Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. It is diagnosed when higher than normal blood glucose levels first appear, usually around the 24th to 28th week of pregnancy.
Between 12% and 14% of pregnant women will develop gestational diabetes. It can be upsetting but it’s important to remember that support is available for you to experience a healthy pregnancy, safe delivery and healthy baby.
At Sydney Endocrinology we take Gestational Diabetes management very seriously, and we do it well. We are the only private service in NSW that has presented data at National Conferences on our performance.
What causes gestational diabetes Mellitus (GDM)?
In pregnancy, the placenta produces hormones that help the baby grow and develop. These hormones also block the action of your insulin. This is called insulin resistance. Because of this insulin resistance, the need for insulin in pregnancy is 2 to 3 times higher than normal.
If you already have insulin resistance, then your body may not be able to cope with the extra demand for insulin production and the blood glucose levels will be higher resulting in a diagnosis of gestational diabetes.
How do I know if I have gestational diabetes?
All pregnant women should be tested for gestational diabetes at 24-28 weeks of pregnancy (unless you already have diabetes). If you have risk factors for gestational diabetes, you should be tested earlier in your pregnancy.
The test is an oral glucose tolerance test (OGTT). You’ll fast overnight before having your blood taken to check your fasting blood glucose level. After this, you will be given a sugary drink and have your blood tested one and two hours later. If your blood glucose level is above the normal range at your fasting, one or two hour test, you have gestational diabetes.
Are some women more likely to develop gestational diabetes?
You might have a greater risk of developing gestational diabetes if you:
Are 40+ years old
Have type 2 diabetes in your family
Have a mother or sister who had gestational diabetes
Are above the healthy weight range
Had previously elevated blood glucose levels
Had gestational diabetes during a previous pregnancy
Are from an Aboriginal and Torres Strait Islander, Melanesian, Polynesian, Chinese, Southeast Asian, Middle Eastern or Indian background
Have previously had Polycystic Ovary Syndrome
Have previously given birth to a large baby (weighing more than 4.5kg)
Are taking some types of anti-psychotic or steroid medications
Have gained weight too rapidly in the first half of pregnancy
Sometimes gestational diabetes occurs in women with no known risk factors. In all cases, it can be managed with the right tools and support.
How is gestational diabetes treated?
A diagnosis of gestational diabetes can be really upsetting but remember lots of help is available from our team of endocrinologists, credentialled diabetes educators and accredited practising dietitians.
Treatment for gestational diabetes includes eating a “gestational diabetes diet”, being physically active and monitoring your blood glucose levels to keep them within the target range while you are pregnant. A gestational diabetes diet enables you to manage carbohydrate intake so that your body’s naturally occurring insulin can metabolise it. Exercise enables you to use up glucose without the need for insulin. Some women may need medication to help manage gestational diabetes.
Your endocrinologist will assess the effect of diabetes on you and guide you on how to manage your gestational diabetes.
After pregnancy it is important to discuss diabetes prevention strategies with your endocrinologist, to prevent yourself from developing type 2 diabetes in the future.
Why do I need to manage my gestational diabetes?
Managing diabetes is a team effort. Our multidisciplinary team will work with you on a plan to manage your gestational diabetes. It’s important to manage your gestational diabetes to ensure you are eating the correct foods to nourish your baby and reduce your risk of complications. If untreated, gestational diabetes can cause birth complications and contribute to an increased risk of your baby needing to go to the special care nursery.
What is the sydney endocrinology difference?
At Sydney Endocrinology, we have audited our own performance. Whilst we believed we were providing the highest possible level of care, we wanted to be certain. We looked at all the births that occurred at the Mater Hospital over a 12 month period in 2017-2018. We compared the outcomes for those with GDM that were cared for through Sydney Endocrinology, with outcomes for those with GDM who were cared for elsewhere.
The results were drastic!
The babies born to ladies treated with Sydney Endocrinology had a 61% lower risk of being admitted to the special care unit (for low blood glucose) than those that were cared for elsewhere. Remember, low blood glucose in newborns is directly linked to how well a mother’s glucose is managed throughout the pregnancy, and at the birth.
Risk of developing type 2 diabetes
When the pregnancy is over, blood glucose levels usually return to normal and the gestational diabetes disappears. However, having gestational diabetes (and therefore insulin resistance) increases your risk of developing type 2 diabetes in later life, to around 50%. After pregnancy it is important to discuss diabetes prevention strategies with your endocrinologist, to prevent yourself from developing type 2 diabetes in the future.
Will my baby have diabetes?
If you have gestational diabetes, your baby may be at increased risk of complications at birth. The baby may also be at risk of developing type 2 diabetes later in life. However, your baby will not have diabetes from birth.
Your endocrinologist can explain how gestational diabetes may affect your baby during and shortly after birth, and what can be done to help.
What should I expect from my appointment for gestational diabetes?
Sydney Endocrinology’s gestational diabetes services offer compassionate care for women diagnosed with gestational diabetes.
We understand it’s an anxious time and we’re here to support you with tools and knowledge to manage your gestational diabetes and enjoy a healthy pregnancy through safe diet and lifestyle changes.
If you have recently been diagnosed with gestational diabetes or have a family member with gestational diabetes, contact us to find out more.