Diabetes is a condition where a person has too much sugar (glucose) in their blood. This increase in blood sugar happens because the hormone 'insulin', which normally moves the sugar from your blood to the cells of the body is not achieved effectively (insulin resistance). Gestational diabetes is a form of diabetes that occurs with pregnancy and usually resolves after birth. If you have gestational diabetes during pregnancy your caregiver will outline what further screening you will need in the months after birthing, to check that your diabetes has resolved.
A routine test for gestational diabetes is done at about 24-28 weeks of pregnancy, The Glucose Tolerance Test (GTT). You may find that your doctor or midwife asks you to test earlier than this if you have any risk factors for gestational diabetes. If gestational diabetes is diagnosed then your doctor or midwife may refer you to a specialised diabetes team. This team will ask you to monitor your blood glucose levels multiple times a day. This is done by using a small device to prick your finger, getting a drop of blood which then goes into a machine (Glucometre) to read the amount of sugar in your blood. The team will discuss diet, physical activity and body weight to help manage diabetes. If diet and exercise alone are unable to adequately control blood glucose levels then tablets or insulin injections may need to be used as well.
If the diabetes is managed well during your pregnancy and there are no other problems, most women will go to ‘full-term’ and await spontaneous labour. However some women with gestational diabetes may need to have their labour induced prior to their due date. If there are concerns that your diabetes is not well controlled or concerns about your baby’s size, you may have additional ultrasound scans during your pregnancy.
During labour an external heart rate monitor is used to continuously check your baby’s wellbeing, as well as regular monitoring of your blood sugar levels. After birth you will generally be told to stop taking any diabetes medication, but may be asked to continue monitoring your blood glucose levels. Your baby will be closely monitored to ensure their blood glucose levels remain stable and do not drop too low.
If you are intending to breastfeed it’s advisable to do this as soon as possible after birth. Immediate and uninterrupted skin to skin contact with you baby will prove helpful in supporting your first breastfeed. It is important that you expand your knowledge about early breastfeeding to give you and your baby the best chance of a positive experience.
