Can anyone tell me the real risks associated with Gestational Diabetes?

[sillysow]

Hi

I am hoping you can help.

I realise there is a fabulous thread on here about support and help for those with Gestational Diabetes. But I am hoping someone could tell me the real risks/liklehoods and implications of GD.

I cant seem to find a lot of factual info on the net, which surprises me. Or maybe I am just looking in the wrong places.

TIA

I have pre-exisint diabetes, which carries more risks.

For gestational diabetes I think the main risk is that the baby will put on excess weight due to the raised sugar in your blood. This can lead to delivery complications, shoulder dystocia etc.

I know that diabetic Mums can have reduced amniotic fluid and lung maturation can be affected, assumed this applies to GD as well as well as pre-exisitng.

All risks can be well-managed by following the presribed dietary/medical regime.

i had gd with DS1 and have it again now. main issues are that baby might get too big and they'll either induce you early or go for CS. In my case they induced on due date as he wasn't scanning big but it didn't work and ended up with a CS for "failing to progress". He had a little low blood sugar when born so was given formula straightaway (within the first 12 hours anyway) so if you have strong feeling about that I would talk to your MW (I did go on to successfully mix feed for four months so don;t panic if your LO does need formula). They do usually try to manage it first with diet, then with a drug called Metformin and then insulin if you really need it. If you do have it, my main advice would be to make sure that they deal with you as an individual and your specific case, not just follow the GD policy of the hospital.

My mum went in to labour naturally 3 weeks premature at nearly 12lbs! Both were fine at the time but mum went on to develop Type I diabetes less than a year later which obviously has had complications and implications long-term.

I have type 1 diabetes (insulin dependent) and have now stopped looking on the Internet about the risks as it's too scary and depressing - birth defects etc. But in terms of gestational diabetes as it mostly develops after the first 12 weeks you are out of that danger as the baby is already formed - it's just a big fat bub you have to be beware of! That's my understanding of it anyway :-)

OK, well the main risk of uncontrolled GD are a large baby which can cause a problamatic vaginal birth (eg shoulder dystosia where the baby can get "stuck")]. The baby may also suffer from hypoglycemia (low blood sugar) after birth (which is where the potential for the pushing of formuala feeding comes in.)

There is also a risk of stillbirth as prolonged high glucose can prematurely age the placenta and it can simply "fail". This is the reason that many hospital protocols are to induce at around 38 weeks for some GD patients.

HOWEVER, there is no reason in the world to expect that you will suffer any of these complications if you have been promptly diagnosed and don't intend to ignore all medical advice from here on in and sit aroud eating donuts

First line of support should be a low GI diet. Basically low carb and no refined sugars. You will have to check your blood sugars several times a day (usually first thing in the morning and 1 hour after every meal)

If you can't keep your sugars within range by diet (and many people including myself can't) then you will be offered metformin or insulin. It's easy to feel that you have failed if you get to this point, you really haven't.

You should be offered regular scans to monitor your baby's growth.

IMO your own blood sugar readings and scans should give you some indication as to how things are progressing and may need managing (eg early induction) rather than a standard hospital protocol but do be warned that it can be an uphill struggle sometimes.

Do use the support thread, it's great.

Good luck. And don't forget it's all worth it when you hold your baby in your arms.

Hi cupcakebakerer

how far along are you? I have type 1 diabetes and have my first joint clinic appt on Wednesday (Obstetrician and Diabetes Consultant). I am 6 weeks today.

Sorry for hijack.

Hi falling and laughing! I'm 19 weeks now. To be honest with you the intense worry and guilt that I'm somehow damaging our unborn baby has subsided - I think I'm all worried out and I'm just relaxing into the pregnancy now (ish) and trying to enjoy. Your team will prob tell you to get your sugars under 7.8 within an hour of eating which I just found impossible without hypo after hypo afterwards. I went with the diabetes uk guidelines which says 2 hours and now aim for one and a half. It's been so tough but I hope I'm getting there and all seems ok to this point - 20 week scan soon so we're praying all will be ok. When were you diagnosed? A huge plus for us is the amount of monitoring we get. Also I started a support thread for us type one girls if you can find it? If not I can comment on it and bump it up :-) p.s congratulations - you must be thrilled!!

Hi Cupcake,

I didn't know there was a support thread, I will try to find it.

I was aiming for 7.8 within an hour of eating and, like you was finding that I was getting loads of hypos. Saw my diabetes nurse on Wednesday and she was very reassuring, told me to aim for the 2 hour mark. It has been a lot easier! I was feeling racked with guilt about some high sugars I had (stuffing my face with cake without covering it the day before I found out I was pregnant) but again my nurwse has been great and out my mind at ease. Can't wait for my first scan. it doesn't feel all that real at the moment and sometimes I worry it is a bad sign, but I am sure seeing the baby will make it all a bit more real!

We are really excited. The baby wasn't planned, but we were about to start trying so it is amazing timing.

Hi falling, it's reassuring to hear someone else has been through the same thing. The diabetes nurses and staff do their best but sometimes I think you have to have diabetes to realise just how hard it can be to achieve those targets. Reassuringly I aimed for the two hours for the first trimester and my hba1c was still 5.9 which me, hubby and my team at hospital were thrilled with, so it can be done!! My God - I'm 19 weeks and still don't feel preggers so don't you worry about that! If you want to private message me and ask anything at all don't hesitate - I know how hard it is to have not just the normal worries of pregnancy but also the bloody diabetes! I recently moved hospital and my new people are so lovely - was told that the guilt thing is VERY common amongst type 1 pregnant diabetics and that made me feel more normal. Hope your 12 scan goes well - it freaked me out but was still lovely and came out with big grin.

Thank you very much for all your replies. Anyone know where I can find some stats?

Sillysow, not sure what stats you are looking for but there is good basic data on reputable sites such as Diabetes UK, BUPA, NHS Direct (I think). The NICE guidelines are also online somewhere, there is a link somewhere on the Support thread if google doesn't work for you (on my phone so can't link for you now). It's a massive document but relatively easy to navigate and there's loads of good data there. HTH