Up to 5% of women giving birth in England and Wales are affected, mostly with gestational diabetes, although some have type one or type two.
Gestational diabetes mellitus is any degree of glucose intolerance that starts (or is first diagnosed) during pregnancy and usually resolves itself shortly after the birth. In most cases, it develops in the third trimester (after 28 weeks), however, it can increase the risk of developing type two diabetes later in life.
If gestational diabetes is not detected and controlled, it can increase the risk of birth complications. It is, therefore, very important that it is recognised and managed appropriately.
Gestational diabetes is usually diagnosed during routine screening and often, it does not cause any symptoms at all. Some women are more at risk of developing the condition and it is more common in:
- certain ethnic groups (Asian, African American, Hispanic)
- women over the age of 25
- women with a previous family history of diabetes
- women who smoke
- women who are overweight or who have a high BMI before pregnancy
High blood glucose (hyperglycaemia) occurs because the body cannot use it properly. This is because the pancreas does not produce any insulin, or not enough to help glucose enter the body’s cells. This can cause some symptoms, including:
- being thirsty
- having a dry mouth
- needing to urinate frequently
- recurrent infections, such as thrush (a yeast infection)
- blurred vision
Although diabetes is a very common condition, complications arising from poor management can be very serious. If it is recognised at an intermediate stage, it can be treated effectively and your blood glucose (sugar) levels controlled throughout pregnancy, reducing the risk of problems.
Gestational diabetes may increase the risk of:
- placental abruption – the placenta starts to come away from the wall of the womb. This may cause vaginal bleeding and/or constant abdominal pain
- needing to induce labour – when medication is used to start labour artificially
- premature birth
- macrosomia – baby with an excessive birth weight
- trauma during the birth – to yourself and the baby as a result of excessive birth weight
- neonatal hypoglycaemia – your newborn baby has low blood glucose, which can cause poor feeding, blue-tinged skin and irritability
- perinatal death – the death of your baby around the time of the birth
- development of obesity and/or diabetes later in the baby's life
After you have given birth, any medication you were on to control your blood glucose will usually be stopped immediately and you will be tested about six weeks after delivery to make sure it has returned to normal. Your fasting blood glucose should be measured (after you have not eaten for eight hours – generally first thing in the morning) at this six-week postnatal check. Your weight and waist measurement may also be monitored and you should be given advice about diet and exercise.
This, or your HbA1c (a marker of your average blood sugar during the preceding three months), should then be measured at least once a year to check you have not developed type two diabetes.
It is important that you speak to your doctor if you are concerned that you may be suffering with gestational diabetes or about any of the potential risk factors. The earlier the condition is diagnosed or warning signs are recognised, the earlier the condition can be monitored and treated.