Gestational diabetes is a condition where a woman who is not diabetic before she is pregnant develops diabetes in pregnancy. Some women are more susceptible to developing gestational diabetes and are in a higher risk group.

These include women who have a BMI over 30, women from certain ethnic backgrounds if you have had previous gestational diabetes or have a family history and women who have polycystic ovarian syndrome. This list is not exhaustive and if you have these risk factors you are more at risk of developing gestational diabetes; however, this does not mean that you definitely will. Equally, you can still develop gestational diabetes when you have no risk factors.

We test for gestational diabetes in a few ways. During COVID the guidelines have adjusted a little if at the time of screening there is an elevated risk of COVID-19. If you have no risk factors, then you simply need a fasting blood glucose test between 24-28 weeks. Depending on the result, you may need no further testing or you may need to do the traditional glucose tolerance test. If you have risk factors, you will be recommended an early glucose test at 16 weeks, and if this is negative you will be recommended to repeat it from 26-28 weeks. This is because you may not develop it until later in the pregnancy and your care will be adjusted to minimize risk to you and the baby. The glucose tolerance test takes several hours. You attend pathology fasted, have a blood test, drink a very sugary drink, and then have your blood tested again at 1 and 2 hours post the drink. 

So why should you get tested for gestational diabetes? 
The health of you and your baby can be impacted if you do not control your diabetes well in pregnancy. If you know you have it, you can ensure that your blood sugars are stable and so minimize the impact on you and your baby. Risk factors to you as a result of having gestational diabetes include increased bleeding at birth, associations with high blood pressure and pre-eclampsia in pregnancy, and also have an increased risk of developing type 2 diabetes later in life. Risks to the baby if you have gestational diabetes include baby growing very large, heart anomalies, term stillbirth, risk of shoulder dystocia at delivery and associated issues with that, and babies not being able to regulate their blood sugars well after birth, sometimes requiring admission to the neonatal unit.

The most important thing you can do if you have gestational diabetes is to modify your diet and activity (and medications if required) to maintain stable blood sugars. This will help your baby to grow normally, help them to regulate their blood sugars when born, keep you well, and also avoid the negative associated outcomes with uncontrolled diabetes. If you want more information, discuss with your obstetrician, midwife, GP or visit www.ndss.com.au/about-diabetes/gestational-diabetes/ where they have information and also a helpline.

Bree Lowing is a Registered Midwife and provides bulk-billed in-home antenatal and postnatal services through The Mountain Midwife www.themountainmidwife.com.au and 0491 750 795