maternity other body system disorders ), which are dangerous for both mother and baby .
As well as causing problems with pregnancy , it can also affect labour and delivery . GDM limits the choice of delivery methods and increases the risk of birth trauma , maternal injury , operative or instrumental delivery . The negative implications for the baby , short and long term , will also cause mothers anxiety . Long term , GDM places mothers at higher risk for developing type 2 diabetes later in life .
How does gestational diabetes affect the baby ? When high levels of glucose cross through the placenta to the baby , the baby must produce more insulin to control it . High levels of glucose along with high levels of insulin ( hyperinsulinism ) cause increased growth ( macrosomia ) and fat storage , meaning the baby will grow bigger and fatter than they should . It can also cause polyhydramnios ( increased fluid levels ).
Large babies may present physical difficulties at delivery , increasing the rates of caesarean section , birth trauma and injury ( such as shoulder injury from vaginal delivery ). There is also an increased risk of stillbirth and preterm birth .
After birth , babies are more likely to be admitted to a neonatal intensive care unit with hypoglycemia , jaundice or breathing difficulties . Long term , babies born with hyperinsulinism are also known to have an increased risk of developing obesity and type 2 diabetes .
What are the warning signs of gestational diabetes ? Most women don ’ t know they have GDM until it is detected with screening , so booking and attending antenatal screening is important for mothers-to-be .
A complication is that some of the symptoms of GDM are also common pregnancy symptoms , including tiredness , increased urination , dry mouth and thirst , nausea , vomiting after meals , and sweet food cravings . GDM symptoms not so commonly reported as pregnancy symptoms include blurred vision , tingling in hands and feet , and urinary tract , vaginal or skin infections .
If you ’ re pregnant and experiencing these symptoms , it ’ s important to let your doctor or midwife know so GDM can be checked for .
How is GDM treated ? Although women cannot completely get rid of gestational diabetes while pregnant , treatment is known to improve both maternal and fetal outcomes . Treatment includes selfmonitoring of blood glucose levels , dietary and exercise changes , and medication if needed . There is no conclusive evidence that gestational diabetes is caused by diet , but hyperglycemia can be lowered naturally through exercise and diet .
Stable blood glucose levels can be achieved with diet by controlling carbohydrate intake according to its glycemic index ( GI ) ( i . e . how fast the food releases sugar into the blood ). Individual tolerance to certain foods changes over pregnancy , so careful monitoring of blood sugar levels after meals will help to identify this . Portion size , the regularity of meals and drinking plenty of water each day will also help .
You can also take up some physical activities . Exercise causes the muscles to take in more glucose , naturally lowering blood glucose levels . After exercising the muscles also remain more sensitive to insulin . So , exercise reduces both blood sugar levels and insulin resistance .
Low blood sugar and GDM GDM can also cause low blood sugar , particularly if medication ( tablets or insulin injections ) is taken or in women who do not eat enough to meet the extra needs of pregnancy . Women may also alternate between the two conditions of hyper- and hypoglycemia , so regular snacks may be needed . If sugar levels remain high or unstable , insulin injections or oral medication may also be required .
Mothers with GDM will experience more clinic appointments with obstetricians , midwives , specialist nurses and dieticians who will all help in successful management . Increased monitoring of the baby ' s size and amniotic fluid levels will also be recommended .
Michelle Resco is part of the team at OT & P Annerley Midwives and has over 20 years ’ experience in nursing and midwifery .
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