Gestational diabetes: how it can impact mother and child and how to ensure a healthier future

Studies show about 50% of women with gestational diabetes – diabetes diagnosed in pregnancy – go on to develop Type 2 diabetes. But don’t panic: with meticulous management and expert care, you can ensure a healthy future.

The hormonal connection

In gestational diabetes, a hormone made by the placenta prevents the body from using insulin effectively, says Dr Martin de Villiers, a physician at Mediclinic Cape Town. Glucose builds up in the blood instead of being absorbed by the cells.

Women who are overweight, over the age of 35 or who have a family history of diabetes can be at risk, so it’s essential to get your blood sugar tested early in pregnancy.

“Ideally, you should get tested before you fall pregnant,” Dr de Villiers says. “If you’re planning to have a baby, ask your doctor to do a blood test to measure your glucose levels so you can devise a plan to stay healthy during pregnancy.”

The risks

Gestational diabetes can lead to heavier babies and this comes with complications, Dr de Villiers explains.

The baby could get stuck in the birth canal, endangering the life of both mother and child. And because gestational diabetes can cause changes in the placenta, it can affect the supply of nutrients and oxygen to the baby and lead to stillbirth.

This is why it’s vital to know whether you have gestational diabetes, De de Villiers says. “A healthy eating plan, moderate exercise and, in cases where lifestyle intervention isn’t enough, medication can be prescribed to get your glucose levels under control.”

Navigating a healthy future

Once you’re safely delivered of your baby, you need to be screened to see if your glucose levels are returning to normal.

“Tests need to be done at four weeks and then at 12 weeks post-partum,” Dr de Villiers says. “Don’t be lulled into a false sense of security and think the pregnancy is over now so everything is okay. A test will show you whether or not your body is effectively processing glucose.”

This involves having a blood test done by your doctor. “A finger-prick test you can get at a pharmacy isn’t sufficient in the post-partum period,” Dr de Villiers says. “It might miss insulin resistance and it’s vital that this is tested.”

After the 12-week period, the body “settles down” to its pre-pregnancy state. “The pregnancy hormones have been washed out and your body should be back in a non-partum state,” Dr de Villiers says.

“If you’ve had gestational diabetes, you should get your blood sugar tested once a year by doing a finger-prick test. It’s only in the post-partum period that you need a blood test for more comprehensive screening.”

Gestational diabetes can “go away” after the birth – but if your glucose levels remain high in the post-partum period, you could be at risk of Type 2 diabetes.

Babies born of mom with gestational diabetes should have no long-lasting health effects, Dr de Villiers adds. “Except of course they could be at risk of developing Type 2 diabetes or gestational diabetes later on.”