Many of us will have heard of diabetes; the inability for the body to control and use glucose in the blood properly for energy, and know that it has some impact on the lifestyle and diet of those diagnosed. During pregnancy, the risk of developing a specific form of diabetes, called gestational diabetes increases, resulting in changes to lifestyle and diet being necessary.

What is Gestational Diabetes?

Gestational diabetes is normally identifiable during the second or third trimester and occurs mainly when the body cannot produce enough insulin to meet the extra needs of pregnancy and your growing baby (Diabetes UK, 2008). It can result in blood glucose levels becoming dangerously high or low, potentially impacting on the health of you and your unborn baby. It is sometimes diagnosed during the first trimester, however it is likely in these cases that diabetes existed before the woman conceived.

How do I know if I Have Gestational Diabetes?

Following a healthy lifestyle normally, and during pregnancy will mean that you are in tune with any changes that may occur to your body. Common symptoms of diabetes include being thirstier than normal and therefore needing to go to the toilet more often, and being tired. However these symptoms can be common in a normal pregnancy too. Generally speaking, the risk factors that increase your risk of developing gestational diabetes are the same risk factors for developing type 2 diabetes, including being obese (a body mass index of over 30 kg/ m²), being of South Asian, Black Caribbean or Middle Eastern origin, or there being anyone within your immediate family who has been diagnosed with type 2 diabetes.

Additional factors that may increase the likelihood of you developing gestational diabetes, specific to pregnancy however, include a past history of gestational diabetes, a previous child with a birth weight of 4.5 kg or over or having had experienced an unexplained neonatal death or stillbirth previously. If you display any of these risk factors, you should be offered a test for gestational diabetes, or if you are concerned you can ask for an Oral Glucose Tolerance Test.

The test for gestational diabetes is straightforward and involves two small blood tests, one before breakfast and one two hours after you have been given a drink with glucose in. The test identifies how much glucose there is in your blood after the drink to see how well your body uses glucose.

What should I do if I have Gestational Diabetes?

If you are diagnosed with gestational diabetes, don't worry; the majority of the time, women can control their blood glucose levels by making changes to their diet. If this is not the case, tablets or insulin may be given to you to help, however this is only the case in 10 – 20% of cases (NICE Diabetes in Pregnancy, 2008). Either way lots of specialist care will be available to you to support you and help you with any worries or concerns you may have; a Diabetes Nurse and a Dietitian may be part of this team. They will give you specialist advice to help you manage your gestational diabetes.

Why do I need to make Changes?

It is important from diagnosis to control your blood glucose levels as best as possible, through following the specialist advice given to you. The longer your blood glucose levels are uncontrolled or poorly controlled for, the greater risk to yourself and your baby. Having poorly controlled gestational diabetes can mean that your baby will grow larger in the uterus, meaning that childbirth may be more difficult for both of you, increasing your risk of emergency Caesarean. Evidence suggests that your baby may be at more risk of becoming overweight or obese as he or she grows older.

An increased risk of malformation or congenital problems can also be due to poorly controlled blood glucose levels, particularly affecting your baby's heart and lungs; however the risk of this reduces dramatically with well controlled blood glucose levels.

Will I have Diabetes forever?

About six weeks after you have had you baby, you will have another blood test to see if your blood glucose levels have returned to normal. In most cases, gestational diabetes is not permanent therefore any medication you may have had to take will not be necessary anymore. If you have made improvements to your diet and lifestyle during pregnancy, it is not necessary to stop these as well, as they will be beneficial to your overall health and wellbeing.

In a small amount of cases, diabetes will be permanent, usually if the individual had undiagnosed diabetes before pregnancy. In this case specialist support and advice will continue to help you manage your diagnosis. If you become pregnant again in the future, having previously had gestational diabetes will increase the likelihood of developing it again. A test will be offered to you again, and you will be monitored regularly to ensure the best blood glucose control.

The Future

You can reduce your risk of getting gestational diabetes, or developing type 2 diabetes in the future, by making simple changes to your lifestyle and following these tips.

• Aiming for a body mass index of 20 – 24.9 kg/m²
• Eating 5 different fruits or vegetables every day
• Reducing the amount of salt in your diet
• Cutting down on foods high in saturated fat and sugar
• Exercising for at least 30 minutes, 5 times a week