12.4% of women in Brisbane are affected by Gestational Diabetes during pregnancy.

In fact, it is also the fastest growing type of diabetes in the country according to diabetes Australia.

What exactly is Gestational Diabetes?

Gestational Diabetes Mellitus (commonly abbreviated to GDM) is a condition that affects the blood sugar levels in women during pregnancy. Prior to pregnancy, these women have normal blood sugar levels but during pregnancy they will experience elevated blood sugar levels.

This is caused by hormones that are produced by the placenta during pregnancy. These hormones help babies grow and develop, but also block the body’s insulin from performing its normal function of helping to convert glucose into energy. As a result, a woman’s pregnant body may struggle to produce the required amount of insulin to regulate her glucose levels and will end up with elevated blood sugar levels (hyperglycemia).

Although many women with gestational diabetes experience no obvious symptoms, it can still cause damage to the body. That’s why all obstetricians should be testing for it during pregnancy.

How is GDM diagnosed?

GDM is universally diagnosed using a Glucose Tolerance blood test.

Gestational diabetes generally presents in the second trimester (the 24^th – 28^th week of pregnancy) which is why testing and diagnosis is normally recommend by obstetrics specialists around 26-28 weeks. However, an obstetrics specialist should make a recommendation based on your risk factors. For example, if you have pre-existing diabetes or a family history of diabetes, they may recommend you are testing earlier.

Risks associated with GDM for the mother

• 50% risk of developing type 2 diabetes within 10-20 years – this is seven times higher than women who have never had gestational diabetes
• 30% risk of gestational diabetes occurring in in a subsequent pregnancy
• Risk of preeclampsia, a disease during pregnancy that can lead to high blood pressure, damage to multiple organs and if untreated, maternal seizures

Risks associated GDM for the baby

• Increased risk of obesity, metabolic syndrome and both gestational and type 2 diabetes
• Risk of the baby being larger than average (macrosomia) which may create complications during delivery, and increasing the likelihood of requiring a surgical delivery or emergency operations
• When GDM is poorly managed, it can also lead to intrauterine foetal death.

Managing gestational diabetes

Any pregnancy involving gestational diabetes is considered high risk so it is important that the pregnancy is managed accordingly.

The conservative approach to managing gestational diabetes is focussed on exercise and improving the diet and this is where I generally start with most of my patients. However, if lifestyle and behavioural changes are not enough to control blood sugar levels, medication such as tablets or insulin injections may also be recommended.

Planning for the delivery is also particularly important for pregnancies affected by GDM, as babies weighing 4.5kg or more may require early induction of labour or an operative delivery in the form of a C-section.

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