Gestational Diabetes

Gestational Diabetes

Diabetes is a condition in which there is too much glucose (sugar) in the blood. The rise in glucose occurs because the body can't make enough of the hormone insulin, or the insulin produced is not working properly. Insulin is the hormone needed to transport glucose from the blood to the muscles.

You may have heard about type 1 and type 2 diabetes, but did you know that there is a third type? Gestational diabetes refers to diabetes that is first recognised during pregnancy. It often occurs after the 26th week when the pancreas gland may be unable to produce or release enough insulin to keep the blood glucose at a normal level. The body must make a lot of extra insulin during pregnancy because the hormones produced by the placenta stop it working properly.

With recent changes in acceptable blood glucose levels during pregnancy, up to 15-20 per cent of pregnant women will be diagnosed with gestational diabetes. It usually disappears after the birth of the baby, but this is often only temporary.

Women who have had gestational diabetes are very likely to develop type 2 diabetes. There is a 10% chance in the first year following the birth of the child and 50% chance in the following 5 to 10 years.

Who is at risk?
You are at risk of gestational diabetes if you:
are over 30
are overweight
have a family history of gestational diabetes or type 2 diabetes
have previously had gestational diabetes
have had a baby who weighed over 4kg when born
have polycystic ovary syndrome (PCOS)
are of Sri Lankan, Indian, Asian or Indigenous Australian backgrounds

How can I avoid it?
Being prepared for a healthy pregnancy before conception by being physically active, controlling weight and eating healthy food has a major impact on preventing gestational diabetes. It is important for pregnant women to optimise a healthy lifestyle, follow recommendations on healthy weight gain and partake in regular physical activity.

Who should be tested?
Current recommendations state that all women should be screened between 24 and 28 weeks of pregnancy. Women at very high risk should be screened earlier. The most commonly used screening test is a glucose challenge test. If this test is found positive a more detailed test, an oral glucose tolerance test, is done. This will help your doctor identify if your body is able to maintain normal blood glucose levels during your pregnancy.

If you do develop gestational diabetes you will need to repeat the oral glucose tolerance test 1 to 2 months after the birth of your baby, to check if the condition has gone away or not. Because you have an high chance of developing type 2 diabetes in the future you will also need to see your doctor regularly (every 1-2 years) to be tested for diabetes.

What does it mean for my baby if I have gestational diabetes?
If undetected or inadequately treated, it can lead to problems for you and your baby. You need to be diagnosed early, carefully monitored and treated during your pregnancy to avoid these risks.

If not managed, your baby may be overweight when born, making delivery difficult. The baby might also be born with low blood glucose levels and may need to spend some time in a special care nursery.

How is gestational diabetes managed?
Gestational diabetes is managed with a healthy eating plan, physical activity, monitoring of blood glucose levels, and insulin injections if required. It is important that you see diabetes health professionals for assistance in managing this condition.

For more information, go to: www.healthforwomen.org.au
Diabetes Australia www.diabetesaustralia.com.au
Australian Diabetes in Pregnancy Society www.adip.org

Published with the permission of the Jean Hailes Foundation for Women's Health

Tollfree number 1800 151 441 for women seeking further health information www.JeanHailes.org.au