As a soon-to-be-mum you may have heard about gestational diabetes, or even have been diagnosed yourself.
This easy-to-understand guide will explain all you need to know about the condition, plus how to reduce the risks for yourself and your baby.
What is gestational diabetes?
Gestational diabetes is a type of diabetes that develops during pregnancy. It can happen at any time, but it is usually diagnosed during the second or third trimester. Unlike other forms of diabetes, gestational diabetes usually disappears after birth.
Diabetes means that your blood sugar (also called blood glucose) is too high. It happens when the body stops responding to insulin. Insulin is a hormone that transports sugar (glucose) from the bloodstream into our cells, where it is used for energy.
Having high levels of glucose in the blood is not good for you, or your baby. This is why it’s important to be aware of the condition.
Why does gestational diabetes develop in pregnancy?
Pregnancy hormones make it more difficult for your body to respond to insulin properly, which can cause your blood sugars to increase.
The extra strain on your body during pregnancy can also mean that your body struggles to make enough insulin to keep your blood sugars in the healthy range.
What are the risk factors?
Although any women can develop gestational diabetes, there are some lifestyle factors that increase the risk. You are at a higher risk if you…
Are overweight or obese
Previously gave birth to a large baby (weighing 10lb or more)
Have a history of gestational diabetes
Have a parent, brother or sister with diabetes
Are from a South Asian, Black or African Caribbean or Middle Eastern background
What do I need to look out for?
Gestational diabetes can be tricky to diagnose because many women have no symptoms. This is why it’s essential to attend screening if invited, where the condition can be detected using a blood test.
If blood sugar becomes too high, symptoms can include:
Feeling thirsty
Needing to wee a lot
Dry mouth
Tiredness
However, lots of these are normal during pregnancy, making it difficult to spot.
Around weeks 8-12 of pregnancy your doctor or midwife will ask you a series of questions during your antenatal appointment to see if you are an increased risk. If you have one or more risk factors, you’ll be offered a screening test.
What are the risks linked with gestational diabetes?
Having high blood sugar can be dangerous for both you and baby. If it happens over long periods, it can lead to a number of complications, including:
Having a larger than normal baby, which can mean a more painful birth
Premature birth, or needing to have your labour induced
Pre-eclampsia
Increased risk of type 2 diabetes in future for both you and your baby
Your baby dying around the time of birth (this is rare)
What happens if I am diagnosed?
If you do develop gestational diabetes, the main goal is to control your blood glucose levels. You can do this through diet and exercise, although some women also need to take medication.
If diagnosed, you will be given a testing kit so that you can measure your blood glucose levels at home. This is extremely important, as you will need to keep your blood sugar at a certain level – and testing is the only way to measure this.
What changes do I need to make to my diet?
There are lots of things you can do to help control your blood sugars – it’s not about giving up foods, but there are some you may need to eat less of, especially sugary foods and drinks.
All carbohydrates raise blood glucose – so it’s important to balance your portion sizes. Most of our carbohydrates come from starchy foods like bread, pasta and rice, plus sugar and sweets. There are also some carbohydrates found in dairy foods like milk and yoghurt, and fruits and vegetables.
To help control your blood glucose you can…
Eat less carbohydrate – this means avoiding ‘double carbs’ – like eating chips with lasagna, or garlic bread with pasta. You could also have toast or cereal instead of both at breakfast.
Choose better sources – wholegrain and high fibre carbohydrates (like wholemeal bread, muesli, lentils and porridge oats) are digested slowly, so they have less of an impact on blood glucose levels. These are called low glycaemic index (GI) foods. You can find more information on these here.
Spread your carbohydrates through the day – this might mean eating one portion of fruit at a time, rather than having juice and fruit in one meal for example.
As well as managing your carbohydrate intake, healthy eating guidelines still apply. This means eating regular meals and snacks, including five serves of fruit and vegetables a day, together with healthy proteins like chicken and fish.
If you are diagnosed, you will be offered an appointment with a dietitian, who can help you to make changes to your diet to help balance your blood sugars effectively.
Exercise is also important, as this will help to keep your blood sugars in the healthy range. Walking is ideal as it’s low impact and can be done even in the later stage of pregnancy. A 10-15 minute walk after meals can help to balance your blood sugars after eating.
What about the long term?
For most women, their blood glucose returns to normal after birth – but a small number will continue to have raised levels.
After your baby is born you’ll be advised to keep checking your blood sugar for 1-2 days before you go home. Around 6-13 weeks after giving birth you can have a further blood test to check for diabetes. If it shows high levels, your doctor will advise on the right treatment for you.
If the result is normal, you’ll be asked to return for a check annually, as the risk of developing type 2 diabetes is greater after you have had gestational diabetes.
The Dietitians Experience
As a registered Dietitian since 2000, I’ve supported hundreds of women experiencing gestational diabetes. Working alongside a brilliant team of midwives and consultants, I’ve spent lots of time advising mums-to-be on the best ways to stabilise their blood glucose levels through diet. Nevertheless, it still came as a shock when in 2015; I developed gestational diabetes during my first pregnancy.
As recommended, I started testing my blood regularly – around 4 times a day. Although I knew lots about the condition, I still made all the mistakes – for example having “double carbs” in the same meal (like bread with pasta), which pushed up my blood glucose levels.
I also remember going out for a Chinese meal quite soon after I was diagnosed, and making all the wrong food choices. Along with eating far too much, this caused my blood sugars to spike into double figures, which meant I had to have a 25 minute walk around my neighborhood to bring them down!
The advice might sound boring – but most of the principles for controlling blood sugar levels are the same as those for healthy eating. You need to eat regular meals, but avoid having double carbs for example spaghetti Bolognese with pasta and garlic bread.
Choosing low G.I. foods that are released slowly is also helpful, and make sure you carry suitable snacks so you always have something to hand when you get hungry. All fruit is fine, but just space it out so you only have one piece at a time.
Remember we are all individual, and part of the challenge is working out which foods do and don’t work for you. What pushes up your blood glucose won’t necessarily be the same for another person. I call these the “food gremlins!”
As part of your care you will have the opportunity to work with a dietitian who can help you to make the right changes to your diet, so do take advantage of this support.
My other tip would be to talk to your team about hand harvesting your colostrum (around 36 weeks onwards) ready for your new baby – this can help out their blood sugar levels on arrival into the world.
