Gestational diabetes: what you need to know

If you’re pregnant, you may already know that you’ll be tested for signs of gestational diabetes around the 24-28 week mark as part of your routine examinations.

Gestational diabetes is a form of diabetes that affects between eight to ten per cent of pregnant women. It’s a condition that is diagnosed when higher than normal blood sugar levels are detected, which happens because the body cannot produce enough insulin to meet the extra needs of pregnancy.

Jean Hailes for Women’s Health endocrinologist Dr Sonia Davison says, “Hormone production is vastly altered in pregnancy and it is thought that the increase in progesterone levels is another factor that contributes to the problem of ‘insulin resistance’ – where insulin is produced but doesn’t work effectively”.

Gestational diabetes in many cases will disappear after the birth of the baby, but women who have suffered from this are at risk of developing type 2 diabetes.

Who is at risk?

According to Diabetes Australia, you may be at risk of developing gestational diabetes if you:

• Are over 40 years of age
• Have previously had gestational diabetes
• Have a family history of gestational or type 2 diabetes
• Are overweight or obese
• Are Aboriginal or Torres Strait Islander
• Have a Pacific Islander, Indian sub-continent or Asian background
• Have polycystic ovary syndrome (PCOS)

If you are pregnant and any of these apply to you, consult your GP or obstetrician to discuss your risk.

How is it tested?

An ‘oral glucose tolerance test’ will be conducted to determine if your body is able to maintain normal glucose levels during pregnancy.

If you develop gestational diabetes during your pregnancy, it is important to repeat the oral glucose tolerance test six to eight weeks after the birth of your baby to check if your blood glucose levels have returned to normal.

How is it managed?

Being diagnosed can be a shock, so it’s important you get support. Dr Davison says: “Management and treatment of gestational diabetes should be done in conjunction with your GP, a diabetes health professional, and your family.”

In the majority of cases, blood glucose levels can be controlled with regular monitoring, a healthy eating plan and physical activity. However, insulin injections may also be needed. The aim is to keep your blood glucose levels within the normal range – around four to six millimoles per litre of blood.

What does it mean for my baby?

It’s important to remember that most women with gestational diabetes go on to have healthy pregnancies and healthy babies. However, if gestational diabetes goes undetected or is inadequately treated, it can lead to health problems for you and your baby. You are at an increased risk of developing high blood pressure and pre-eclampsia. The baby might be born with low blood glucose levels and may need to spend some time in a special care nursery.