I absolutely loved being pregnant but amongst the wonderful memories of when I was an expectant mother there are flashbacks of nausea/sickness, constant exhaustion and despite my sweet tooth, I had to deal with the restriction of sugary and high GI foods due to a diagnosis of gestational diabetes.
This was SO not fair, especially when similarly pregnant friends are scoffing chocolate and loading up on pizza…it’s cravings…it’s the only time you can really get away with it…*sobs*
I was pregnant over the christmas/new year periods as well so goodbye festive choccies and xmas cake! 🙁
What is gestational diabetes?
As your pregnancy progresses, hormones produced by your baby’s placenta make your body less responsive to insulin to allow the necessary levels of glucose to be passed to your baby.
In a normal pregnancy, the body will make extra insulin to deal with this temporary change but gestational diabetes occurs when your body cannot meet this new quota.
Due to the lack of insulin, your blood sugar levels will rise and, if left untreated, this can cause problems for both you and baba.
When is gestational diabetes diagnosed?
If certain risk factors are identified, you are likely to be tested for gestational diabetes at around 28 weeks in to your pregnancy.
A glucose tolerance test (GTT) will be conducted at your local hospital or GP surgery and you will be asked not to eat or drink anything (except water) for 8 – 12 hours before the test is completed (usually overnight).
2 hours before the test, you will be asked to make up a sugary solution at home (powder and instructions to be provided to you beforehand) and you will need to drink this over a period of no more than 5 minutes.
It is important that you are tested at the correct time (i.e. 2 hours later) and it’s just a simple blood sample that is needed.
Often, you will be able to wait around for the results but sometimes you will be asked to carry on with your day as usual and wait to be contacted when the sample has been tested.
If this shows that your blood sugar levels are above 7.8, it is likely that you will be diagnosed with GD and referred for specialist advice as to the next steps.
I was diagnosed at 28 weeks and was tucking in to my Mum’s amazing strawberry cheesecake when I got the call that my reading was 8.1 🙁
I cut down on all of my sugars for the weekend until I was seen the following Monday.
At this time, they did say that I was possibly ‘borderline’ due to my reading being just a few decimals above the normal limits.
However, it turned out that this was definitely NOT the case so girls, even if your levels are only slightly up, please make sure that you take the advice provided seriously.
What are the risk factors?
- An existing diagnosis of Polycystic Ovary Syndrome (as this itself can often cause some degree of insulin resistance);
- A high BMI;
- A family history of diabetes;
- You have previously given birth to a larger baby (approx 10lbs+);
- You had gestational diabetes in a previous pregnancy (if so, your Doctor should arrange for you to be tested again, for this subsequent pregnancy, at an earlier stage of gestation);
- You have South Asian origins.
I was diagnosed with PCOS when I was only 16 and at the time of my pregnancy, my BMI was also above the recommended figures.
I was, therefore, offered the test as routine following initial questions from my midwife during my booking appointment at 8 weeks.
If any of the above apply to you, it might be worth making enquiries with your midwife to see whether you should be screened for the condition, just to be on the safe side.
What are the symptoms?
Gestational diabetes is often symptom-free but you may find that:-
- You have a dry mouth and/or are very thirsty;
- You need to empty your bladder more frequently than expected;
- You suffer from recurring infections (i.e. thrush -> this is the most common infection contracted during pregnancy);
- You are always very tired
- You have experienced blurred vision.
Of course, we all know that constantly needing a bloody wee and being absolutely knackered is to be expected in pregnancy so don’t worry too much if these points ring a bell with you!
How is gestational diabetes treated?
It is likely that you will be assigned to a specialist consultant who will handle your care until the end of your pregnancy and you may also be offered ultrasound scans every 2-4 weeks until your baby’s birth.
You will also be given a small test kit to monitor your blood sugar levels at certain intervals (to be discussed with your midwife/consultant).
This consists of a meter, lancets, pricking device and testing strips.
You will be shown how to use the machine but the gist of it is that you load the lancet (small needle) in to the pricking device and set it to the desired level (this depends on how soft your fingertips are), prick your finger and hold it below your heart until a small drop of blood appears, touch the blood to a testing strip which you should have pre-loaded in to the machine, wipe the remaining blood away with a tissue and wait for your sugar level reading to appear.
It sounds quite long-winded but once you get the hang of it, it takes seconds!
I was told to wash my hands before testing with water only (no soap) as hand wash sometimes contains sugars which may tamper with the readings so that’s something to bear in mind.
You will be told what your target blood sugar levels will be and how often to take readings.
I was asked to take a fasting reading before breakfast, a reading 1 hour after breakfast and then another reading 1 hour after lunch and another 1 hour after tea.
My targets were a fasting level of no more than 5.6 and daytime levels of no more than 7.8.
In the first instance, you will usually be asked to make changes to your diet to try and keep your blood sugar levels stabilised.
This involves switching to low-GI foods (slow-burning) such as porridge, brown rice, proteins etc. You should be referred to a dietician who will make a personalised plan with you.
You should also be advised to try and do some light exercise such as walking after a meal as this can also help to keep your levels balanced.
If a change in diet isn’t working as well as it should, you may be given insulin to try to artificially bring down any high sugar levels.
The insulin provided is usually in the form of a pen device that can be carried around with you and used as needed.
Again, you will be shown how to use this medicine and you will also be made aware of any signs/symptoms to look out for which may indicate that your blood sugar levels are too low as this can happen sometimes with the use of insulin (it goes too far the other way!) You will be provided with a small packet of Dextrose sweets (or similar instant glucose) to carry around with you incase this does happen.
You may also be offered metformin tablets (instead of insulin) to control your sugar levels.
Despite initial success with the diet approach, it became apparent that my after-breakfast glucose level could not be controlled in this way, even though I had stuck so rigidly to the strict eating plan provided.
I was prescribed insulin to be injected after breakfast and also to adjust down any other high readings should they occur throughout the day.
The only thing I could eat that wouldn’t send my breakfast reading through the roof was scrambled eggs! Every day. Urghhhh.
You will be shown how to inject the insulin by a trained professional before the prescription is given to you.
What about the birth of my baby?
If your blood sugar levels stay within normal levels you can usually wait for labour to start naturally (woo-hoo!) although it is often advised to induce labour after 38 weeks of pregnancy to avoid any complications.
If your baby is very large at this stage, you may be offered a c-section instead.
In any event, it is strongly recommended by the NHS that you have a hospital birth to ensure that you and baby are closely monitored throughout labour. I was OK with this because I was so blooming paranoid anyway that I had always planned to give birth in hospital to take advantage of the support provided by the midwifery team and consultants.
However, I had sometimes dreamt of a natural home birth but I knew that my nerves just wouldn’t allow it!
A few hours after birth, your baby’s glucose level will be checked by way of a heel prick.
A low level may show whilst your baby adjusts to producing the right amount of insulin for itself. The hospital will advise you of the next steps if this is the case but it’s usually easily rectified.
Jaundice in new babies can also be a side effect of gestational diabetes in the mother but again, this is quickly dealt with and treated.
Any medication you have been taking for the diabetes will usually be stopped immediately after the birth of your baby and your glucose levels will be tested 6-12 hours post delivery to check that they have returned to normal.
Be safe in the knowledge that gestational diabetes does usually goes away after birth but unfortunately, you will be at a higher risk of developing diabetes in the future.
You should be offered a repeat glucose tolerance test 3 months postpartum to ensure that there are no further problems.
My ultrasound scans later on in pregnancy showed that our baby girl had a very large tummy. She looked very un-proportioned on the screen and I cried so hard, my mind filled with guilt, fear and self-loathing.
At 36 weeks, they told me that she weighed around 7lb, 12oz and we arranged induction for 38 weeks. By then, it was expected that she would weigh somewhere between 9-10lb and I was terrified that she would get stuck or they’d have to use forceps to assist her.
Luckily, there is some margin of error with these scans and at 38+4 Lily was born at 7lb, 10oz and was perfectly proportioned (so try not to take them as red!)
However, upon testing Lily’s glucose levels, there was a great deal of worry as these were very low.
We were advised to feed her 50ml formula which she happily accepted and I continued to breastfeed her as normal. The next day, her levels were nice and high and we were allowed to go home, yipee!
Please don’t worry…
I’ll be honest, a diagnosis of gestational diabetes does class your pregnancy as ‘high risk’ but remember that it is easily treated and very common.
You can be reassured that you will be closely monitored (extra scans, yay!) and if your sugar levels are well controlled, there’s usually nothing to worry about.
Don’t stress and enjoy your bump! 🙂
Pretty soon you’ll have a beautiful baby (see below, our wonderful Lilybear a few hours after birth) and you’ll have new things to worry about like why their poo has gone a funny shade of green or whether the nursery is warm enough!
Have you been diagnosed with gestational diabetes or did you have this during your last pregnancy? If you’ve got any tips to offer other mummies please do let me know either using the comments below or via my social media channels.