Gestational Diabetes

Dr Ken Law
11:30 pm

Gestational Diabetes

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World Diabetes Day took place on Tuesday this week, and there was a resounding urgency to raise further awareness of gestational diabetes which can occur in pregnancy – with one in seven births affected. A large number of women that develop Gestational Diabetes go on to develop type 2 diabetes in later life. My post below explains gestational diabetes (GDM) in more detail. What is Gestational Diabetes? In a previous post I explained that when a woman is pregnant, her body requires two to three times more insulin than when she is not pregnant. Gestational diabetes occurs when the body is not able to produce this increased insulin, leading to higher glucose levels than normal, as the action of insulin in the body is to reduce glucose levels. During your pregnancy at around 24-28 weeks you will have a Glucose Tolerance Test (GTT) to ensure your blood glucose levels are not higher than normal. If the glucose levels are abnormal, then it is at this stage that your obstetrician will diagnose gestational diabetes. Problems can arise in the pregnancy if gestational diabetes is not diagnosed and managed properly.  It can lead to problems with the baby’s growth (usually leading to big babies, but sometimes there can also be growth restriction, leading to small babies), and the risk of stillbirth is increased in mismanaged or undiagnosed gestational diabetes. What happens if I am diagnosed with Gestational Diabetes? If you are diagnosed with gestational diabetes, the best way to manage it is with help from your Obstetrician, dietitian and diabetic educator, and your doctor who will provide you with help to manage your gestational diabetes. Daily management Blood glucose level monitoring It is extremely important to monitor the blood glucose levels during pregnancy once gestational diabetes has been diagnosed. This usually involves checking the blood glucose levels 4 times per day – before breakfast, and then two hours after each main meal (breakfast, lunch, dinner). The current targets for blood glucose levels are: Fasting (pre-prandial) <5.1 mmol/L 2 hours after meals (post prandial) <6.8 mmol/L The targets are stricter than the targets used for […]

Gestational Diabetes in Pregnancy

Gestational diabetes affects up to 5% of expectant mothers and is marked by blood glucose levels that are higher than they should be. This form of diabetes most often arises around the 24th week of pregnancy and most women will cease to have it after giving birth. Some women can develop diabetes earlier in pregnancy.  A Glucose Tolerance Test (GTT) is recommended in all pregnancies at 26 to 28 weeks.  In addition, if you are at increased risk of having gestational diabetes, an early GTT is performed at 12 to 16 weeks. Risk Factors for Gestational Diabetes Some women are more at risk than others of having gestational pregnancy. For example, being over 30 or overweight can increase your chances. If you have a family history of type 2 diabetes (or if you have a personal history of gestational diabetes), your risk is also higher than average. Women of certain ethnic backgrounds (including Aboriginal, Torres Strait Islander, Polynesian, Chinese, Melanesian and Vietnamese) are also more at risk. The Cause for Gestational Diabetes When you are pregnant, your placenta creates the necessary hormones to help your baby develop. However, these same hormones can also counteract your regular insulin production. This insulin resistance is what can lead to gestational diabetes. How to Manage Gestational Diabetes As with standard diabetes, the key steps to take are: Improving your diet Exercising regularly Regular monitoring of the blood glucose levels Diabetic educator review Dietitian review Regular reviews with your obstetrician. In some cases, a medication called Metformin may be prescribed, and sometimes insulin injections may be required. If you’re concerned about gestational diabetes, our clinic can help put your mind at ease. Book a consultation with us today by calling 1300 464 464. We can answer any questions or concerns you have and help you prevent or manage gestational diabetes during your pregnancy. Dr Ken Law is a Brisbane Obstetrician specialising in the management of pregnancy and delivery.  For more information and to discuss your specific situation, please contact Dr Ken Law to arrange a consultation at Greenslopes Obstetrics and Gynaecology.

Greenslopes Obstetrics and Gynaecology