Gestational diabetes: what you need to know

Pregnancy sends an expectant mother’s hormones out of whack. The body focuses fully on the baby’s growth. These hormonal changes result in an increased need for insulin. If the expectant mother’s pancreas is unable to produce this level of insulin, this can result in what is known as gestational diabetes. It occurs in 5 to 10% of all pregnant women, making it one of the most common complications of pregnancy.

Gestational diabetes refers to high blood sugar levels in women during pregnancy. This often occurs in the second trimester and can also affect those who do not suffer from diabetes outside of pregnancy. During pregnancy, more glucose (sugar) is released in order to give the body the energy it needs. At the same time, the pancreas produces more insulin to reduce the concentration of sugar in the blood. In some pregnant women, the pancreas can’t handle that extra load, causing an insulin deficiency. However, some people find their pancreas can boost its insulin production, but their cells do not react to this stimulus, so their blood sugar level cannot be lowered.

Gestational diabetes usually doesn’t cause any symptoms. This means those who have it often don’t notice. That’s why a glucose tolerance test is carried out between weeks 24 and 28 of pregnancy as standard. The expectant mother must drink a sugar solution on an empty stomach within a few minutes. The doctor will take a blood sample one hour and two hours later and measure the blood sugar level. They then compare this with the fasting blood sugar level. If the blood sugar level exceeds a specific value, women are diagnosed as having gestational diabetes.

Most women with gestational diabetes display one or more risk factors. These include:

• Overweight
• Poor diet
• Diabetes mellitus in the family
• Gestational diabetes in previous pregnancies
• Being over 30 years of ageA history of multiple miscarriages
• Taking corticosteroids 

Have you been diagnosed with gestational diabetes? Your gynaecologist will refer you to a diabetes specialist. They will discuss what to do next. The initial focus will be on diet and nutrition. You should eat less fat and more protein. Generally, you should reduce your carbohydrate intake, and eat higher-value carbohydrates. Gestational diabetes usually responds well to a balanced diet.

Make sure you get enough exercise, too. Gentle forms of exercise like swimming are suitable. Specific courses are also available for pregnant women. If you exercise enough, your cells are better equipped to absorb insulin and break down sugar.

Your blood sugar levels will be checked regularly. Insulin treatment may be required if your blood sugar level remains permanently high despite a healthy diet and exercise.

Gestational diabetes must be well-monitored and treated. A persistently high blood sugar level during pregnancy leads to an increased supply of glucose to the baby. The baby seeks to reduce its blood sugar level by producing more insulin. This leads the baby to grow bigger than it otherwise would. This gain in weight increases the likelihood of birthing complications, premature birth or a caesarean section. 

In most women, gestational diabetes usually goes away by itself shortly after they give birth. Another blood sugar level test is carried out six weeks following the birth to be on the safe side. After that, a yearly check is sufficient.

Once your child is born, their blood sugar will be checked more often and their nutrition observed more closely. Regular and adequate nutrition is important until the newborn’s metabolism has adjusted. Midwives, specialist carers and pregnancy specialists will help you.

Shortly before giving birth, pregnant women with diabetes can express their first milk (colostrum) and freeze it. This additional milk can then be given to babies after they are born if necessary.

For more information, contact your birthing centre or breastfeeding specialist.

The organisation “diabetesschweiz” has more useful information on gestational diabetes.