What is gestational diabetes?
Gestational diabetes mellitus (GDM) is a type of diabetes that arises during pregnancy (usually during the second or third trimester).
In some women, GDM occurs because the body cannot produce enough insulin to meet the extra needs of pregnancy. In other women, GDM may be found during the first trimester of pregnancy. In these women, the condition most likely existed before the pregnancy.
Because pregnancy affects blood glucose levels in all women (even those without diabetes), doctors currently are debating how high blood glucose has to be before making a diagnosis of GDM.
How will I know if I have it?
All pregnant women are given urine and blood tests to check for the presence of glucose.
If glucose is found in your urine, you will be given a blood test to determine whether or not you have blood glucose problems.
There also are certain risk factors that can make you more likely to have gestational diabetes. These include:
• obesity
• a family history of Type 2 diabetes
• an unexplained stillbirth or neonatal death in a previous pregnancy, and/or
• a very large infant in a previous pregnancy
How will it affect my baby?
In most cases, Gestational diabetes comes to light during the second trimester of pregnancy. Since the baby’s major organs are fairly well developed at this stage, the risk to the baby is lower than for women with Type 1 or Type 2 diabetes.
However, babies of women who had blood glucose problems that were undiagnosed before pregnancy, have a higher risk of malformations. The degree of risk depends on how long blood glucose levels have been high and on how high the levels have been.
What is the treatment?
Often, blood glucose levels can be controlled by diet. You will be given a diet to follow that is low in simple carbohydrates. If your blood glucose cannot be controlled by diet, you will have to take insulin injections. Between ten and 30 per cent of women with GDM take insulin.
There is much debate among doctors about how specialised treatment should be for women with GDM, which is diagnosed during the second or third trimester. Blood glucose target levels are the same as for women with Type 1 or Type 2 diabetes.
However, if your blood glucose remains in good control by watching your diet, then you probably will receive the same care during labour and delivery as any woman without diabetes.
Will it go away after my baby is born?
Usually it does. To make sure your blood glucose levels have returned to normal, you should have a glucose tolerance test six weeks after your baby is born. If you took insulin injections during your pregnancy, you may be able to stop them after your baby is born.
Women with GDM have a 30 per cent risk of developing Type 2 diabetes during their lifetime (compared to a ten per cent risk in the general population). Women from ethnic groups that have a high rate of Type 2 diabetes (African, African-Caribbean and Asian) are more likely to develop Type 2 diabetes if they have had GDM.
About five to ten per cent of women with GDM develop Type 1 diabetes sometime in their life. These women have a slowly developing form of Type 1 that is ‘unmasked’ during pregnancy.
Will I get gestational diabetes with other pregnancies?
Possibly. You are more likely to have GDM again if you’ve had it in previous pregnancies; but, if you are overweight and lose weight, you may cut your risk of having GDM again.
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