Gestational diabetes: Australian information and care

If you have been diagnosed with gestational diabetes, your pregnancy diabetes team can help you understand monitoring, treatment and follow-up. Care is tailored to your pregnancy and blood glucose results.

What is Gestational diabetes?

Gestational diabetes is high blood glucose first diagnosed during pregnancy. You needn’t have ever been diagnosed with diabetes in order to get this during your pregnancy.

Gestational diabetes is managed with blood glucose monitoring, an individual eating plan and suitable physical activity. Some women also need medicine, such as insulin injections or metformin, to keep their blood glucose within their target range. Treatment is tailored by the pregnancy diabetes team. Read Diabetes Australia’s gestational diabetes guidance. Check out our recommendations on healthy options for eating and drinking during pregnancy.

After delivery, gestational diabetes usually goes away, though it increases your chances of getting Type 2 diabetes at a later stage in life. It can also affect the health of the baby, so you need to take certain steps to ensure the well-being of you and your baby.

What causes Gestational Diabetes?

Insulin is a hormone, produced by the pancreas when you eat; insulin helps regulate the level of glucose in your blood by moving it to the cells which use it for energy. What happens during pregnancy is that the placenta makes hormones that cause glucose levels to rise in the blood. Normally the pancreas are able to manage the glucose levels by sending out enough insulin. However, if it is unable to produce enough insulin, the sugar levels in the blood rise, causing gestational diabetes.

When do you get Gestational Diabetes?

Testing is usually offered at 24 to 28 weeks, but some people need earlier testing based on their history and risk factors.

What are the signs of gestational diabetes?

Most women don’t have active symptoms or gestational diabetes signs and tend to find out about it during a routine prenatal screening.

However certain common patterns have been noticed which include:

Being thirstier than usual
Being hungrier and eating more than the regular
Excessive urination frequently
Fatigue which maybe confused for pregnancy fatigue

How do you diagnose GD?

If you are high risk category then your doctor will check you earlier than usual; else the time for getting this test is between 24 to 28 weeks in the second half of the pregnancy.

In Australia, diagnosis usually uses an oral glucose tolerance test (OGTT), with blood taken while fasting and one and two hours after a glucose drink. Follow your pathology service’s preparation instructions. Your care team will explain the results. See NDSS testing guidance.

If these tests are normal but your fall in the high-risk category, the doctor may test your blood glucose levels from time to time.

Gestational diabetes cannot always be prevented. Healthy habits can help reduce risk, but they do not guarantee that gestational diabetes will be avoided.

Can gestational diabetes be prevented?

Gestational diabetes cannot always be prevented. Healthy eating and regular physical activity can help reduce the risk, and a healthy lifestyle before pregnancy can also make a difference. These steps do not guarantee that gestational diabetes will be avoided. Read NDSS gestational diabetes FAQs.

Discuss suitable physical activity with your healthcare team.
Ask a diabetes dietitian about an individual eating plan, including suitable carbohydrate types and portions spread across regular meals and snacks.
Ask your care team about appropriate weight gain during pregnancy.

What problems can Gestational Diabetes cause for you and your baby?

If you have gestational diabetes and you are not being able to control the blood sugar levels, it could cause problems for both you and the baby.

An Extra-Large Baby and C-Section

High blood glucose levels during pregnancy can increase the chance of having a larger baby and needing interventions during birth, including a caesarean. However, gestational diabetes does not automatically mean a caesarean is needed. Birth planning depends on the health of the mother and baby and how the pregnancy progresses. Read Healthdirect’s guidance on gestational diabetes.

High Blood Pressure or Preeclampsia

Pre-eclampsia is a serious pregnancy complication that usually develops after 20 weeks. It causes high blood pressure and can affect organs such as the kidneys, liver and brain. Many women have no noticeable symptoms, so regular antenatal checks are important. Severe cases can cause seizures or stroke, and an early birth may be recommended to protect the mother and baby. Severe headaches, vision changes, pain under the ribs or sudden swelling require urgent medical assessment. Read Healthdirect’s guidance on pre-eclampsia.

Low Blood Sugar or Hypoglycaemia

Insulin can sometimes cause low blood glucose. If you use insulin, ask your diabetes team how to recognise and treat a hypo and when to get urgent help. The baby is prone to developing low blood sugar post birth incase the mother’s diabetes was not controlled during the pregnancy – in this case the baby’s blood sugar needs to be monitored post-delivery.

Tips for women with gestational diabetes: diet and exercise

1. Gestational diabetes eating plan

Follow a meal plan tailored to pregnancy and your glucose results by your diabetes dietitian.
Fruit and other nutritious carbohydrate foods can fit your plan, but portions and how you spread them through the day still matter.
Spreading carbohydrate foods across regular meals and snacks can help manage blood glucose levels. The number, timing and size of meals and snacks should suit individual needs, with guidance from a dietitian. See Diabetes Australia’s eating-plan guidance.
Fibre-rich foods, including vegetables, legumes, fruit and wholegrain breads and cereals, can form part of a balanced eating plan for gestational diabetes. A dietitian can help tailor food choices and portions to pregnancy nutrition needs and blood glucose results.
Healthy fats can be included in a balanced eating plan. The focus is on choosing healthier fats and limiting saturated fat, with food choices and portions tailored by a dietitian.
Take supplements as advised by your doctor.

Carbohydrates are an important source of energy and nutrients in pregnancy. A diabetes dietitian can help you choose suitable types and portions, spread across meals and snacks. Lower-GI choices may help manage glucose levels, but portions still matter. Needing medication does not mean you have failed. See NDSS advice on eating well and medication.

2. Exercise regularly

Regular physical activity can help manage gestational diabetes. Suitable activities, their intensity and their duration depend on the pregnancy and any complications, so an activity plan should be discussed with the healthcare team. Activity can be divided into shorter sessions. Read the Australian physical activity guidance for pregnancy.

3. Keep a check on your blood glucose

Monitor your blood glucose as advised by your diabetes team. They will explain your targets and whether you need medicine to help manage your levels.

Get tested for diabetes after pregnancy

After gestational diabetes, an oral glucose tolerance test is recommended 6–12 weeks after birth, or as soon as possible afterwards. Ongoing diabetes checks are generally recommended every 1–3 years, even when the first result is normal. A GP can advise on the test and timing based on previous results, individual risk factors and plans for another pregnancy. Read NDSS advice on health checks after gestational diabetes.

Keep following up with your maternity and diabetes teams throughout pregnancy and after birth.

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