Monday 14 November is World Diabetes Day, a chance to build a greater understanding of diabetes and keep it in the global spotlight.
Gestational diabetes is a type of diabetes that can occur during pregnancy. Gestational diabetes is the fastest growing type of diabetes in Australia. The number of women diagnosed with the condition annually has more than doubled since 2008-09.
Gestational diabetes is a temporary form of diabetes that only develops during pregnancy and disappears once you have had your baby. It often comes along between the 24th and 28th week of pregnancy, but it can appear earlier or later.
Gestational diabetes is similar to type 2 diabetes and develops when there is insulin resistance. During pregnancy, your body is working harder and there are lots of hormone changes. As such, sometimes the insulin in your body is not enough and the cells in your body use the insulin less effectively to control the sugar levels.
Some women are more at risk of developing gestational diabetes than others. Some risk factors include:
Even if you don’t have any risk factors you can still develop gestational diabetes.
Without testing, gestational diabetes can be hard to diagnose. Most women will have no symptoms. As such, your Grace obstetrician will organise for you to be tested for gestational diabetes in your second trimester, between 24 and 28 weeks.
Oral glucose tolerance test:
Your GP or obstetrician will send you for an oral glucose tolerance test that measures how your body breaks down glucose.
Before the test you will need to fast overnight (after dinner, skipping breakfast). You will take a blood test that measures the glucose in your body. Then, you will be given a sweet drink (75g glucose load) and your blood will be tested again after one hour, then two hours. This shows how your body manages the glucose in your system.
The test can take more than two hours so we recommend bringing a book or something to keep you occupied while you wait.
First of all, don’t worry. While it may be a shock to find out you have gestational diabetes, it is a common condition and we can help you manage it to ensure it doesn’t pose a risk to you or your baby. In most cases, it can be navigated with lifestyle changes alone.
At Grace, our in-house endocrinologist, Dr Aakansha Zala specialises in treating women with diabetes including gestational diabetes. Your Grace Private obstetrician may also refer you to our dietitian, Sharnie Dwyer, who can help design an eating plan that will help you ensure your blood sugar doesn’t spike. Regular exercise is also important.
In some cases, you may need a little extra help to manage gestational diabetes. The most common medications are insulin or metformin, which are considered safe in pregnancy. Your baby will also be closely monitored with regular ultrasounds.
Once the baby is delivered, these treatments can stop as the blood sugars usually go back to normal. Gestational diabetes is also a risk factor for the development of Type 2 diabetes, similar to other risk factors like family history. As such, it is important that after delivery the oral glucose tolerance test is repeated at 6 weeks and if this is normal, to have regular 1-2 yearly blood tests with your GP to screen for Type 2 diabetes.
In most cases, if you receive proper treatment and monitor your gestational diabetes, there will be minimal impact on your baby. However, in some cases if gestational diabetes isn’t treated it can affect your baby. This can result in complications like preterm birth, a bigger baby (>4000g), neonatal respiratory distress syndrome and neonatal low blood sugars, high maternal blood pressure or pre- eclampsia.
For more information ‘ask for Grace’ when you next visit your GP and book in to see one of our obstetricians or our endocrinologist, Dr Aakansha Zala. We take a holistic approach to helping you during your pregnancy and you can be sure you’re in safe, experienced hands.