Dr Tarig Abdalla, consultant endocrinologist and diabetologist, and chief health specialist for women at Imperial College London Diabetes Centre, Abu Dhabi, answers our questions on diabetes during pregnancy.
What is gestational diabetes?
Gestational diabetes can develop during pregnancy. It occurs because your body can’t produce enough insulin [a hormone important in controlling blood glucose] to meet its extra needs during pregnancy. This results in high blood-glucose levels. Gestational diabetes usually starts in the middle or towards the end of pregnancy. Early tests should be taken for those at high risk – which includes South Asians, those with a family history of diabetes, anyone who has had gestational diabetes in previous pregnancies, and for those who are overweight or have previously had a large baby.
How can gestational diabetes affect the baby?
If your blood glucose is too high, your baby will produce more insulin, which can make your baby grow bigger, and this increases the likelihood of having your labour induced or undergoing a caesarean section. High maternal blood glucose can also lead to serious birth problems and stillbirth. A baby that’s making extra insulin may have low blood-glucose levels after birth and is more likely to need additional care in a neonatal unit. Your baby may also be at greater risk of developing obesity and/or diabetes in later life.
How does it affect the mother?
Gestational diabetes may increase the mother’s risk of high blood pressure, as well as pre-eclampsia – a complication during pregnancy that results in high blood pressure and other symptoms such as fluid retention and high protein levels in the urine that can be life threatening. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You’re also more likely to develop type 2 diabetes as you get older, however, eating healthy foods and exercising can reduce the risk.
How can women reduce their chances of developing gestational diabetes?
• Maintaining a healthy diet that includes plenty of vegetables, fruit, protein, lean meat and lots of water.
• Exercising to help control your blood sugar levels – yoga, walking or swimming are safe during pregnancy.
• Keeping a healthy body weight.
What treatments are available for women with gestational diabetes?
For the majority of women, gestational diabetes can be managed by changing their diet and lifestyle. If that isn’t enough to keep their blood sugar under control, they may need to take tablets and/or insulin injections.
Is there a diet to keep gestational diabetes under control?
No single diet is right for every woman, so they may need to see a dietician to create a meal plan. A good place to start, however, is by limiting refined carbs, including sugary foods.
Will a woman with gestational diabetes continue to have diabetes after the baby is born?
Gestational diabetes usually gets better after birth. Women with gestational diabetes have a one-in-three risk of developing type 2 diabetes within the following five years. We advise a glucose test six to eight weeks after the baby is born. If blood glucose is in the normal range, we advise a follow-up fasting blood glucose test once a year.