GDM or Gestational diabetes mellitus is a type of diabetes that occurs during pregnancy. Usually the diabetes will disappear after the pregnancy but in some cases it can continue. GDM is identified when a a woman’s blood glucose levels are higher than normal.
According to the Diabetes Australia, “gestational diabetes is the fastest growing type of diabetes in Australia, affecting thousands of pregnant women. Between 12% and 14% of pregnant women will develop gestational diabetes. It usually occurs around the 24th to 28th week of pregnancy. All pregnant women should be tested for gestational diabetes at 24-28 weeks of pregnancy (except those women who already have diabetes). Women who have risk factors for gestational diabetes should be tested earlier in their pregnancy”.
So What Increases Your Risk Factors for Diabetes
Many factors can increase your chances of developing gestational diabetes.
- older than 40 years of age
- family history of type 2 diabetes or a first-degree relative (mother or sister) who has had gestational diabetes
- above the healthy weight range
- a history of elevated blood glucose levels
- Aboriginal and Torres Strait Islander backgrounds
- Chinese, Southeast Asian, Polynesian, Melanesian, Indian or Middle Eastern
- history of gestational diabetes during a previous pregnancy
- previously had Polycystic Ovary Syndrome
- history of delivering a large baby (weighing over 4.5kg)
- taking some types of anti-psychotic or steroid medications
- rapid weight gain in the first half of pregnancy.
In some cases, gestational diabetes can occur randomly in women with no known risk factors.
How is GDM diagnosed?
To find out if you have gestational diabetes, you will need to undergo an oral glucose tolerance test (OGTT). You can have this done at a pathology lab. First you will need to fast overnight. Then the next day you will have a sample of your blood taken. The blood test will check your fasting blood glucose level. After this, you will be given a sugary drink and then have your blood tested again in one or two hours. During this time you will be asked to sit and wait for the results. Take a book or magazine along to pass the time while you wait. If your blood glucose level results come back greater than the normal range at your fasting, one or two hour test then you have gestational diabetes.
What Happens After Diagnosis?
It is normal to feel upset or emotional after being diagnosed with diabetes. Keep in mind though that the majority of women with gestational diabetes have a healthy pregnancy, normal delivery and a healthy baby. To keep on top of the diabetes you must follow a healthy eating plan, get regular physical activity and monitor and managing your blood glucose levels during pregnancy. In some cases medication (metformin) and/or insulin injections will be needed. You can read more about managing gestational diabetes at Diabetes Australia.
Don’t worry – you are not alone. You can work with your family, your doctor and other health professionals to keep you on track. Some professionals that may be able to assist you are:
- accredited practising dietitians
- credentialed diabetes educators
- accredited exercise physiologists
- your GP and
Why Does GDM happen?
During pregnancy, your placenta produces hormones to help your baby develop. These hormones can cause insulin resistance in the mother by blocking the action of the woman’s insulin. Your body needs about 2-3 times more insulin during pregnancy due to this resistance. However, if you are already predisposed to insulin resistance, then your body may not be able to cope with the extra demand for insulin production caused by pregnancy. This results in the mother’s blood glucose levels rising and a diagnosis of gestational diabetes.
The Importance of Diagnosis
It is very important to test for and treat gestational diabetes. It can be well managed and complications minimised as much as possible. Some complications that might occur are delivery of a large baby, miscarriage and stillbirth. A large baby can create the risk of injury at delivery, caesarean delivery, forceps delivery and a need for the baby to be looked after in special care until the glucose level stabilises after delivery. Other complications may include pregnancy loss and premature delivery. If any problems occur, the hospital will care for you and your baby.
Eating well with gestational diabetes
Diet is so important in managing gestational diabetes. It can maintain blood glucose levels within the target range advised by your doctor as well as assisting with weight changes during pregnancy. Your pregnancy diet should focus on providing excellent nutrition for you and your growing baby.
Risks of Developing Further Diabetes After Pregnancy
In most cases, the maternal blood glucose levels will return to normal levels after the birth of the baby. Unfortunately there is an increased risk of the mother developing type 2 diabetes in the future. The baby also has a higher risk of developing type 2 diabetes later on life. If you are at higher risk, you will need to be tested for type 2 diabetes every one to three years. Speak to your doctor for further information or go to Diabetes Australia.