About gestational diabetes
Approximately 4-5% of all women develop diabetes during pregnancy. The body’s sugar metabolism is strained by pregnancy hormones during pregnancy, which means the body needs to produce more insulin to maintain normal blood sugar levels. A person develops diabetes if their body cannot produce enough insulin.
Most women’s blood sugar levels return to normal shortly after giving birth.
Gestational diabetes typically doesn’t have any symptoms. However, high blood sugar levels during pregnancy can be unhealthy for the baby. Gestational diabetes can put you at higher risk of high blood pressure, pre-eclampsia, excess amniotic fluid or premature delivery.
How gestational diabetes can affect your baby
When your blood sugar levels rise, so do the blood sugar levels of your baby. High blood sugar levels for extended periods of time are not healthy for the baby. Gestational diabetes can cause problems such as:
A large baby
If your baby intakes too much sugar during the pregnancy it can grow larger than usual, which can cause issues during delivery. We track your baby at additional ultrasounds every 4-6 weeks. In some cases, we recommend inducing labour. We will discuss this with you.
Low blood sugar
The baby may experience low blood sugar the first few days after delivery if you had high sugar levels during pregnancy. In these cases, the baby would have produced extra insulin while in the womb, and it can take several hours before insulin production decreases after birth.
We measure the baby's blood sugar 2 and maybe 4 hours after birth. The doctor ordinates whether you can go home or you should stay. Low blood sugar is best managed by breastfeeding or by feeding the baby milk in a cup.
Jaundice
Your child has a slightly increased risk of developing jaundice when you have had gestational diabetes. Jaundice usually develops 3-5 days after birth, and in some cases will require treatment using light therapy.
Obesity and type 2 diabetes
The baby has an increased risk of developing type 2 diabetes or obesity later in life. Breastfeeding can have a preventative effect.
Expressing milk by hand during pregnancy
It is normal to begin producing milk (colostrum milk) in small quantities in the middle of your pregnancy. Your colostrum is better than formula at stabilising the baby's blood sugar and can be used after delivery if the baby has low blood sugar or to prevent the baby from developing low blood sugar. You can start expressing the milk by hand from the 36th week of pregnancy.
In this link you can see a short video about expressing milk:
Danish video about expressing milk
The colostrum must be stored in a freezer and should be transported to the hospital in a cooler bag.
You should stop expressing the milk by hand if it hurts or if you begin experiencing Braxton Hicks contractions.
Treatment during pregnancy
Gestational diabetes can be treated by changing your diet and being physically active, although it may become necessary to take insulin.
Diet
You will be offered a meeting with a dietician, who can help you develop an eating plan. Eating the right food can prevent your blood sugar from getting too high.
Being physically active Physical activity can help lower your blood sugar. We recommend being moderately physically active at least 30 minutes every day, for exampling by walking, riding a bike, or swimming.
Insulin
If your blood sugar does not return to normal levels by changing your diet and being physically active, then it will be necessary to take insulin. 20-25% of women with gestational diabetes will need to take insulin.
Checking your blood sugar
You should keep an eye on your blood sugar throughout the pregnancy. After being diagnosed, you will need to check your blood sugar levels 6 times a day the first week:
- Before breakfast.
- 1½ hours after you started eating breakfast.
- Before lunch.
- 1½ hours after you started eating lunch.
- Before dinner.
- 1½ hours after you started eating dinner.
Your blood sugar level should be between 4-5,5 mmol/l before meals, and between 4-7 mmol/l after meals.
Extra check-ups
You will be invited for additional check-ups during your pregnancy if you have gestational diabetes.
Prevention and treatment after delivery
Diet and exercise
It is important that you maintain a healthy diet and continue being physically active after delivery.
Checking your blood sugar
If you followed a certain diet or taken insulin during pregnancy, we recommend you continue checking your blood sugar the first 2 days after delivery. You should check your blood sugar 6 times a day. Your blood sugar should be under 10mmol/l approx. 1½ hours after you started eating a meal.
Preventing type 2 diabetes
You have an increased risk of developing type 2 diabetes if you have had gestational diabetes. 50% of women with gestational diabetes will develop type 2 diabetes later in life.
You can help prevent diabetes from developing by:
- exercising at least 30 minutes every day
- eating a healthy diet
- losing weight if you are overweight
Breastfeeding your child can be preventative.
Check-up
In the vast majority of cases, gestational diabetes goes away by itself within a few days of delivery. You will be invited for a check-up of your sugar metabolism approx. 8 weeks after delivery, so we can check your blood sugar and insulin levels.
We recommend booking an appointment for a check-up with your general practitioner every 1-3 years to check whether you have developed type 2 diabetes.