Gestational Diabetes – Everything You Need To Know
It’s natural to worry if you’re diagnosed with gestational diabetes or told you’re at risk of developing the condition during pregnancy.
You may feel anxious gestational diabetes will change your birth plans or cause you to need interventions during labour.
Remember, being informed about your pregnancy care and health means you can make the best decisions for you and your baby.
Most women who develop gestational diabetes will have healthy pregnancies, normal births and beautifully healthy babies.
Let’s take a dive into the topic of gestational diabetes, what causes it and how it’s treated.
What is gestational diabetes?
Gestational diabetes mellitus (GDM) is a type of diabetes that only occurs during pregnancy. It’s diagnosed when your blood sugar levels are too high, usually between the 24th and 28th weeks of pregnancy.
According to health data from 2017, 1 in 7 or 15% of pregnant women in Australia develop gestational diabetes, and this number is growing each year.
The increase in number is potentially due to more women having babies later, as the incidence of GDM increases as women age.
What causes gestational diabetes?
During pregnancy, the placenta produces hormones to support your baby’s growth and development. These hormones have an effect on your insulin, which is the hormone that regulates your blood sugar or blood glucose levels. It moves glucose from your blood to your cells to be used for energy.
In pregnancy, your body becomes slightly insulin resistant, so there’s more glucose in your bloodstream and this is passed onto your baby. But if the resistance to insulin increases, this causes blood glucose levels to become very high, leading to GDM.
Usually once you’ve given birth, your blood sugar levels will return to normal. However, having gestational diabetes increases your risk of developing type 2 diabetes in the future.
Who is at risk of developing gestational diabetes?
There are some women who are more likely to develop GDM than others. These women have risk factors such as:
- Had GDM in previous pregnancy
- Have a family history of type 2 diabetes
- Mother or sister had GDM
- Are older, especially over 40 years of age
- Before pregnancy above healthy weight range
- Have had elevated blood glucose levels before
- First Nations women
- Women from African, South Asian, Polynesian, Middle Eastern, Melanesian, Chinese, Southeast Asian, Hispanic and South American backgrounds
- Have polycystic ovarian syndrome
- Have had a large baby (>4.5kg)
- Taking certain medications, such as steroids.
Bear in mind, women with no known risk factors can also develop gestational diabetes.
What are the warning signs of GDM?
It’s actually not very common for gestational diabetes to cause symptoms. Most women who have symptoms find they’re mild, and include:
- Excessive thirst
- Extreme hunger
- Frequent urge to urinate
- Blurred vision.
Most often women don’t realise they have GDM until they have routine screening at 24-28 weeks pregnant.
How do you diagnose gestational diabetes?
It’s recommended all pregnant women are screened for gestational diabetes between 24-28 weeks of pregnancy.
Screening involves having an oral glucose tolerance test (OGTT). You need to fast for 8-12 hours (usually overnight) and then have a blood sample collected. After the blood test, you will drink 75mg of sugar and then have your blood sugar levels tested 2 hours later.
If the blood test shows glucose levels above normal, you’re then diagnosed with gestational diabetes.
What’s the treatment for gestational diabetes?
The good news is, most women with gestational diabetes can have a healthy pregnancy, normal birth and a healthy baby. Much of this will depend on two things:
- How you manage your gestational diabetes
- Your care provider’s attitude and support.
Nutrition is so important during pregnancy, but a diagnosis of GDM can mean extra focus on the quality of food you’re eating.
It’s recommended you include plenty of nutrient dense vegetables, high quality protein, healthy fats, legumes and pulses, and wholegrain carbohydrates.
Strive to include a variety of foods and stay away from foods high in sugar and highly processed. They provide little in terms of nutrients and are likely to cause your blood sugar levels to spike.
Exercise not only helps to keep blood glucose levels stable, there are other benefits too! Did you know pregnant women who exercise are likely to have shorter labours and easier births? Aim for at least 30 minutes of moderate activity most days, which can be as simple as a brisk walk or swimming laps.
Managing gestational diabetes means having the support of those around you – family, friends and your healthcare providers.
It’s not uncommon for women to be told they will need interventions due to having gestational diabetes when it comes time to give birth. Having a supportive care provider who works with you to achieve a normal and positive birth experience is important.
It also means being informed about the best options for you, when you get close to full term.
Some women are fortunate and can manage their GDM with lifestyle changes alone. Others will need to take medication.
Metformin is a medication that helps your body to respond better to insulin, as well as keeping your weight and blood pressure down. There are some side effects, which include an upset stomach and diarrhea.
Insulin may be needed, which is given via injection, if Metformin isn’t working or can’t be taken. Your healthcare team will show you how to use the insulin injections, where to store them and so on.
What happens if GDM is untreated?
If GDM isn’t managed, it can lead to high blood sugar levels that cause problems for you and your baby.
Gestational diabetes can cause you to:
- Develop high blood pressure and preeclampsia
- Have interventions such as a c-section
- Develop diabetes in the future.
Gestational diabetes increases the risk your baby will:
- Grow larger than usual due to the increased blood glucose. The main concern is the baby will be too big and need interventions to be born, such as c-section
- Be born prematurely, either unplanned or due to induction
- Have breathing problems at birth and need special care
- Have low blood sugars which can cause seizures. This needs monitoring, early feeding and sometimes IV fluids
- Be stillborn (very rare)
- Develop obesity/type 2 diabetes later in life.
What should I avoid eating with gestational diabetes?
As we mentioned earlier, the best diet you can have while pregnant is one that takes in as much variety of nutrient dense foods as possible. There’s no need to remove any food group, but there’s certainly a case for watching how much you eat of certain foods, such as simple carbohydrates.
Simple carbs are the type which cause your blood sugar to rise quickly after eating. The best way to avoid this is to swap them out with more complex carbohydrates, such as wholefood grain options, more vegetables and lean protein.
Definitely assess the amount of sugar you’re eating, and limit sugary foods like sweets, chocolate and biscuits. If you’re craving sugar, opt for healthier options like berries with yoghurt or chia pudding. Try to include protein with your meals and snacks to encourage blood glucose levels to stay stable.
Can drinking water help gestational diabetes?
It’s important to think about what you’re drinking, not just your food intake.
Sugary drinks or beverages like chai lattes are likely to drive your blood glucose levels up so try to avoid them. Even fruit juices and smoothies can be high in sugar so keep that in mind as well. A smoothie made at home with almond milk, berries and yoghurt with a dash of cacao is a much better option.
But the main fluid you should be drinking is water. Water has no calories or carbohydrates so it’s perfect as it won’t raise blood glucose levels.
Can you get rid of GDM while pregnant?
Many women want to know if they can prevent or reverse gestational diabetes, especially if they’re concerned having the condition will impact their birth choices.
Nearly 50 years ago a study looked at the effects of vitamin B6 on gestational diabetes. The study size was small but the results indicated a deficiency of B6 was linked to gestational diabetes. Further research has been conducted since then which suggests there is definitely a link between vitamin B6 and gestational diabetes.
Ensuring your diet has plenty of vitamin B6 when pregnant is important for your developing baby too. It’s vital for their brain and nervous system development, and helps their body to metabolize carbohydrates and protein. Fish, lean meat, and nuts are excellent sources of vitamin B6, as well as chickpeas.
If you’re worried about your nutritional profile, ask your healthcare provider to organise blood tests. Supplements are useful only if you are deficient in nutrients.
Does gestational diabetes go away after birth?
Normally, GDM disappears after you give birth. It’s usual for your doctor or midwife to test your glucose levels 6-12 weeks and it’s recommended to have testing every year for type 2 diabetes if you’re planning another baby.
Breastfeeding after birth is especially beneficial for mothers who had gestational diabetes as it helps to regulate both your weight and your baby’s.
To reduce your risk of developing type 2 diabetes after GDM, it’s important to maintain a healthy weight range, eat a wonderfully nutritious diet and be physically active whenever possible.
If you need support for the prevention or management of gestational diabetes, you may like to see Nurtured Birth’s naturopath who can work with you to create a holistic pregnancy care plan.
Please contact us for more information or to book an appointment.