Gestational diabetes (GDM) is a type of diabetes that occurs during pregnancy and affects 5-10 percent of pregnant women (Diabetes Australia 2023). During pregnancy your placenta produces hormones to help the baby grow. These hormones can block the action of insulin in your body, thus leading to increased blood glucose levels. Testing for gestational diabetes via a glucose tolerance test should be taken at 24-28 weeks pregnant, those with a predisposition should be tested earlier. Women who have gestational diabetes can continue to have a healthy baby, but it is important that they manage their condition to reduce the risk of complications. Gestational diabetes can increase the need for caesarean sections or interventions required at birth. It is important to talk to your doctor or obstetrician about how this may affect your birth plans.
Risk factors for GDM include:
- Previous history of GDM
- Older than 40 years of age
- Family history of type 2 diabetes OR a mother or sister than had GDM
- Increased BMI
- History of PCOS
- High blood pressure
- Sedentary lifestyle
- Currently taking anti-psychotic or steroid medications
What Happens if I have GDM?
It should be said that women who have gestational diabetes can continue to have a healthy pregnancy and baby (Diabetes Australia 2023). GDM can be managed with:
- Health eating
- Regular physical activity
- Monitoring blood glucose levels
You won’t be alone, you’ll be working with your diabetes health care team including: obstetrician, diabetes educators, dietitians, physiotherapists, GP’s and midwives.
What’s the treatment for GDM?
Typically, GDM can be managed with:
- Healthy eating
- Physical activity: 20-30 minutes of moderate intensity exercise 3-4 times a week
However, people who have “insulin resistance” where the body no longer responds to the action of insulin on your body may require:
- Medications OR
- Insulin injections
This is a conversation that will be had between you and your GP.
Is Baby going to be ok?
Women who have GDM, their babies can be affected in these ways:
- Macrosomia (larger birth weight)
- Increased risk of developing type 2 diabetes later in life
- Preterm delivery
- Increased need for interventions at birth
- Shoulder dystocia
- Need for NICU and have longer stay times in hospital (Crowther CA etal 2005)
Typically, women with gestational diabetes will no longer have diabetes after the baby is born. You are however at an increased risk of developing type 2 diabetes later in life. Depending on your risk factors it is recommended to follow up every 1-3 years with your doctor to monitor your glucose levels.
Next week we’ll be discussing the exercise guidelines surrounding gestational diabetes and how physiotherapy can help you through your pregnancy journey. It is always important to speak with your GP if you have any concerns related to you and your pregnancy.
Until next time,
Courtney
References
Diabetes Australia https://www.diabetesaustralia.com.au/about-diabetes/gestational-diabetes/
Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–2486. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515443/