Diabetes in Pregnancy

Once the diagnosis of gestational diabetes (GDM) has been made, it is time to commence glucose monitoring. The aim is to maintain fairly tight control of your blood sugar levels ( a Blood Sugar Level between 3.5 - 7.5).

Initially, you will check your blood sugar level just before each main meal (lowest level) and 2 hours after each main meal (peak level). You will also commence a diabetic diet which is organised through a dietician (nutritionist).

• If your sugars are well controlled by diet alone, there is no increased risk to the baby, above that of a normal pregnancy. YOU ARE NORMAL.
• If your sugars are not well controlled, then you will need to see an Endocrinologist and commence Insulin injections. The need for Insulin indicates that your diabetes is significant and there are some increased risks to you and the baby. Some of these risks are dealt with by a planned delivery, earlier than your due date. There is therefore a higher chance you will need an induction of labour or caesarean section (emergency or elective).

If you follow the correct diet and your sugars are not well controlled - it is not your fault. The hormones in pregnancy are to blame and you have no control over this.

Some of the potential problems which can occur in the mother are:

• Polyhydramnios, extra fluid around the baby. This can lead to premature breaking of the waters and premature labour.
• Difficult delivery of a large baby.
• Increased risk of diabetes later in life.

Some of the potential problems which can occur in the baby are:

• Macrosomia, a big fat baby with broad shoulders.
• Difficult delivery, the shoulders can get stuck. This is an emergency.
• Jaundice after delivery.
• Low blood sugar levels in the baby after delivery, requiring intravenous glucose solution.

This is not meant to be a complete list but should alert you to the fact that this can be a serious condition.

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