Diabetes In Pregnancy: Symptoms And Causes

Gestational diabetes is a type of diabetes that can develop in pregnancy. It affects around one in five pregnant women, and can impact on the health of both mother and baby. 

When you are already coping with the physical and emotional strains of pregnancy, discovering that you have gestational diabetes can be worrying. But there’s no need to panic. Your team will have lots of experience in dealing with diabetes and can help you control your sugar levels and stay healthy. 

With support, information, the right treatment and lifestyle changes you can remain well and protect your unborn child.

 

What causes diabetes in pregnancy?

 

Pregnancy puts extra demands on your body and your pregnancy hormones can stop the hormone insulin working as efficiently. Usually your body will respond by releasing more insulin, but when you have gestational diabetes, your body doesn’t make enough of the insulin it needs. 

Insulin is the essential hormone released when we eat, it works to allow the body’s muscles and tissues to use glucose for energy, regulates your blood sugar and safely stores any excess for the future. 

Without enough insulin for your body’s increasing needs, the glucose energy is locked out of your cells making you feel tired, weak and unwell. The unused glucose builds up in your bloodstream. Your kidneys will work hard to get rid of it, so some sugar will leak into your urine bringing with it lots of fluid. So if you’re wondering why you’ve got a raging thirst and are passing urine every few minutes, that’s the reason.

 

What are the symptoms of diabetes in pregnancy?

 

If you are feeling exhausted, constantly thirsty and spending all day on the loo- don’t assume it’s just a natural result of pregnancy. These are all symptoms of gestational diabetes. Your midwife will check for diabetes during your pregnancy, but it’s also important to seek advice if you develop symptoms between appointments. Look out for:

• Feeling more thirsty
• Tiredness
• Dry mouth
• Blurred vision
• Passing more urine
• Repeated candida infections 

However, many women with gestational diabetes will have no symptoms. The midwife will diagnose their diabetes following routine screening, blood or urine checks.

 

Who is at risk of developing diabetes in pregnancy?

 

As many as 1 in 20 pregnant women in the UK will develop gestational diabetes, so if you have diabetes in pregnancy you are not alone. There are a number of factors that can put you at increased risk. These include:

• History of gestational diabetes: if you became diabetic during a previous pregnancy, you are likely to develop it in subsequent pregnancies
• Large baby: having had a baby that weighs more than 10lbs increases your risk of gestational diabetes when you become pregnant again
• Obesity: having a BMI over 30
• Family history: a tendency towards diabetes can run in some families. You are more at risk if a close relative has had gestational or type 2 diabetes
• Ethnicity: women from Afro-Caribbean, South Asian or Middle Eastern backgrounds are more likely to develop diabetes in pregnancy

Your doctor and midwife will make a note of any risk factors and keep a close eye to ensure you and your baby remain well. However, it is also sensible to look after your own health, eat a healthy balanced diet, live an active life, and seek help if you feel unwell.

 

Screening for pregnancy diabetes

 

Gestational diabetes most commonly develops in the third trimester, often between 24 and 28 weeks. Many people will be diagnosed as having gestational diabetes before they become unwell or notice any significant symptoms. 

If you are at risk of diabetes in pregnancy, your doctor or midwife may send you for a screening test before 16 weeks. Your midwife may also identify that you’re developing diabetes during your antenatal appointments. When the blood sugar levels rise, some leaks out into the urine so that it can be picked up with dipsticks.

If your sugars start to climb between check-ups you may notice that you develop diabetes symptoms, if you are worried about gestational diabetes see your midwife or GP.

 

Ante-natal care with gestational diabetes

 

It’s important to identify gestational diabetes at an early stage and work hard to control and monitor blood sugar levels. High sugar levels can put your health at risk and affect the development of your unborn child. Uncontrolled diabetes is associated with higher levels of caesarean section, difficult births, big babies and, sadly, increased rates of perinatal death. 

The good news is that you and your ante-natal care team can work together to control your sugars and protect your health as well as that of your baby. Your team will give you blood sugar targets and a glucose monitor to help you keep a close eye on your levels. They will support you to keep your glucose levels at the optimum level for you and your baby. 

For many people, their gestational diabetes can be controlled with diet and exercise alone. That doesn’t mean weight loss, instead you should focus on a healthy balanced diet cutting back on refined carbohydrates and sugars. Tuck into fresh fruit and vegetables, plenty of fish, pulses and wholegrains and stay away from processed and fast foods, which are often high in calories and low in nutrients.

It’s not a good idea to embark on a rigorous exercise regime if you’re not used to it. Instead stay active, long walks or swims and choose the stairs instead of the lift whenever you can. Sometimes medication is also needed to get the glucose levels down. This may be tablets or sometimes you may need to inject to achieve the very best control.

 

Diabetes in labour

 

It’s a good idea to give birth in hospital so that there will be plenty of assistance and medical back-up if there are any problems during the birth or afterwards. Your blood glucose levels will be carefully monitored and you may need a drip to keep things stable if they are becoming too high or too low. 

After the birth, your baby will need to be fed regularly to keep their blood sugar levels stable. Your midwife should support you to do the first feed within half an hour and every two to three hours after that. They will also check their glucose levels with a pinprick, in the same way as you have been monitoring yours. At least 24 hours of close monitoring will be needed to check for any medical problems, make sure that breast-feeding is established or your baby is bottle-feeding well and that their blood glucose is stable.

 

Postnatal care and gestational diabetes

 

Usually your body’s insulin needs will drop dramatically immediately after the birth, so any medication will be stopped to ensure your sugars don’t become dangerously low. Your levels will be checked on discharge and again at your six-week check. However, it’s essential to see your doctor immediately if any symptoms are returning because sometimes pregnancy can reveal underlying diabetes.

 

What does gestational diabetes mean for the future?

 

If you develop diabetes in pregnancy, you have an increased risk of developing type 2 diabetes in the future, as well as having gestational diabetes in future pregnancies. But this tendency doesn’t have to be your destiny, you can make changes to help protect yourself. 

Arrange an annual blood glucose test with your GP to keep an eye on things. Try and lose weight to reach a healthy BMI, eat a balanced diet and exercise regularly. By taking control of your own weight, fitness and wellbeing, you can keep yourself healthy and well for future pregnancies and future life.

To find out more about effective diabetes medications, or to speak to one of our specialists at the London Diabetes Clinic about prospective treatment options, contact us today.

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Sources:

https://www.nhs.uk/conditions/gestational-diabetes/

https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes

https://www.tommys.org/pregnancy-information/pregnancy-complications/gestational-diabetes

https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-gestational-diabetes.pdf