What is Gestational Diabetes and who can get it?
When you're pregnant there can be a world of health and medical situations cropping up, which you've never even heard of before! Whilst some have a pregnancy with very little intervention or concerns, you might be one of those few that does experience some medical attention along the way.
One of these medical issues could be Gestational diabetes. It is a type of diabetes that develops during pregnancy and usually goes away after giving birth. Occurring when your body cannot produce enough insulin to meet the extra needs in pregnancy it can happen at any stage - but is more common in the second or third trimester.
It happens when your body is struggling to produce enough insulin, which is a hormone that helps to control your blood sugar levels. It can cause problems if undiagnosed or managed incorrectly, so it is important to take note of any indicators and raise concerns to your healthcare professional as soon as you can.
Who can get gestational diabetes?
Anyone can have gestational diabetes when pregnant and contrary to popular belief, it is not caused by eating too much sugar. According to Diabetes UK, it can affect up to 1 in 20 pregnancies. It can be caused by your placental hormones blocking your ability to use insulin, leading to insulin resistance. There are several factors that your midwife will be looking out for as a general guide as to whether or not you would be at risk. These are outlined on the NHS website, and include indicators such as having a higher BMI, your age (generally over 40), if a parent has diabetes or being from certain ethnic backgrounds such as South Asian, Black, African-Caribbean or Middle Eastern origin (even if you were born in the UK). This list is not exhaustive though and Gestational Diabetes can be detected in women of any size, ethnicity or background.
Questions will be asked during your booking appointment which will give your midwife an overview of any risk factors to keep an eye on as your pregnancy develops.
What are the signs of gestational diabetes?
There are a few signs that may prompt your midwife to order a screening test, which will be referred to as an Oral glucose tolerance test (OGTT). There are often no direct symptoms of Gestational Diabetes though, which can make it tricky when it comes to diagnosis. If you have any of the following issues during your pregnancy, you must inform your midwife who can guide you most effectively:
- increased thirst
- needing to pee more often than usual
- a dry mouth
- tiredness
- blurred eyesight
- genital itching or thrush
Some of these symptoms can be common during pregnancy though, so there is nothing to panic about if some do manifest at any point. Just check in with the relevant people and stay on top of monitoring them and continue to raise any concerns you may have.
An ultrasound scan may also prompt a OGTT test when certain things are spotted. Again, this does not mean that anything is definitely wrong with you, or your baby, but as with everything in your pregnancy it's better to test early to avoid any risks or concerns later on.
Some signs that may come up on your ultrasound could be:
Larger than average measurements (macrosomia): A common sign is when the baby measures larger than expected for their gestational age. This occurs because excess glucose in the mother's bloodstream can cross the placenta, prompting the baby to produce more insulin, which leads to increased fat storage and growth.
Excessive amniotic fluid (polyhydramnios): High levels of amniotic fluid can be identified during ultrasounds. This may indicate that the baby is urinating more frequently, a condition associated with elevated blood sugar levels in both the mother and the baby.
Fat deposits around the baby’s abdomen: Ultrasound may reveal increased fat deposits in the baby's abdominal region, resulting from heightened glucose levels in the mother’s blood.
These could be perfectly normal and risk-free during your pregnancy, so if you do have any of the signs it's important not to panic and let the healthcare professionals do their thing and check as required.
The only way to diagnose for certain is by taking part in the OGTT screening.
How do they test for gestational diabetes?
As mentioned the test, or screening, for gestational diabetes is called a Oral glucose tolerance test (OGTT). This test usually takes place when you are between 24 and 28 weeks pregnant, but if you have had gestational diabetes in a previous pregnancy you will be offered the screening sooner during future pregnancies.
The screening takes around 2 hours. You attend a clinic in the morning and are asked to drink a glucose drink. This must be done before you have anything to eat or drink to provide the most accurate results. They will take a blood sample before your drink and then you will be asked to wait for some time so your body can do it's thing! You will usually have to stay in the clinic, or go and sit in your car if you like, as you need to keep movement to a minimum during this time.
Once the time has passed you will be called back into the nurse who will then take a second blood sample. This will be sent off to the labs to determine the final glucose levels and how your body processed the glucose in the drink.
When you're done they will tend to contact you within a few days if your blood glucose levels are higher than the threshold. If it is lower and there is not sign of gestational diabetes, you will usually be informed by a letter in the post within 14 days or so.
How is gestational diabetes managed during pregnancy?
Managing gestational diabetes can feel like a challenge on top of everything else you need to consider when cooking a baby! It mainly involves monitoring blood sugar levels, following a healthy eating plan, and staying physically active. It is essential to research which foods you can eat safely and also work closely with healthcare providers to ensure the best outcomes for both the mother and the baby.
Monitoring blood sugar
One of the main things you will be asked to do is to monitor your blood sugar levels regularly. This is often by doing a finger prick test on a monitoring machine provided to you. You simple prick the end of your finger and place it on a little strip that collects the blood and can be inserted into the machine. How frequently and when you will be asked to do this would depend on your healthcare provider but it is generally before and after meals. If you continually go over the threshold for your readings, regardless of how much you stick to your diet plan, you must alert medical staff as soon as possible to consider if you need medication to help manage the condition.
Adjusting your diet
A diet tailored to keeping blood glucose low is also key to managing your gestational diabetes. Whilst you may think this is simply avoiding sugary food, it is a little bit more complex with some unexpected items you might not be able to process well. For example, oat milk has a higher carb content so can spike blood sugar levels, whereas whole milk can be processed much easier when you need to keep your readings low. Like everything, you need to strike a balance and learn what does and doesn't work for you, alongside following the advice of a dietician or healthcare professional.
Staying active
When in the final weeks of pregnancy it can be easier said than done when it comes to keeping active. But when you have gestational diabetes it is important to try and move when you can. Sometimes just a small walk at your own pace after eating can be just what you need to keep on top of those blood sugar levels, but if you are able to, you can turn this into a quicker walk or whatever else you are personally comfortable with.
For anything else you need to know about gestational diabetes...
If you have any concerns about gestational diabetes or are trying to navigate it during your pregnancy, we would always advise that you check in with healthcare providers as soon as possible. There are also some fantastic groups you can join on Facebook where people share their own experiences and meal ideas to help you to make the most of this magical time!