Gestational Diabetes

Evidence  

https://www1.racgp.org.au/ajgp/2018/july/gestational-diabetes-mellitus 

Alison Nankervis, Sarah Price, Jennifer Conn   

It is important that all women who have had GDM have an OGTT to clearly document their glycaemic status after pregnancy, using WHO criteria for the diagnosis of diabetes. This testing is organised by either the maternity service or the woman’s GP, ideally six weeks to three months postpartum. Type 1 diabetes or monogenic diabetes may present for the first time during pregnancy, although this is uncommon. Unusual clinical or biochemical characteristics or strong family history should prompt further investigation.  

The timing and form of long-term follow-up is another area of controversy. Annual measurement of HbA1c is simple and practical and is reimbursed for diagnostic purposes in high-risk individuals. Another common recommendation is a fasting blood glucose measurement every 1–2 years, with the interval dependent on the woman’s level of risk.4 Ideally, subsequent pregnancies will be planned, enabling optimisation of pregnancy preparation and early testing for hyperglycaemia. 

Education 

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 healthcare 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. There is 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.  

It is recommended that you see your general practitioner yearly for blood pressure checks after a pregnancy complicated by gestational diabetes. You should also aim to maintain a healthy weight and exercise regularly to reduce your chance of developing both diabetes and high blood pressure later in life. 

This handy guide Life after gestational diabetes provides you with information, hints and tips to help you stay healthy.  

Empowerment 

Gestational diabetes in future pregnancies  

Many women who have gestational diabetes will develop it again in a future pregnancy. To go into your next pregnancy in the best possible health and reduce your risk of gestational diabetes, there are steps you can take BEFORE pregnancy:  

• Aim to have your weight as close to the healthy range as possible  

• Be active for at least 30 minutes each day  

• Make healthy food choices  

• Ask your doctor for a diabetes check  

• Ask your health professionals for advice on healthy weight gain during pregnancy. 

Useful Links 

Diabetes Australia 

https://www.diabetesaustralia.com.au/about-diabetes/gestational-diabetes/ 

The National Diabetes Services Scheme (NDSS)  

https://www.ndss.com.au/about-diabetes/gestational-diabetes/ 

The Royal Womans Hospital, Victoria 

https://www.thewomens.org.au/health-information/pregnancy-and-birth/pregnancy-problems/pregnancy-problems-in-later-pregnancy/gestational-diabetes 

COPE – Centre for Perinatal Excellence   

https://www.cope.org.au/getting-help/e-cope-directory/  

Panda - Perinatal Mental Health  

https://panda.org.au/  

Beyond Blue - Mental Health Support   

https://www.beyondblue.org.au/  

For When - Perinatal Depression & Anxiety Helpline - PND  

1300 24 23 22 

https://www.forwhenhelpline.org.au 

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