Gestational diabetes

Gestational diabetes is a type of diabetes that only happens during pregnancy. The hormones you produce during this time can make insulin less effective. This can lead to poorer control of your blood sugar levels. ^{1, 2}

It affects approximately 1 in 20 pregnancies. ^{1, 2}

Gestational diabetes can happen to anyone who is pregnant, but you are at greater risk if you:

• Are over 40 years old
• Are overweight
• Have had gestational diabetes before or had a baby weighing over 10 lbs or 4.5 kg at birth
• Have PCOS
• Have a family history of diabetes or are from Black Caribbean, Black African, South Asian, Middle Eastern descent or are of mixed ethnicity
• You have had a gastric bypass or other weight loss surgeries.^{2, 3}

It is difficult to spot gestational diabetes yourself as you may not always have symptoms. If you do develop symptoms, you may:

• Get extreme thirst and a dry mouth
• Need to pee more than normal
• Have extreme fatigue
• Get blurred vision
• Experience genital itching or thrush.³

Some of the symptoms of gestational diabetes are the same as common pregnancy symptoms. If you are worried about your symptoms, it is important to speak to your midwife or GP so they can properly check what the problem may be.³

You will be asked a few questions at your first appointment about your health and family history to determine whether you have an increased risk of gestational diabetes. If your healthcare team think you are at an increased risk, you may be tested early in your pregnancy. Some healthcare teams may test for gestational diabetes between 24 and 28 weeks if you are not at an increased risk.^{1, 2}

If your GP thinks you may be at risk of gestational diabetes, you will be invited for a glucose tolerance test which is a set of two blood tests. It is used to check how well your body processes sugar.⁴

During your appointment a nurse, or other health professional, will check your fasting glucose level. This is your blood sugar level before eating.

You will have to fast (not eat) from midnight before your appointment.

You will then have a sugary drink. You will have a second blood test 2 hours later to check how your body has reacted to the increased sugar.⁴

You will be diagnosed with gestational diabetes if your blood sugar levels are too high (over 7 mmol/l) 2 hours after having the drink.⁵

After your diagnosis, you will be referred to a joint diabetes and antenatal team. This team specialises in gestational diabetes care and they will be responsible for monitoring you throughout your pregnancy.⁵

They will help you find a treatment that is suitable for your needs. They will explain how you can test your blood sugar at home. They will also make sure you are comfortable managing your condition.⁵

You may be able to control your diabetes with lifestyle changes, such as eating a healthier diet or exercising more. If lifestyle changes aren’t enough to control your blood sugar, your healthcare team may prescribe insulin. Insulin can be administered in a variety of ways. You may be offered an insulin pump, or injections to help control your blood sugar.³

It is unlikely your baby’s long-term health will be affected if you have gestational diabetes.⁶ However, your baby may have a high birth weight or jaundice when they’re born.

Jaundice happens when there is too much bilirubin (a substance produced during the break down of red blood cells) in the blood. It can cause yellowing of the skin or eyes. Jaundice can go away on its own in newborns they will be assessed to see if they need treatment.⁶

Gestational diabetes may make you go into labour before your 37^th week. It may also cause a build-up of amniotic fluid (the fluid inside the womb during pregnancy).This can cause complications during birth but will be treated as soon as possible if it happens.

You may also experience pre-eclampsia, if your blood sugar is too high. If this happens you will receive immediate treatment.³

Preeclampsia can be serious. It is a condition that causes high blood pressure and protein in your urine. These changes to your body can result in facial swelling, vomiting and blurred vision. If preeclampsia isn’t treated promptly, it can cause complications for you and baby.

If you have preeclampsia, it is better for you and your baby if you give birth before 41 weeks, so you may be induced at 37 to 38 weeks if labour doesn’t naturally occur before this time. You may also have to have a caesarean section, but your healthcare team will prepare you for this outcome if it is necessary.³

Gestational diabetes usually goes away after you have given birth, but it may come back if you get pregnant again and it can increase your chances of getting type 2 diabetes in the future. ³

If you have gestational diabetes, you will be offered a blood test to monitor your blood sugar levels. This typically happens 6 to 13 weeks after giving birth. If results are normal, you will then have annual blood tests to monitor your condition.

To avoid developing diabetes after your pregnancy, you should try to maintain a healthy lifestyle. Eating a balanced diet and doing regular exercise may help.³

If you are concerned about your gestational diabetes and you are worried about your mental wellbeing, there is lots of help you can access online and in person. Talk to your diabetes and antenatal team. They will be able to point you in the direction of local groups that may be able to help.

There are organisations that have lots of information about gestational diabetes, as well as helplines you can use to speak to someone directly. These organisations include Tommy's and Diabetes UK.

It is important to remember that gestational diabetes is not your fault. It can happen to anyone, and you should not feel guilty or responsible for it happening.