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Managing Gestational Diabetes
From 3 to 8 % of all pregnant women will develop gestational diabetes usually around the 24th to 28th week of pregnancy however, women who are pregnant with more than one baby may develop GDM earlier in the pregnancy.
As the pregnancy progresses, the mother's energy needs increase. Coupled with this, the placenta produces hormones that help the baby grow and develop, but these hormones also block the action of the mother's insulin. This is called insulin resistance. The pregnant woman needs extra insulin so the glucose can get from the blood into the cells where it is used for energy. Insulin needs in pregnancy are 2 or 3 times higher than normally required. If the body is unable to meet this requirement, then diabetes develops. When the pregnancy is over and the insulin needs return to normal, the diabetes condition disappears.
How will it affect my baby?
As Gestational Diabetes usually develops around the 24 - 28th weeks of pregnancy the baby's development is not affected. As glucose crosses the placenta the baby is exposed to the mother's high glucose level. This high level of glucose in the baby's blood stimulates the baby's pancreas to produce extra insulin. The extra insulin promotes excessive growth and fat. The result of this may be a large baby that may need to be delivered early but who is not mature enough for delivery. Another problem is that once the baby is born and no longer getting glucose from the mother, low blood glucose may result shortly after the birth.
When Gestational Diabetes is well controlled, these risks are greatly reduced.
Physical Activity
Continuing your current physical activity level is also beneficial in helping to reduce the insulin resistance. Regular exercise like walking helps keep you fit and prepares you for the birth of your baby. However, always check with your doctor before starting or continuing physical activity.
Monitoring blood glucose levels
Regular monitoring of blood glucose levels is essential so that treatment can be assessed and changed as necessary. Insulin injections may be needed to bring the blood glucose levels into the normal range. Blood glucose lowering tablets are not often used during pregnancy in Australia.
After Gestational Diabetes
High blood glucose levels are not usually a problem after the birth of your baby. An OGTT will be performed around 6 weeks after the birth. This will usually show your body is able to deal with glucose correctly. However there is a risk of developing Type 2 diabetes later in life. There is a 30 - 50% chance of developing diabetes in the next 15 years. It is important to:
- maintain a healthy eating plan
- maintain your weight in the ideal weight range
- be physically active
- have a follow-up appointment with your doctor to screen for diabetes every 1-3 years (depending on your previous test results).