What does it mean to have Gestational Diabetes?

One of the most commonly asked questions in pregnancy is “What does it mean to have Gestational Diabetes?”.

Most mums-to-be are aware of the condition, but are not too familiar with the causes, symptoms and effects of gestational diabetes, so we thought to coincide with National Diabetes Week we’d take a look at this in our blog.

Here are answers to some of the questions you may be asking around what it means to have gestational diabetes.

What is Gestational Diabetes?

Gestational diabetes affects 1.5 out of 10 pregnant women and is high blood sugar (glucose) that develops during pregnancy which usually disappears after giving birth. It happens when your body cannot produce enough insulin, a hormone that helps to control blood sugar levels, to meet your extra needs during pregnancy.

Whilst gestational diabetes is more common during the second and third trimester, it can occur at any stage of pregnancy.  If detected early and managed well the risks to you or your baby are low, however gestational diabetes can cause problems, so it’s best to understand if you are at risk and how to look out for those tell-tale signs that you may have the condition.

How do I know if I am at risk?

Gestational Diabetes can affect any pregnant woman; however some people are more at risk than others. Here’s what you should look out for:

• your body mass index (BMI) is above 30 – use the NHS healthy weight calculator to work out your BMI
• you’re over 25 years old
• you have high blood pressure
• your baby weighed 4.5kg (10lb) or more at birth in a previous pregnancy
• you had gestational diabetes in a previous pregnancy
• 1 of your parents or siblings has diabetes
• you are of south Asian, Black, African-Caribbean or Middle Eastern origin
• you gained a significant amount of weight in early adulthood and between pregnancies
• you’re pregnant with multiples, such as twins or triplets
• you have polycystic ovary syndrome (PCOS)
• you are taking glucocorticoids

If any of these apply to you, you should be offered screening for gestational diabetes early on in your pregnancy

What causes Gestational Diabetes?

I know this is hard to believe, but the exact cause of gestational diabetes is unknown. It’s generally believed to be occur when hormones, produced by your placenta to help your baby grow, stop insulin from doing its job. So, if your body isn’t sensitive to insulin, the sugar in your bloodstream isn’t moved out of your blood into your cells like it usually is. This causes insulin resistance, when your body isn’t able to convert sugar into energy in the cells, which makes your blood sugar levels increase.

What are the signs that I might have Gestational Diabetes?

Many women with gestational diabetes have no symptoms and if any do appear they are easily overlooked because they are very similar to typical pregnancy symptoms. However, it’s best to keep an eye out for the following signs:

• being more thirsty than usual
• needing to pee more frequently
• having a dry mouth
• suffering from tiredness
• snoring

If you find you are experiencing these symptoms more than usual, then it’s best to call your doctor or midwife.

Will I be screened for Gestational Diabetes?

If you are high risk or have any of the symptoms of gestational diabetes you will be tested early. However, routine screening, called an Oral Glucose Tolerance Test, is carried out between 24-28 weeks for all women in pregnancy.  This test measures your body’s response to glucose. You’ll be asked to fast overnight, although you are usually allowed water – check this with your hospital first, and then when you attend your appointment you will have a blood sample taken from your arm.  You will then be given a special glucose drink and your blood will be tested again after two hours. It usually takes a week for the results and if they are abnormal you’ll be given an appointment with a diabetic midwife.

You can find out more about an OGTT here.

How will gestational diabetes affect me in pregnancy?

Most women with gestational diabetes have otherwise normal pregnancies with healthy babies, so you shouldn’t worry too much.  However, it’s always good to be aware of problems that could arise, just so you’re prepared.

Here’s a list of some issues that gestational diabetes can cause:

• your baby growing larger than usual – this can lead to difficulties during labour and delivery, which increases your chances of having an induced delivery or caesarean
• polyhydramnios – this is a condition when you have too much amniotic fluid (the fluid that surrounds the baby) in the womb, which can cause premature labour or problems at delivery
• premature birth – giving birth before the 37th week of pregnancy
• pre-eclampsia –  this condition causes high blood pressure during pregnancy and can lead to pregnancy complications if not treated
• your baby developing low blood sugar or yellowing of the skin and eyes (jaundice) after he or she is born, which may require treatment in hospital
• the loss of your baby (stillbirth) – though this is rare

Will it affect my baby?

Gestational diabetes means you are giving the baby more blood glucose than they need.  This causes the baby's pancreas to make extra insulin to get rid of the excess blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

This can lead to your bay storing extra fat and if your gestational diabetes isn’t controlled this can create health problems such as damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk of having breathing problems. Some medical experts also think that babies born with excess insulin can become children who are at risk of obesity and adults who are at risk for type 2 diabetes.

What can I do to prevent gestational diabetes?

Of course, some risk factors can’t be controlled – a family history of diabetes, your age and PCOS_for example – however you’ll stand a better chance of not getting gestational diabetes if you eat a balanced diet and stay fit. Staying active will allow you to burn glucose even without the insulin your body should normally produce. Eat high-fibre, low-fat foods such as whole grains, low-fat diary, lean red meat, poultry, fish, legumes such as lentils, chickpeas, beans and soyabeans, plenty of veg - and watch your portion sizes.

How do I treat gestational diabetes?

If you find you have gestational diabetes you will need to keep your blood sugar levels under control so you can reduce the chances of having problems with your pregnancy. Your doctor or midwife will monitor your condition frequently. They’ll use sonograms to keep an eye on your baby’s growth and you will be given a blood sugar testing kit so you can monitor the effects of treatment at home.

You’ll be advised to reduce your blood sugar levels by changing your diet and exercising regularly (we have many exercises for all three trimesters on our Exercises Page and also post free virtual trimester specific workouts every week on our facebook page). Many women manage to control their gestational diabetes themselves, but if you can’t reduce your sugar levels you may need to take insulin (either in tablet form or by injection).

Be rest assured that you'll be more closely monitored during your pregnancy and birth to check for any potential problems. It’s best to give birth before 41 weeks if you have this condition so if your labour doesn’t start naturally by then you may be induced or be offered a caesarean.

Will I notice any long-term effects of Gestational Diabetes after birth?

Most women find that gestational diabetes goes away after birth. But it can mean you’ll get it again in future pregnancies. You have a higher chance of developing Type 2 diabetes later in life too, so it’s best to get yourself checked for diabetes between 6 to 13 weeks after giving birth and also once a year after that.

Keep an eye out for those tell-tale symptoms – increased thirst, urination, tiredness and a dry mouth. And make sure you do all you can to reduce your risk of getting Type 2 diabetes by eating a balanced diet, maintaining a healthy weight and exercising regularly.

How can I cope with the stress of Gestational Diabetes?

Many women take gestational diabetes in their stride, however you may find that receiving this diagnosis leaves you feeling emotionally drained.  You may feel anxious about your health and that of your baby, or worried that you won’t be able to follow your birth plan. Remember that many women with gestational diabetes go on to have perfectly normally deliveries and, through diet and exercise, manage their condition well throughout their pregnancy.

If, however, you’re feeling anxious why not try some self-help strategies, such as those in our earlier blog.  And it’s always best to talk to your doctor or midwife – this is a fairly common condition and they will have lots of sound advice and ideas for dealing with your worries.

Will Gestational Diabetes effect my chances of getting stretch marks?

You may well have an increased risk of stretch marks, as this condition usually means your baby will be bigger. Whilst you may not worry about this as much as the more serious potential issue of Type 2 diabetes in later life, you may want to work hard to prevent them.  Our 3-step stretch mark prevention system is your best insurance against these permanent scars – find out more here.

If you have any good tips about what it means to have gestational diabetes, or ways to cope with this condition, either physically or mentally, please feel free to share them here.