Diabetes in Pregnancy (Gestational Diabetes)
What is Gestational Diabetes?
During pregnancy a women's body undergoes many changes to provide the best possible environment for the developing baby. Most of these changes happen naturally and without problems. Sometimes, however, the body is unable to make all of the necessary changes and therefore requires a little help. One of the problems that can develop during pregnancy is a condition known as Gestational Diabetes. Gestational Diabetes means the body is unable to adapt to the changing amounts of pregnancy hormones as your baby and placenta grow.
When baby is born, in most women Gestational Diabetes disappears.
In Gestational Diabetes the blood glucose level of the woman is raised above normal ranges for pregnancy.
Why test for Gestational Diabetes?
This extra glucose in your (mum"s) blood has been shown to increase the risk of some health problems during pregnancy and following birth of your baby. The Australasian Diabetes in Pregnancy Society (ADIPS), as well as other world authorities on diabetes, recommend that each woman be tested during their pregnancy, for diabetes.
Will my baby be born with Diabetes?
No. There is no risk of your baby being born with diabetes as a result of having Gestational Diabetes.
Will the diabetes go away at the end of the pregnancy?
It is very likely that the diabetes is only associated with pregnancy, and in almost every case, will go away as soon as the baby (and placenta) are born. As you have been identified with the gene for diabetes you are at risk of developing diabetes some time in the future. ADIPS recommend that you be tested 6 - 12 weeks following birth of your baby, and again each 2-3 years.
What are the risks of Gestational Diabetes?
The immediate risk for baby if the blood glucose remains uncontrolled is for the baby to be overweight which makes birth difficult. Large infants can mean an episiotomy (cut in the perineum to allow baby to be born), a forceps delivery or caesarean section. Learning to control blood glucose levels within normal range can reduce these risks significantly. Babies born to mothers with undiagnosed Diabetes or who have been unsuccessful in controlling blood glucose levels are more likely to be overweight as children. This may increase the child’s risk of health problems (eg high blood pressure, heart disease and diabetes) in the future.
How common is Gestational Diabetes?
In Australia, about 5%, or one woman in every 20, are affected. Statistics are generous as not all women are screened for diabetes in pregnancy. The number of women developing GDM is increasing, and is more common in women of Aboriginal and Torres Strait Islander descent and other certain ethnic groups ie Asian, Indian, and Mediterranean, and also in women older than 30.
Is there an increased risk of birth deformities in infants of women who have diabetes?
This is true for women who have diabetes before they get pregnant (usually Type 1 Diabetes). It is not generally a problem associated with Gestational Diabetes.
Will my baby need to go to special care nursery?
One of the aims of management during pregnancy is to reduce the risk of separating mother and baby when born, ie taking baby to special care nursery.
Discuss the care and policy with your obstetrician or staff at your place of birth. Better understanding and knowledge of gestational diabetes has reduced the risk of baby needing to go to special care nursery for observation.
Will I be able to breastfeed my baby?
Yes. You have the right to choose how you feed your baby. The baby will not develop diabetes or gestational diabetes from breast milk. Your baby will be tested for low blood glucose levels (blood test from heel prick) on the first day and early breastfeeding (within half an hour of birth) will assist baby to maintain normal levels of blood glucose. Talk to your midwife about strategies to reduce separation time of you and your baby and steps to take for successful breastfeeding.
Why was I not tested until around 28 weeks? Could this have been diagnosed earlier?
It is possible in some women that gestational diabetes may be present and could have been diagnosed at an earlier stage of pregnancy. However, few women develop gestational diabetes earlier. Gestational diabetes is most commonly found during the last 12 weeks of pregnancy as the pregnancy hormone levels rise further. At 28 weeks, control of blood glucose levels can be effective in controlling the growth of the baby.
Why have I got gestational diabetes?
There was no problem in my last pregnancy / no one in my family has diabetes / my diet is healthy / I do lots of physical activity. There are certain risk factors associated with the development of gestational diabetes. Age, weight, family history of diabetes or previous complicated pregnancy are the main risk factors. Gestational diabetes may occur in women with no identifiable risk factors. This is why ADIPS recommend that every woman be screened at 24-28 weeks.
My result of glucose level is only a little above normal. Do I really have to bother?
The level of blood glucose is only a predictor of potential problems. Generally, the higher the level the higher the risk. Blood glucose levels rise as the pregnancy progress, you and your baby are still at risk if no education and management of blood glucose occurs.
Will I need insulin injections?
Between 10% - 25% of all women with gestational diabetes need to use insulin injections as part of their treatment. The best method of determining this need is by checking your blood glucose levels daily as recommended by your Doctor or Diabetes Educator.
No proof yet exists that tablets are a safe way of controlling blood glucose levels during pregnancy. Trials are in process and some women may continue to use their diabetes tablets under supervision during pregnancy.
What is the real risk to my baby and I?
No one can give you a full guarantee that problems will not occur during your pregnancy. Being aware of gestational diabetes is your opportunity to lower the chances of a problem occurring. In many cases of gestational diabetes, the health of mother and baby is better than in other pregnancies because of the extra information and care you take in maintaining a healthy lifestyle. The close supervision by your obstetrician/ doctor and other specialists work with you towards a healthy pregnancy, baby and child.
Information on this page comes from the website of the Australian Diabetes in Pregnancy Society,
ADIPS, c/o RACOG
8 La Trobe St
MELBOURNE, VIC 3000
Ph: (03) 9663 5606
Fax: (03) 96623908