What is gestational diabetes?

Diabetes is when there is higher than normal amount of glucose in the blood.  Gestational diabetes is a temporary form of diabetes that begins in later pregnancy & usually goes away after you have had your baby. More rarely, diabetes may have been present for some time but is first detected when you are pregnant.

There are two main reasons gestational diabetes happen;

• extra hormones produced during pregnancy work against insulin so your body needs more insulin to do its job.
• some women may not be able to produce enough insulin to cope with the body’s increased demands.

In 2018, 8% pregnant women in the Northern Trust developed gestational diabetes.

You are at risk of gestational diabetes if you;

• have had gestational diabetes in previous pregnancy
• have a family history of diabetes (parent, brother, sister with diabetes)
• previously had a baby >4.5kg
• are of South Asian, Middle Eastern, African or Afro-Carribean origin
• have a BMI >30
• have extra fluid around your baby
• have one episode of glycosuria 2+ or above on 1 occasion or 1+ of glycosuria on two separate occasions
• are carrying “large for gestational age” baby

If you have any of these risk factors, we will recommend you are tested for gestational diabetes.

Blood glucose levels may be controlled by changing your diet to reduce sugars & doing more exercise. If that is not enough, tablets and/or insulin treatment will help control your blood glucose levels.

Risks of some complications in pregnancy are increased for both the mother & baby.

Mother’s risks include:

• increased risk of caesarean section
• high blood pressure
• developing diabetes in later life

Risks to the baby include:

• growing too big, >4.5kg
• difficult delivery due to baby’s size
• breathing difficulties after birth
• low blood sugar in first 48 hours
• may need transfer to neonatal unit
• becoming obese later in life
• small risk of stillbirth

Antrim maternity unit has a team of midwives, diabetes nurses and doctors who will help care for you and your baby. This means that more of your antenatal care will happen at hospital – where the diabetic team are based – and your progress during pregnancy will be monitored more closely. Extra antenatal checks & scans will be needed to monitor your baby’s growth.

If you require a glucose tolerance test you need to do the following;

1. fast from 12 midnight on day of OGTT (drinks of water permitted)
2. following verbal consent a venous blood sample will be taken for fasting blood sugar
3. 75g oral glucose dissolved in 250 to 300mls water or the Rapilose OGTT pre-made solution is given and is to be consumed in no more than 5 minutes followed by a further 100mls water
4. rest and refrain from smoking for two hours
5. a further venous blood sample for glucose estimation must be taken at one hour and two hours after consumption of the drink
6. there will be provision for a drink & snack following your test however if you cannot wait, please bring a snack with you. We advise you to have something to eat and drink prior to leaving the hospital.