Will Gestational Diabetes Go Away After Pregnancy
Most womens blood sugar levels come down after they give birth and hormone levels return to normal. But about 50% of women with gestational diabetes develop Type 2 diabetes later in life. Diet and exercise can help lower your risk. Your healthcare provider may recommend blood glucose tests every six to 12 weeks after pregnancy to watch for diabetes.
What Happens Once Youre Diagnosed With Gestational Diabetes
Its important that blood glucose levels are controlled during pregnancy to reduce long-term effects for mother and baby.
A monitor is used to check glucose levels, usually each morning and 1-2 hours after each main meal. Stephs GP taught her how to monitor her blood glucose levels using a finger prick test. I tested first thing every morning and then an hour after each main meal, says Steph. At first, I was told just to record what I ate and what my blood glucose levels were, and not worry too much about the numbers.
A team of health care providers will help manage GDM and an Accredited Practicing Dietitian will be able to provide information on what to eat and physical activity that will help keep blood glucose levels in the target range.
Steph had a group appointment at the hospital with a Diabetes Educator and a Dietitian where they talked a small group of expecting mums through more detailed recommendations. They talked in more detail about exactly what types of foods we should eat and when, and what should be avoided, says Steph.
A diabetes management plan is personalised for each pregnancy. Steph monitored and recorded her blood glucose levels and food intake for a week before meeting with a specialist who looked at the data and gave her personalised advice on what worked for her body.
How Gestational Diabetes Can Affect You
As mentioned above, gestational diabetes often comes with no symptoms, so you probably wont know that you have it until the doctor diagnoses it. However, gestational diabetes can still have an effect on you.
Gestational diabetes can increase your risk of high blood pressure while youre pregnant. Also, you may have a larger baby, which can make delivery difficult or require a C-section.
Gestational diabetes can also put you more at risk for developing type 2 diabetes later in life.
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Q What If I Need Insulin
A. For some women, diet and exercise will not be enough to bring their blood glucose into the required range. If this is the case, you will probably need to have insulin injections.
Based on what times of day your blood glucose readings are high, members of your health team will advise you when you should inject insulin. If your glucose levels are staying high after a meal, you will probably be advised to inject short-acting insulin before meals.
In some women, oral diabetes medicine may be given, sometimes in combination with insulin, to treat gestational diabetes.
Is There Anything I Should Be Afraid Of
If gestational diabetes is diagnosed and treated effectively, there is little risk of complications. In such cases, women with gestational diabetes can have healthy babies, and diabetes should disappear after delivery.
However, if it is not treated, effects on the mother and baby can include:
- Large birth weight -those who weigh 9 pounds or more are more likely to become wedged in the birth canal, have birth injuries or need a cesarean delivery.
- Premature delivery an early delivery may be recommended because the baby is large.
- Respiratory distress syndrome babies born early to mothers with gestational diabetes may experience Serious breathing difficulties.
- Low blood sugar sometimes babies of mothers with gestational diabetes have low blood sugar shortly after birth. Severe episodes of hypoglycemia may cause seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the babys blood sugar level to normal.
- Obesity and type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
- Stillbirth. Untreated gestational diabetes can result in a babys death either before or shortly after birth.
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How Are Medications Used To Treat Gestational Diabetes
Women with GDM are taught to check their blood sugars after meals using the finger stick glucose machine. This may sound scary but actually, after a short time, it will become simple and second nature.
Furthermore, if your sugars stay controlled you may not have to test your sugar after every meal. If you and your doctor find that your sugars are not controlled with diet alone you will need to be started on medication.
There are two types of medications used to treat gestational diabetes: oral and injectable. For oral treatment, a medication called glyburide is typically used. This is taken once or twice a day and has few side effects. It does not cross the placenta in big amounts so does not affect the baby.
Some physicians prefer to use insulin injections or will switch to insulin if the oral medications are not working well enough. Insulin is self-injected two to four times per day. Again, though a little daunting at first, soon it will seem simple and routine.
Large randomized studies have shown that diligent treatment of GDM leads to fewer abnormally large babies, fewer shoulder dystocias, less neonatal hypoglycemia, fewer Cesarean sections and less high blood pressure in pregnancy. There is some data to suggest that treating GDM leads to less fat cells in infants and possibly less tendency toward obesity during that babys childhood and adult life.
Medications For Gestational Diabetes
Its possible that even after changing your eating habits and exercise routine, your blood sugar levels will continue to remain too high during pregnancy. This is not your fault, just as developing gestational diabetes in the first place was not your fault. Continue to work with your doctor to get your blood sugar levels under control. Doing so will ensure the best outcomes for your pregnancy.
The preferred medication for gestational diabetes is insulin. Insulin does not cross the placenta, so you dont need to worry about it harming your baby. Because blood sugars can fluctuate during different stages of pregnancy, youll probably be advised to monitor your levels at home to maintain the correct dosage. Dont worry, your doctor will walk you through the process each step of the way.
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Q Will I Have To Monitor My Blood Glucose Levels
A. Self-monitoring of your blood glucose levels is the best way of knowing whether you have achieved good control of your blood glucose levels. Usually you will be advised to take fasting measurements as well as measurements one to 2 hours after you have eaten. You should record all your results in a home glucose diary.
Measuring your blood glucose levels should be done 4 times per day to start with. If your blood glucose levels are well controlled, you may be able to start measuring your levels less frequently.
Monitoring of your blood glucose is done using a blood glucose meter. To get a drop of blood for monitoring, your finger is pricked with a special device. There are several different types of these devices available and they aim to make it as easy and as painless as possible.
Whos At Risk Of Gestational Diabetes
Any woman can develop gestational diabetes during pregnancy, but youre at an increased risk if:
- your body mass index is above 30 use the healthy weight calculator to work out your BMI
- you previously had a baby who weighed 4.5kg or more at birth
- you had gestational diabetes in a previous pregnancy
- 1 of your parents or siblings has diabetes
- you are of south Asian, Black, African-Caribbean or Middle Eastern origin
If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy.
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Q What Are My Chances Of Getting Gestational Diabetes Again In A Later Pregnancy
A. Once youve had gestational diabetes, the chance of you having it again in any future pregnancy is increased. In future pregnancies, its recommended that you have early testing for gestational diabetes and testing again at the usual recommended time if the first test was normal.
Following a healthy diet, getting regular physical activity and maintaining a healthy weight will help to reduce your chance of developing gestational diabetes again.
More Than One Test May Be Needed For Diagnosis
There are a couple of tests used to determine whether a woman has gestational diabetes. The first is called a Glucose Challenge Test. Depending on the results of this first test, a second test called a Glucose Tolerance Test may be necessary.
For the glucose challenge test, you do not need to fast before the appointment. There are two steps for this test:
- At the beginning of the appointment, youll be given about five ounces of a glucose solution to drink. The solution is syrupy and some women may find they do not like the taste.
- You stay in the office or lab setting for an hour to wait to have your blood tested. After the hour is up, blood is drawn from a vein in your arm. The blood will then be tested to see your blood sugar level.
If your blood sugar is too high , you might have gestational diabetes. To confirm the diagnosis, you will need to have a different test done.
The second test will be a glucose tolerance test. This test differs from the glucose challenge test in several ways even if the general idea is the same. For example, the glucose tolerance test takes three hours instead of just one and you must fast before the appointment. Then the process is as follows:
- A blood sample is taken at the beginning to determine fasting blood sugar.
- You will drink about eight ounces of the glucose solution.
- Your blood glucose level will be tested again one, two and three hours after you drink the solution.
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Using Insulin During Gestational Diabetes
Your doctor may prescribe insulin injections during gestational diabetes to help manage blood sugar. Your doctor may suggest that you eat at regular intervals and base your insulin timing and dose around meal times and amount of carbohydrate. Your prenatal appointments may become more frequent, and your doctor may have you monitor your blood sugar at home.
How Can I Reduce My Risk Of Type 2 Diabetes
Women who have gestational diabetes have a high chance of developing type 2 diabetes at some point later in their lives. However, type 2 diabetes can be prevented. The following steps can reduce your risk:
- maintain a healthy eating plan
- maintain a healthy weight for your height
- do regular physical activity
- have regular follow-up blood tests every one to three years to check your blood glucose levels, especially if you may have further pregnancies.
Talk to your doctor about follow-up blood tests to check for diabetes. The frequency of the tests will depend on your risk for developing diabetes.
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What Does This Mean For Me And My Baby
If you have gestational diabetes, it means your glucose levels are too high. Only pregnant women can get gestational diabetes. And roughly 1 in 20 women do get it during their pregnancy. When you are pregnant, your baby shares your bloodstream. So, if the glucose levels in your bloodstream are a little too high, then your babys glucose levels are also high. In order to counteract these high glucose levels, your babys developing pancreas will work harder to produce more insulin to even things out. This means your baby is getting more calories than they need. And it means they will grow bigger than normal. This could lead to a C-section, traumatic birth or early delivery. After your baby is born and begins using their own bloodstream, rather than depending on yours, the doctor will test your babys blood sugar to make sure everything is okay.
What Is The Initial Treatment For Gestational Diabetes
A carbohydrate controlled diet is the cornerstone of the treatment of gestational diabetes. This diet limits the patient to no more than 40% of calories from carbohydrates, 20 % from protein and 40% from fat. It is important to note that a GDM diet is not for weight loss. All pregnant women should gain some weight during pregnancy even if they are overweight, to begin with.
Usually, the patient consults with a dietitian or diabetes nurse and is prescribed a meal plan with breakfast, lunch, and dinner plus two or three snacks. Watching carbs in a diabetic diet is not like watching calories when you are trying to lose weight. There you can restrict your calories during the day to compensate for the big dinner you are planning to have.
With diabetes, the number of carbs must be the same at every meal every day. Complex and high fiber carbs are better than sugary drinks and foods because they are metabolized slower and dont cause high spikes in blood sugar. Moderate exercise also helps control blood sugar. Check with your doctor to see what kind of exercise is appropriate for you.
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How Is Gestational Diabetes Managed After Pregnancy
Research has shown that women with gestational diabetes have a 3 to 7 percent chance of developing type 2 diabetes within five to 10 years which is why its so important to make those healthy habits routine during pregnancy and keep a check on your health even after your pregnancy is over.
Here are a few ways to stay healthy after baby is born:
Who Gets Gestational Diabetes And Why Do I Have To Be Tested
Approximately 2-5% of pregnant women develop gestational diabetes this number may increase to 7-9% of mothers who are more likely to have risk factors. The screening for this disease usually takes place between your 24th and 28th week of pregnancy.
Doctors test for gestational diabetes during this time because the placenta is producing large amounts of hormones that may cause insulin resistance. If the results indicate elevated levels, further testing would be done to confirm a gestational diabetes diagnosis.
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Gestational Diabetes Test: The Aftermath
Like I said earlier, some women struggle to keep the drink down. This is rarer though- youll probably keep it down just fine. But that doesnt mean you wont have side effects!
I felt pretty shaky and had a pretty crazy sugar rush for a couple of hours. You may feel a little sick or nauseous after drinking it. Dont feel bad if you need to take some time off! Either way, the side effects arent too bad and youll feel better in no time.
After you get your blood drawn and the test is over, youll typically hear your results in a couple of days. More likely than not, youre all clear!
Symptoms Of Gestational Diabetes
Gestational diabetes does not usually cause any symptoms.
Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.
Some women may develop symptoms if their blood sugar levels gets too high , such as:
- needing to pee more often than usual
- a dry mouth
- tiredness
But some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you’re worried about any symptoms you’re experiencing.
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Can You Prevent Gestational Diabetes
In the UK, approximately 16 out of every 100 pregnant women will develop gestational diabetes. Some women have a higher risk of developing it. You cant prevent it but there are some things you can do to reduce your risk. This includes managing your weight, eating healthily and keeping active before pregnancy.
Tips For Women With Gestational Diabetes
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Oral Glucose Tolerance Test
The oral glucose tolerance test is routine for all pregnant women. It is far from definitive, so don’t worry if you get a call that you need to come back for a follow-up test.
When it’s Done: During weeks 24 through 28 of pregnancy, or earlier if you have any risk factors.
How it’s Done: There is little you can do to prepare for this test. During the test, you will drink a sugary beverage containing 50 grams of glucose. Your doctor will draw your blood one hour later to see how efficiently your body processes the glucose. Some women may feel nauseated from the sugary beverage.
What Your Results Mean:If your one-hour plasma glucose level is greater than or equal to 140 milligrams per deciliter of blood some doctors place the cutoff at 130 mg/dLgestational diabetes is suspected and further testing is recommended. If your one-hour plasma glucose level is less than 120 mg/dL, you likely do not have gestational diabetes.