Gestational Diabetes Symptoms and Treatment

Gestational diabetes is a type of diabetes that develops in pregnancy. It is characterised by high blood sugar levels and can lead to various complications if not properly managed. Proper diet and exercise play a crucial role in managing gestational diabetes and it’s important to work closely with your doctor and midwife to monitor your blood sugar levels and ensure a healthy pregnancy for both you and your baby. In this article, we will explore what causes gestational diabetes, its symptoms, and how to manage this condition (including diet and exercise).

What Is Gestational Diabetes?

Gestational diabetes is a form of diabetes that affects some people during pregnancy.

Similar to other forms of diabetes mellitus, gestational diabetes affects how your body uses glucose, resulting in high blood sugar. Here’s how: Pregnancy hormones make it harder for the body to process sugar (glucose) because they stop insulin from doing its job of keeping blood sugar levels more stable. Usually, the body produces more insulin to counteract this, but, for some pregnant people, not enough extra insulin is produced, resulting in blood sugar levels remaining high. As a result, too much glucose remains in the blood, instead of moving to cells where it’s used up as energy.

When Does Gestational Diabetes Occur?

This condition usually occurs in the second or third trimester, but it can also occur at any stage of pregnancy. This is because, as the baby grows, the placenta produces more of those hormones that stop insulin from working as it should. A modest spike in blood sugar levels after eating is normal, but if you have gestational diabetes the rise in blood sugar levels can impact the growth and development of your baby.

Generally, the standard blood sugar level during pregnancy an hour after eating a meal is below 7.8mmol/L. However, this number may vary, so it’s always important to ask your doctor or midwife what they recommend as ‘normal’ blood sugar levels.

How Is Gestational Diabetes Diagnosed?

You may not notice any signs or symptoms of gestational diabetes during pregnancy. However, if you have any of the risk factors listed below, your doctor will offer a screening test for gestational diabetes at an antenatal checkup. This is commonly done using the oral glucose tolerance test (OGTT). The test takes around 2 hours and it involves fasting for 8 to 10 hours beforehand. You’ll be given a glucose drink, and after 2 hours, a blood sample will be taken to test your glucose levels. 

If you’re at a lower risk of gestational diabetes, your doctor may wait and do a screening test during the second half of your pregnancy, usually between 24 weeks and 28 weeks. 

If you’ve previously had gestational diabetes, your doctor will offer the screening earlier in your pregnancy.

Risk Factors of Gestational Diabetes

It’s not known why certain people develop this condition during pregnancy (and some may even have none of the following risk factors); however, common risk factors for gestational diabetes include

• being over 40 years 

• being physically inactive

• being overweight

• having polycystic ovarian syndrome (PCOS)

• having prediabetes (a precursor to type 2 diabetes), or a close family member having type 2 diabetes

• having had gestational diabetes during a previous pregnancy

• have previously delivered a baby who weighed more than 10 pounds

• having had an unexplained stillbirth in a past pregnancy.

Your doctor and midwife might be aware that you have some of the risk factors, but make sure you mention whether any of these factors apply to you, either before trying to get pregnant, or at your first antenatal visit.

The Signs and Symptoms of Gestational Diabetes

Gestational diabetes generally doesn’t present with noticeable signs or symptoms and is typically diagnosed through routine screening rather than symptoms. However, some people may experience increased thirst, frequent urination, dry mouth or fatigue. Because some of these symptoms can be common during pregnancy anyway, it’s best to consult your doctor or midwife if you’re concerned about any symptoms you’re experiencing.

If gestational diabetes is not managed effectively, it can lead to complications, which we will discuss further in the section, How Can Gestational Diabetes Affect the Baby and Your Pregnancy?

What Causes Gestational Diabetes?

As we mentioned earlier, gestational diabetes arises primarily due to hormonal changes during pregnancy that interfere with insulin’s ability to regulate blood sugar. As the pregnancy progresses, the body produces more hormones that block insulin, increasing the risk of insulin resistance. 

The risk factors listed above, including being overweight before your pregnancy, may increase your risk of developing gestational diabetes.

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How to Treat and Manage Gestational Diabetes

If you have been diagnosed with diabetes during your pregnancy, your doctor will provide you with the best possible treatment and care and help you keep your blood sugar under control throughout your pregnancy.

Your doctor and midwife will likely recommend more regular antenatal checkups to monitor your health and your baby’s and to test your blood sugar levels. In some cases, your doctor may provide you with a blood sugar testing kit so you can check your own blood sugar on a daily basis (possibly even several times a day). If this is the case, they’ll be able to walk you through exactly how and when to do this.

To keep your blood sugar under control if you have gestational diabetes, it’s recommended to follow a healthy diet, exercise regularly, and take any medication your doctor may prescribe you. Some pregnant people with gestational diabetes need insulin (usually in the form of tablets or injections) to help control their blood sugar levels. Your doctor will prescribe insulin if this is needed.

After you give birth, you should continue to check your blood sugar levels for 1 to 2 days. Your doctor will typically test your baby’s blood sugar levels 2 to 4 hours after birth. It’s likely your doctor will also recommend a blood test to check for diabetes about 6 to 13 weeks after delivery.

Can Gestational Diabetes Go Away?

If you were diagnosed with gestational diabetes during your pregnancy – and you didn’t have diabetes before getting pregnant – It likely won’t be an issue after childbirth. However, there’s an increased risk of developing diabetes later in life if you had gestational diabetes.

Gestational Diabetes Self-Care

As well as the treatment and advice your doctor and midwife give you, here’s what you can do to help control your blood sugar levels and reduce the chance of complications from gestational diabetes:

• Follow a healthy diet. Although it’s not recommended that pregnant people lose weight, eating a healthy and balanced diet may help control gestational diabetes. Eating lots of fruit, vegetables, lean sources of protein and low GI (glycaemic index) foods is recommended. Avoid sugary food and drinks and processed foods. Eat regular meals throughout the day, but keep an eye on portion sizes. Your doctor or midwife may recommend a diet designed to help control gestational diabetes and can give you information on the healthy amount of weight to gain throughout your pregnancy.

• Incorporate physical activity. Exercise helps lower blood sugar levels and is also good for your general health. Speak to your doctor or midwife about what type of exercise is OK for you during pregnancy. Walking, swimming or pregnancy yoga may be good options. If your doctor or midwife gives you the OK, aim for at least 150 minutes of moderate exercise a week. It’s also recommended to include strength exercises at least 2 days a week.

• Take medication. If your doctor prescribes you medication for your gestational diabetes (usually tablets (metformin or insulin in the form of injections) to help control your blood sugar levels, remember to take it at the recommended times and monitor your blood sugar levels. It’s also helpful to keep a log of your blood sugar levels to show to your doctor and midwife at each appointment.

It can be upsetting to find out you have gestational diabetes, and you probably have many questions. But keep in mind your healthcare team will be available to answer your concerns and provide the best care for you and your baby.

How to Prevent Gestational Diabetes

If you’re planning to get pregnant soon or you’re in the early stages of pregnancy, there are some practical steps you can take to help prevent gestational diabetes. Adopting healthy habits before becoming pregnant may help reduce the risk, but there are no guarantees. If you can, eat a healthy diet recommended for gestational diabetes mellitus, exercise regularly and lose any excess weight well before you conceive.

Effects of Gestational Diabetes on Your Baby and Pregnancy

Most pregnant people with gestational diabetes will go on to have healthy babies. However, if your gestational diabetes is untreated or not carefully controlled and monitored by your doctor, it may lead to complications. These are some of the possible risks and effects of high blood sugar during pregnancy on your baby’s health and your pregnancy:

• Excessive weight gain for your baby. The increased glucose in your blood means more sugar is passed on to your baby, leading to your baby becoming too large. This can cause complications or injuries at birth. 

• Increased risk of preterm birth. While the average week of delivery with gestational diabetes is generally around weeks 38 to 40, in some cases – due to uncontrolled blood sugar levels or the health of the baby – the doctor may recommend inducing labour before the due date. 

• Low blood sugar level (hypoglycemia)

• Jaundice

• Developing type 2 diabetes later in life

• Being overweight or obese later in childhood.

Delivery of a large baby may often involve

• Labour difficulties

• Increased chance of caesarean section

• Heavy bleeding after delivery

• Tears in the vagina or the area between the vagina and the anus (perineum) in the case of a vaginal birth.

Gestational diabetes also increases your risk of

• High blood pressure and preeclampsia (a high blood pressure disorder) during pregnancy

• Type 2 diabetes.  Blood sugar levels should return to normal soon after giving birth but there is a higher risk of developing type 2 diabetes later in life. The good news is that eating a healthy, balanced diet, exercising and getting to your ideal body weight after delivery helps lower this risk. Avoid a strict weight-reducing diet during pregnancy and breastfeeding. For more advice, consult your doctor. 

Some people may have had a mild form of diabetes before becoming pregnant without realizing it. For these people, diabetes may be a lifelong condition that may not go away after giving birth.

The Bottom Line

Gestational diabetes, a form of diabetes that develops during pregnancy, is primarily caused by hormonal changes that affect how the body processes blood sugar. While it can pose risks for the pregnant person and baby, such as increased chances of high blood pressure and the need for caesarean delivery, managing the condition through diet, exercise and medical oversight can lead to a healthy pregnancy and delivery. If you have been diagnosed with gestational diabetes, you should work closely with your doctor and midwife to monitor and manage your blood sugar levels to ensure the best outcome for yourself and your baby.

_{How We Wrote This Article The information in this article is based on expert advice found in trusted medical and government sources, such as the National Health Service (NHS). You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.}