Gestational Diabetes: Everything you need to know
Let’s start at the beginning - Glucose.
Glucose is a sugar, used by the body for energy. We get glucose from the food and drink we consume. Glucose levels fluctuate throughout the day but are kept within a safe limit by a hormone called insulin.
Insulin is an essential hormone that helps lower blood glucose levels by storing excess glucose in the body’s cells for later use. During pregnancy, your body naturally produces high levels of hormones, some of which can alter the efficiency of insulin. This is known as insulin resistance.
Insulin resistance is triggered by the body either producing too much or too little insulin, resulting in high glucose levels. When insulin is affected and glucose levels are too high, a condition known as Gestational Diabetes can develop.
Not all women will develop gestational diabetes, but for those affected, it typically starts in the second or third trimester. Some women are at higher risk of developing gestational diabetes, and it’s natural to feel concerned, but on average, only 18% will actually develop the condition.
Tell me more…
The exact cause of gestational diabetes is unknown and is still being researched, but there are some biological factors that can cause a higher risk.
You will typically be offered a test for gestational diabetes when you’re between 24 and 28 weeks pregnant, but during your first antenatal, or ‘booking’ appointment, your midwife will run through your medical history and will ask about potential risk factors including:
- You have a parent, sibling or child with diabetes.
- You are of black Caribbean, black African, South Asian or Middle Eastern origin, even if you were born in the UK.
- You have polycystic ovary syndrome (PCOS).
- You have a high body mass index (BMI) and/or fall into the obese category.
- You had a large baby (weighing 10lb or more) in a previous pregnancy.
- You developed gestational diabetes during a previous pregnancy.
Gestational diabetes can be diagnosed by your midwife with a simple blood and urine test that will not affect your baby. You can learn more about the test here.
How will it affect me?
Many of the indicating symptoms of gestational diabetes are common during pregnancy, so it is important to follow guidance and be tested for the condition, especially if you fall into the high-risk category. Symptoms include:
- Feeling thirsty
- Needing the toilet frequently, especially at night
- Low energy levels
- Sudden, unexplained weight loss
- Intimate itching or thrush
Whilst gestational diabetes typically goes away after birth, it may put you at a higher risk of developing type 2 diabetes in the future. This can be managed and risk reduced through diet and lifestyle.
Will it affect my baby?
As a result of high glucose levels, your baby will produce more insulin, which can make your baby grow faster and lead to low glucose after birth. This may affect when and how you give birth but your midwife will be able to provide monitoring and guidance on this.
Sadly, in some cases, undiagnosed or untreated gestational diabetes can increase the risk of stillbirth and neonatal death.
“This sounds frightening, but try to remember that with careful management, most women who develop diabetes in pregnancy have healthy pregnancies and healthy babies.” - Tommy’s Pregnancy Hub
Treatment and lifestyle changes
If you are diagnosed with gestational diabetes, you will have extra care throughout your pregnancy. You may be offered medication to help manage your glucose levels, but diet and exercise play a key part in preventing your likelihood and reducing the impact.
Eating a nutrient-dense, balanced and diverse diet is important at any stage of life, but during pregnancy, and especially if diagnosed with gestational diabetes, it is especially important. Eating regularly, monitoring portion sizes and aiming for foods with a low glycemic index (GI) score are great places to start and will limit the impact of glucose on the body.
Foods high on the glycemic index (GI) include:
- sugary drinks and confectionery
- breakfast cereals
- fruit juices
- white bread
- potatoes
- white rice
A few simple swaps will allow you to fuel your body and feel satiated whilst reducing the impact of glucose as levels are raised much slower. Monitoring what you drink is just as important - limiting sugary drinks and keeping hydrated with water.
Foods low on the glycemic index include:
- Leafy green vegetables
- pulses, such as chickpeas or lentils
- wholegrain foods, such as oats and lentils
- protein sources such as lean meat
Increasing your intake of fibre is also a great way to limit the impact of glucose on the body after eating. Fibre is a food supplement that can be a great addition to your daily routine during pregnancy and for those experiencing gestational diabetes. We always recommend that you consult your midwife before taking any nutritional supplements during pregnancy.
The bottom line
Gestational diabetes may seem daunting, but it can be managed to reduce the risk to your pregnancy. Once diagnosed you will have extra appointments and specialised support from your midwife and there are lots you can do at home to improve your diet and lifestyle.