Mr William Dennes from Queen Charlotte’s & Chelsea Hospital, talks to us about managing diabetes in pregnancy.
Type 1 or 2 Diabetes
If you have Type 1 or Type 2 Diabetes (a condition in which the body is unable to process sugar effectively), the chances are that you have already had conversations with your diabetes specialist and health team about getting pregnant and then managing your condition while you are pregnant. It’s important that you stay on top of your diet and insulin routines while you’re trying for a baby and even more so once you are pregnant, to ensure that both you and your baby stay well. You should also take the increased dose of folic acid.. You can get this on prescription from your doctor, as it’s not available over the counter.
Having Diabetes may increase the risk of pregnancy complications such as miscarriage and also of having a large baby (fetal macrosomia), so you may be advised to have an earlier induction of labour or a caesarean section. You should be under the care of an obstetrician for your pregnancy and birth. Babies born to diabetic mothers may themselves have health problems, which you should discuss with your Obstetrician. The key to good outcome in diabetes in pregnancy is tight sugar control.
Gestational Diabetes is a condition that develops while you are pregnant and whilst it goes away again after you have had your baby, it increases the life-time risk of developing type 2 diabetes. It can come on at any time, but is more common in the second and third trimester. It is a condition in which your body becomes unable to produce enough insulin, the hormone that controls your blood sugar levels. With careful management of the condition and its symptoms, both you and your baby should be fine.
There are a number of risk factors for Gestational Diabetes including, increased Body Mass Index (BMI) (over 30), if your family is southern Asian, Afro-Caribbean, Middle Eastern and Chinese, if you had Gestational Diabetes during a previous pregnancy or if you had a baby weighing over 10 lbs (4.5kg) before. It may be completely without symptoms, though you may be thirsty more often, need to pass urine more often or have a dry mouth. For women at an increased risk of gestational diabetes, a glucose tolerance test (GTT) is arranged usually at 28 weeks (although sometimes earlier).
If your blood test picks up Gestational Diabetes, you’ll be given a blood testing kit so that you can keep a close eye on your blood sugar levels. You will be given dietary advice on how to reduce your blood sugar levels and you may need tablets (such as Metformin) or insulin injections to control your blood sugar levels.