Gestational diabetes and you
Women who have had gestational diabetes are more likely to develop:
- gestational diabetes in future pregnancies
- Type 2 diabetes (a lifelong condition).
Gestational diabetes
Gestational diabetes tends to reoccur in future pregnancies.
If you choose to have another baby, tell your community midwife. She will make a note of this on your maternity record.
We recommend you have a test for gestational diabetes at around 16 weeks. This can help to diagnose and treat it, if it does return.
Type 2 diabetes
All women who have experienced gestational diabetes during pregnancy have an increased chance of developing Type 2 diabetes in the future.
Within 5 years of having a baby, 5 out of 10 of these women are likely to develop Type 2 diabetes.
When your baby is about 3 months old, we recommend you book an appointment at your GP to have an HbA1c blood test.
This test will show your average blood glucose levels over the previous 12 weeks. It is a good way to make sure your blood glucose levels have returned to normal.
About Type 2 diabetes
Symptoms
As Type 2 diabetes develops, some commonly reported symptoms are:
- tiredness: constant exhaustion or feeling of weakness
- toilet: needing to pass large volumes of urine (wee) often
- thirst: drinking lots of water, but still feeling thirsty.
| !!! Book an urgent GP appointment if you experience any of these symptoms. |
Make sure you book your yearly HbA1c blood test, even if you feel well. This is because Type 2 diabetes may not give you noticeable symptoms in its early stages.
Reducing the risk of Type 2 diabetes
You can reduce the risk of developing Type 2 diabetes in the following ways:
- by following a well-balanced diet that is low in sugar
- by trying to keep as active as possible.
You can also self-refer to the Healthier You Diabetes Prevention Programme.
This is a series of NHS-approved, group-based education sessions. They can be delivered in person or remotely.
Increased risk of diabetes
If you have had gestational diabetes during pregnancy, we strongly recommend you do the following every year:
- Make a GP appointment for an HbA1c blood test.
This is because you have a lifelong increased risk of Type 2 diabetes.
Gestational diabetes and your baby
Your baby will not be born with diabetes.
However, as your baby may have been exposed to higher-than-normal blood glucose levels, it does have an increased chance of developing a low blood glucose level, following birth.
This is because it may have produced extra insulin during pregnancy. It will therefore process the glucose in its milk more quickly than normal.
To reduce the risk of this happening, your midwife will support you to:
- Initiate skin to skin contact with your baby following birth. This helps the baby to regulate their temperature and blood glucose level.
- Offer your baby a feed (breast or bottle) within the first hour of birth, during skin to skin contact.
- Continue to feed your baby (breast or bottle) whenever it shows hunger cues (at least every 2 to 3 hours).
We will also offer to check your baby’s blood glucose level, to make sure it is within normal range. We do this at your bedside, using a simple heel-prick test, prior to your baby's early feeds.
Extra observations
For 12 hours following birth, a member of the maternity team will carry out regular observations of your baby, at your bedside. These will include temperature, heart rate and breathing rate. This is to make sure they are not showing signs of hypoglycaemia (low blood glucose).
We will ask you to stay on the postnatal ward for at least 1 night following birth, so we can carry out these observations. We may ask you to stay longer if we have concerns about your baby.
If your baby’s blood glucose level is low, or we have concerns about your baby’s observations, we will ask a specialist nurse or doctor to check them.
Special Care Baby Unit (SCBU)
Some babies need extra monitoring and support in our Special Care Baby Unit (SCBU). This is rare.
The SCBU is next to the labour ward, and you and your designated birthing partner can visit the baby at any time (24 hours a day).
Advantages of breastfeeding
When a pregnancy is affected by gestational diabetes, the baby has an increased chance of developing childhood obesity and diabetes in the future.
Colostrum
From 36 weeks of pregnancy, we encourage any woman with gestational diabetes to start hand-expressing and collecting colostrum.
Colostrum is the first milk that your breasts produce. You may notice small amounts leaking from your nipples during pregnancy.
Colostrum is clear to yellow in colour and packed with energy and protective factors for your baby. It can be given to your baby following birth while you are both learning how to breastfeed. If your baby’s blood glucose level is low, giving expressed colostrum often works effectively to improve it.
We will offer you guidance (and equipment) to start hand-expressing colostrum if you feel comfortable doing so.
Breastfeeding
One of the most effective ways to reduce these risks is to breastfeed your baby. Breastfeeding brings many health benefits to both you and your baby. These include the following.
- For your baby: reduced risk of obesity, diabetes, serious ear and digestive infections, asthma and eczema for your baby.
- For you: reduced risk of diabetes, heart disease, osteoporosis (weak bones), ovarian cancer and breast cancer.
For guidance, see 'More information' below.
Returning equipment and medicines
Follow these instructions when returning equipment and medicines.
Monitor
Give your monitor to your ward midwife or community midwife. They will return it to the manufacturer for recycling.
Needles
- Tip any spare needles and testing strips into your yellow sharps box. Take care when doing this.
- Press down firmly on the lid to securely lock the box.
- Leave the box at Kingston Hospital for disposal. If you forget to do this, you can give it to your community midwife or your GP's practice.
Medicines
If you have spare Metformin tablets and/or insulin, you can:
- give them to a member of the maternity team, or
- return them to any pharmacy for safe disposal.
Leftover insulin needles need to go into your sharps box (see 'Needles' above).
Contact information
Kingston Hospital Diabetes Midwives, Monday to Friday 8am to 6pm