’ve recently been diagnosed, or you’re concerned that you may be at risk of a diagnosis – you’re not alone. In 2019, 41,000 women were diagnosed with this chronic condition making it the fastest growing type of diabetes. In fact, according to the Australian Institute of Health and Welfare gestational diabetes affected 15% of all women who gave birth in hospital in 2016-2017.

Women who have gestational diabetes are also at higher risk of developing type 2 diabetes in the future. What’s more, if gestational diabetes is not well managed, it can result in serious complications such as premature birth, miscarriage and stillbirth.

However, the good news is that when gestational diabetes is found early, and it’s well controlled, you can lower the health risks for yourself and your baby.

What causes gestational diabetes?

Diabetes occurs when your blood sugar (glucose) levels are too high. Insulin is the hormone responsible for controlling the amount of sugar in your blood so if your body isn’t making enough insulin, or it’s not working efficiently, your blood sugar levels can become too high.

When a woman is pregnant, the placenta produces hormones that block the action of insulin in the body, resulting in insulin resistance. If you already had some level of insulin resistance before you were pregnant, then your body might not be able to cope with an increased demand for insulin production. This means that your blood glucose levels will be higher and may result in gestational diabetes.

In untreated gestational diabetes, the baby receives excess glucose through the placenta, and produces more insulin in response. This can cause the baby to grow too large, which may cause birth complications or premature labour.

“Did you know 41,000 Australian women were diagnosed with gestational diabetes in 2019?”

Who is most at risk?

There are a variety of factors that can place you at a higher risk of gestational diabetes. These include the following:

You’re aged 40 and over
You have a family history of type 2 diabetes
You are overweight or obese
Your background is Aboriginal or Torres Strait Islander
You belong to a cultural group such as Indian, Vietnamese, Chinese or Middle Eastern
You’re taking an antipsychotic or steroid medication
You were diagnosed with gestational diabetes in a previous pregnancy
You’ve had a baby weighing more than 4.5kg
You have polycystic ovarian syndrome.

What are the symptoms of gestational diabetes?

Gestational diabetes often doesn’t have any symptoms, but you may experience:

Increased thirst
Excessive urination
Thrush (yeast infections)
Fatigue.

How is gestational diabetes diagnosed?

A pregnancy oral glucose tolerance test (OGTT) is used to diagnose gestational diabetes. Your health professional will take a blood sample before and after a glucose drink. This test usually happens between weeks 24 and 28 of your pregnancy. If you've had gestational diabetes before, or you have risk factors, your doctor may also ask you to take an earlier test.

Gestational Blog managing gestational diabetes

Four ways to manage gestational diabetes for your health – and your baby’s

With the right medical attention, diet and lifestyle choices, you can still enjoy a healthy pregnancy with gestational diabetes.

Setting up regular appointments with your doctor, dietitian or diabetes specialist is your first priority, followed by:

1. A healthy, nourishing diet

A varied and nutritious diet with the right balance of carbohydrates, protein, healthy fats and plenty of vegetables can help you manage your blood glucose levels. In fact, eating regular meals in small amounts throughout your day is highly recommended. It’s also a good idea to spread complex carbohydrates such as wholemeal bread, brown rice and rolled oats evenly across your meals and snacks. Try to avoid carbs that don’t have a high nutritional content, like cakes and soft drinks. It’s particularly important to choose foods that are low in saturated fats and high in fibre.

If you’re not sure about the kind of diet you should be following, speak with a dietitian or your pregnancy healthcare team, who can advise you on the right nutrients for you and your growing baby.

2. Regular, gentle exercise

If it’s safe for you to do so, consistent but moderate physical activity is especially important when it comes to managing gestational diabetes. Regular, gentle exercise can help reduce insulin resistance and manage your blood glucose levels.

Moderate, safe exercise during pregnancy means you will notice a slight but noticeable increase in your breathing and heart rate. So, remember to take it easy and be kind on yourself. If in doubt, make some time to speak with your obstetrician or midwife before you begin an exercise program.

Incidental movement in your day including playing with the kids, doing household chores or taking the stairs is also great for helping to manage blood glucose levels.

3. Monitor your blood glucose levels

When you monitor your blood glucose levels, you’ll be able to see whether your diet and lifestyle changes are having an impact on your gestational diabetes. Your doctor or diabetes educator will teach you how to monitor your blood glucose levels and advise you on the target range for a healthy mum and baby. Usually, your healthcare team will expect you to check (and record) your blood glucose levels at set times throughout the day using a blood glucose monitor, which tests a tiny drop of blood. You’ll use a lancet, which looks a bit like a pen, to prick your finger to get the blood each time.

Top tip: You can claim on blood glucose accessories through your CBHS Extras cover. However some items you might need are free or heavily subsidised when you register with the National Diabetes Services Scheme (NDSS).

Gestational Blog monitoring blood glucose

If healthy eating and physical activity alone aren’t sufficiently controlling your glucose levels, your doctor may suggest medication. These medications may include insulin injections or metformin.

Insulin injections

Not every pregnant woman with diabetes will need insulin injections. However, if this is what’s needed to keep your blood sugar level within the target range, your GP or diabetes educator will guide you on how to safely inject insulin. They can also help you understand exactly how the insulin will work in your body. You can read more about insulin treatment here.

“If you’ve been diagnosed with gestational diabetes it doesn’t mean your baby will also have this chronic condition.”

What happens after your baby is born?

Your insulin injections will most likely stop when your baby is born. This is because for many women, their blood glucose levels will return to optimal levels after the baby’s birth. To make sure the diabetes has gone away, you will most likely have an oral glucose tolerance test (OGTT) six to 12 weeks after you have your baby. Their blood glucose level will also be measured (with heel pricks) for around 24-48 hours in hospital after the birth as a precaution. This is because the baby’s body has been used to producing higher levels of insulin in utero. If he or she continues to produce higher levels of insulin after birth as the body adjusts, this can cause low blood glucose levels. This is generally easily treated with extra feeds or glucose.

It’s important to remember that even if you were diagnosed with gestational diabetes, this doesn’t mean your baby will have diabetes too. However, they may have a higher risk of developing type 2 diabetes later in life. And you also have a higher chance of developing type 2 diabetes in the future. Around half of all women who have had gestational diabetes will develop type 2 diabetes or prediabetes within 10–20 years.

The good news is that it’s possible to help prevent type 2 diabetes. To find out more visit, healthdirect Australia.

Enjoying a healthy pregnancy with gestational diabetes

Pregnancy can be a complex, challenging time in a woman’s life. However, even with a gestational diabetes diagnosis, you can still have a healthy experience. The first – and possibly most important – step is to set up regular appointments with a team of healthcare professionals including your GP, obstetrician and diabetes educator. Working as a team during your pregnancy can help you manage your diabetes in a healthy, safe way.

Making the necessary dietary and lifestyle changes are also vital, such as choosing a quality diet of vegetables, healthy fats, proteins and unprocessed carbohydrates. Adding appropriate daily exercise and movement is especially important to manage and maintain healthy blood glucose levels.

You can find out more about managing gestational diabetes by visiting the Diabetes Australia website. For more helpful articles on healthy living during and beyond pregnancy, be sure to check out our Pregnancy section.

All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.