gestational diabetes

Gestational diabetes

What is gestational diabetes developing high blood sugars in pregnancy which settles down after giving birth? this is known as gestational diabetes

why does gestational diabetes happen

it happens because, at one stage, your body cannot produce enough insulin(a hormone that controls blood sugar levels) to meet the extra demands of pregnancy. most of the time, it kicks in during your late second or third trimester

how will I be diagnosed of having gestational diabetes

there are two methods to diagnose it

1 screening during your first booking visit

your first antenatal visit is around 12 weeks. Your urine will be tested. If sugar is present in urine. A blood sample will be taken to test further if you suffer from this condition or not.

you are at high risk if-

a if you had gestational diabetes in a previous pregnancy

b if you suffer from PCOS

or any other high-risk condition which make you more prone for gestational; diabetes.

In such cases, a special test call GTT or HbA1C will be done at your first visit. If that is normal. it might be again repeated at 28 weeks

2 screening around 28 weeks 

Suppose you fall under the high-risk category or are more prone to developing gestational diabetes. A special test known as the glucose tolerance test is done. You have to fast overnight, and then in the morning, you will be called to give a blood sample once the first fasting blood sample is given. You will be given a sugary drink and then 2 hours later. Another blood sample is taken. The results of both tests will show if you have gestational diabetes or not.

Am I at high risk of having gestational diabetes

you are at high risk if-

1. Your BMI is 30 or more

2 weight of your precious baby was 4.5kg

3 you had gestational diabetes in a previous pregnancy

4 one of your parents or siblings suffer from diabetes

5 you are of South Asian, black, African- Caribbean or middle eastern background

Will I get any symptoms?

Most of the time, you will not get any symptoms. It is detected on screening. few women do get symptoms as

increased thirst

dryness of mouth

tiredness

need to pass urine more times than usual

How will my gestational diabetes be treated?

Once you are diagnosed with gestational diabetes, you will need a special diabetic team of specialized nurses, doctors, and dieticians. they will tell you in detail how your pregnancy can be affected by diabetes if it is uncontrolled and what measures you need to take in order to control your blood sugar levels

What is the treatment for gestational diabetes

complications related to gestational diabetes can be prevented by having good control on blood sugar levels. treatment by diabetic team usually involves-

1 checking your blood sugar levels regularly

2 eating a healthy diet- you will be referred to a dietician who will make changes in your diet. overall, you are advised to-

a eat three meals a day

b eat starchy foods like pasta, brown rice, bread

c take plenty of fruits and vegetables

d do not take sugary or fatty foods

3 exercise- exercise helps to lower blood glucose levels. 150 minutes a week is the safety limit of performing the exercise.

4 medicine- initially, your diabetic team will see if your blood sugars can be controlled with diet. If diet didn’t help and your blood sugars remain uncontrolled, the next option will be to take oral medicines. These medicines will help to normalize blood sugar levels. Commonly used oral medication is in the form of metformin. It is taken orally after meals. Usually three times a day. you can get certain side effects as – feeling sick, stomach cramps, diarrhea, loss of appetite at times

5 insulin injections-if metformin tablets didn’t help; the next step is to start insulin injections. You will be taught by a diabetic nurse how to inject insulin injection. insulin dose will be adjusted according to your blood sugar levels

how will my pregnancy be monitored

you will need extra appointments during your pregnancy to know if everything is going well or not. Extra scans will be offered to you around 28 weeks and then after every 4 weeks at 32 and 36 weeks. All these additional scans will tell the size of your baby and the amount of amniotic fluid around the baby. This will help to make a delivery plan for you.

when is it safe for me to give birth

the ideal time is around 38 to 40 weeks if you have gestational diabetes.

How will I be monitored in labour?

During labour and delivery, your blood sugar levels will be monitored regularly and if insulin is needed. it will be given through a drip

what will happen after the birth of my baby

you can have skin to skin with your baby. You must feed your baby as soon as possible and then at frequent intervals until your baby’s blood sugar levels return to normal. your baby’s blood sugar levels will also be checked regularly 

how gestational diabetes can affect my baby and me

gestational diabetes can cause various complications in pregnancy, such as

1 polyhydramnios- a lot of amniotic fluid surrounding your baby

2 your baby growing larger than normal

3 premature labour- you can go in labour before 37 weeks

4 pre-eclampsia- that is high BP in pregnancy

are there any long term effects of gestational diabetes

you are at higher risk of-

1 having gestational diabetes in your future pregnancies

2 type 2 diabetes

for this reason, a blood test is done 6 to 13 weeks after giving birth and once every year.