Managing gestational diabetes If you’ve just been diagnosed with gestational diabetes, don’t panic. About one in seven Australian women has gestational diabetes during pregnancy Gestational diabetes usually goes away after the baby is born. Most women manage their gestational diabetes effectively and have a pregnancy and birth free of serious complications. Read Crystal’s story and experience with gestational diabetes Gestational diabetes happens when hormones made by the placenta cause the body’s insulin to not work as well as usual. This makes your blood glucose levels go up. Can gestational diabetes affect my baby? When blood glucose levels are above target during pregnancy, this can put you and your baby at risk of serious complications both during pregnancy and birth. This can include your baby growing too big, needing an emergency caesarean section or your baby needing special care when it is born. The good news is that the risk of complications is greatly reduced when gestational diabetes is diagnosed and managed. Managing gestational diabetes means that you can have a healthy pregnancy and options for your birth. If you are newly diagnosed with gestational diabetes, here are some key steps to consider. Healthy Eating Healthy eating helps keep your blood glucose levels in the recommended range and can stop you from gaining too much weight. Find out more about healthy eating, food swaps and meal plans for gestational diabetes. Regular exercise Unless you have been told not to exercise by your healthcare team, some moderate intensity exercise is good for you, your baby and managing gestational diabetes. Exercise helps reduce blood glucose levels. This means you’re more likely to keep your levels in the target range. There are plenty of pregnancy-safe activities you can try to help you get fit and strong for the birth and when carrying around that newborn. Learn more about safe exercises for gestational diabetes. Blood glucose monitoring Monitoring your blood glucose levels is an essential part of managing gestational diabetes. Generally following a diagnosis of gestational diabetes, you will be referred to the local diabetes service. The diabetes educator may provide you with a blood glucose meter or support you in obtaining one. The diabetes educator will then show you how to use the meter and perform a blood glucose check. They will recommend when to monitor your blood glucose levels and the recommended target ranges for gestational diabetes. Routinely, you will be recommended to monitor first thing in the morning (fasting) and then 2 hours after the start of your main meals. Blood glucose monitoring shows you the amount of glucose in your blood at that exact point in time. It is normal for your blood glucose levels to fluctuate and many things will impact them. Things that will impact your blood glucose levels are food, exercise, stress, illness, medication or insulin (if required) The levels can help you and your health care team decide if changes are needed – changes to carbohydrate intake, more regularly exercise, practising stress management techniques or commencing medication or insulin. It’s important to let your team know if your levels are above your target to determine if changes to management are required. It’s not because of anything you’ve done wrong, we are all different and our bodies react in different ways. Don’t be afraid to speak up so that you can get the best treatment straight away. Tablets and medication If your blood glucose levels aren’t in your target range following changes to diet and exercise, you might need to take tablets, or have insulin injections. This is to make sure your levels are where they need to be so that your risk of any complications can be minimised. Approximately 10 – 20% of women will need insulin; however, once the baby is born insulin is no longer needed. Taking tablets and insulin as directed is safe for both you and your baby. Research to date shows that these medications are safe during pregnancy. Like any medication, there are risks and side effects. Your healthcare team can explain the risks and benefits of taking medication in your situation. Where can I get more help? There are many health professionals who can help you. This includes specialist doctors, diabetes educators and dietitians. They can help you understand how to manage your glucose levels and help you to make healthy changes that work for you. For more information about gestational diabetes download our helpful factsheet, or download this guide Gestational diabetes: Caring for yourself and your baby. You can also call our helpline if you have a question about gestational diabetes. If you’re really struggling with your diagnosis, don’t be afraid to reach out. Pregnancy is stressful enough without a diagnosis of gestational diabetes too. If you’re wanting to talk about your feelings and emotions in more detail, ask to speak to our psychologist over the phone. Your emotional wellbeing Being diagnosed with gestational diabetes can come as an unpleasant shock. You may experience a range of emotions such as anger, sadness, denial or fear. As well as wondering will it hurt the baby? Or will everything be okay? This is all perfectly normal. Everyone experiences this to some degree. Getting the appropriate support and education, will help keep you and your baby healthy. If you find that these feelings become too difficult to deal with, it’s important to talk to your doctor or seek professional help. Diabetes Australia have a telephone counselling service, where you can speak with a psychologist who has experience in diabetes. Or you can talk to your own diabetes educator, GP or your local community health centre. The pressure of monitoring and managing gestational diabetes can be stressful. Stress can cause changes in your blood glucose levels and impact on your overall mental health too. It’s important not to panic. This will put additional stress on you and your baby. Tips to manage stress and keep your emotional health on track Try to set realistic expectations and practical strategies for dealing with your thoughts, feelings and emotions. Keep perspective on what you can realistically manage at the moment Accept that you can’t control everything, and Look for support from family, friends or others who can relate to your situation. Here are some ways to help keep your emotional wellbeing and mental health on track: Join a gestational diabetes or pregnancy support group Seek professional counselling if you feel overwhelmed or would like someone to talk to. Make healthy lifestyle choices, including a healthy balanced diet and enough rest Regular exercise is great for gestational diabetes and can produce natural chemicals that make you happier, healthier and make it easier to maintain a balanced perspective Make it a priority to do something that you enjoy every day. Relationships Being diagnosed with gestational diabetes can be challenging. Don’t forget family and friends can offer comfort and support. Take time to discuss your feelings with your family and friends. Most people do like to help. Talk to them about how they can best help you through this time. Post pregnancy Gestational diabetes usually goes away by itself after your baby is born and you should be able to stop taking any gestational diabetes medication after childbirth. However, some women continue to have high blood glucose levels after delivery. Before you’re discharged from hospital your medical team will run some tests to make sure your glucose levels have returned to normal. To make sure your blood glucose levels remain stable, you will be advised to have an oral glucose tolerance test (OGTT) six to twelve weeks after your baby is born. It is important not to forget, or avoid having these follow up tests. You have a 60% risk of developing Type 2 diabetes at some point in your life after a diagnosis of gestational diabetes. Your GP will do regular tests every couple of years to check for Type 2 diabetes, because of your increased risk and the symptoms are often silent and go unnoticed. However, if you do happen to notice any of the signs or symptoms of Type 2 diabetes like thirst, frequent urination, or tiredness, talk to your GP. This handy guide Life after gestational diabetes provides you with information, hints and tips to help you stay healthy. Resources The NDSS has a dedicated webpage for gestational diabetes. The webpage includes information, resources and support about gestational diabetes and information about the gestational diabetes register. Visit the Gestational Diabetes NDSS website Gestational Diabetes – Caring for yourself and your baby The NDSS has developed a booklet for women with gestational diabetes which provides comprehensive information about gestational diabetes, its management and where to get assistance. This booklet is also available to download in five other languages – Arabic, Turkish, Vietnamese and traditional and simplified Chinese. Read the Gestational Diabetes- Caring for yourself and you baby booklet Visit the NDSS website to access booklet in other languages. Life After Gestational Diabetes Booklet This booklet is sent to every woman diagnosed with gestational diabetes and is registered with the NDSS. It is designed to assist women who have had gestational diabetes, and their families to understand how to take steps to reduce their risk of developing type 2 diabetes. You can download your copy here. Australasian Diabetes in Pregnancy Society The Australasian Diabetes in Pregnancy Society is a professional body established to advance clinical and scientific knowledge of diabetes in pregnancy.