About gestational diabetes
What is gestational diabetes?
Gestational diabetes mellitus is a type of diabetes you can have when pregnant and usually goes away once the baby is born. It is often called GDM for short.
With gestational diabetes, women continue to produce insulin normally, but the hormones produced during pregnancy mean their bodies are temporarily less responsive to insulin. This means normal blood glucose levels cannot be maintained.
GDM will normally be diagnosed with a blood test and an oral glucose tolerance test (OGTT) when you are between 24 and 28 weeks pregnant. You will have a blood test before the glucose drink and then two more blood tests after the drink. Your doctor may get you to do this test earlier in your pregnancy if you have symptoms or risk factors for gestational diabetes.
If you’re diagnosed with GDM don’t panic. You haven’t done anything wrong and you are not alone.
About one in every seven Australian women have gestational diabetes during pregnancy.¹ It can generally be managed with diet and exercise, although some women may need to take tablets or insulin injections too.
Having gestational diabetes increases your risk of developing type 2 diabetes later in life.
Why does gestational diabetes happen?
When you are pregnant, the placenta produces special pregnancy hormones. These hormones can make the insulin in your body work less effectively than it normally does which causes high blood glucose levels. If you have a lot of glucose in your blood, it can pass through the placenta to your baby and make them grow too big. This is known as macrosomia.
As well as this, your body might not be able to make enough insulin to meet the extra amount that you need in pregnancy.
Find out more about the risk factors associated with gestational diabetes and prevention.
When will I be tested?
All women are tested for GDM in the 24th to 28th week of pregnancy. This is because symptoms are not obvious. If you are you are classed as being at higher risk you may have the test earlier.
How is it diagnosed?
Gestational diabetes is diagnosed with a blood test and an oral glucose tolerance test (OGTT). The test requires you to fast for 8-10 hours (generally overnight, missing breakfast). Once you arrive at the clinic you will be given a blood test, followed by a sweet drink containing glucose. An hour later your blood is tested again. You are not allowed to have anything to eat or drink, except water, during this time. A third and final blood test an hour after the second test. The test is looking to see how well your body has used glucose over that period of time.
Some clinics give you the results later that day, but others may take up to 48 hours.
How is gestational diabetes managed?
If you are diagnosed with GDM there are things you need to do to manage it. A healthy diet, regular exercise, checking your blood glucose levels and taking tablets or insulin all help to manage gestational diabetes by keeping your blood glucose levels in a healthy range. This will reduce the risks to you and the baby.
Your health care team can help you learn how to manage gestational diabetes.
Will gestational diabetes harm the baby?
Untreated gestational diabetes can cause problems for you and your baby. Women with gestational diabetes are more likely to have a caesarean section, pre-term labour and birth, and induced labour than women without gestational diabetes.
Treating gestational diabetes by keeping blood sugar levels as close to the targets recommended by your GP and healthcare team will reduce the risk of any complications. They will also keep a close eye on your baby and how it grows to prevent any complications from happening.
Don’t panic. Keep the risks in perspective.
While there are risks associated with gestational diabetes it is important to remember that every pregnancy has risks, regardless of whether the mother has gestational diabetes. Of course, you want a perfect pregnancy and it’s natural to be worried. Look at your diagnosis as the first step towards reducing any chances of complications. Your healthcare team will be able to guide and support you throughout the rest of your pregnancy to significantly lessen any risks. Read Crystal’s personal story and experience with gestational diabetes.
1. AIHW September 2019