DC2 was 9lb11 (4.4kg) at birth even though I did not have GD. He also had shoulder dystocia. I did have GD with DC3 (I was 36).
I had an appointment very quickly where I was given info and a diet sheet and given a blood glucose monitor. I had to test my blood sugars 4 times a day: before breakfast, one hour after breakfast, one hour after lunch, one hour after dinner. I recorded all these measurements in a book, and I had appointments every fortnight at the diabetes clinic at the maternity. At those appointments I was weighed and had BP, then a chat with the consultant and the dietician. I had a growth scan at 32 weeks. I was told I would be induced between 38-40 weeks, and not let to go beyond 40 weeks as a diabetic placenta ages more quickly.
The diet was simple (though boring) enough. Small meals, low carb, obviously no pudding, easy on fruit and protein snacks in between meals. Breakfast was tricky as it is when sugars are highest. Apart from the odd high reading (target was no more than 5.6 in the morning, no more than 7 after meals) I managed to control the diabetes with diet alone.
If I had needed insulin I would have been induced at 38 weeks, so I was induced at 39 weeks. I think at that point they were more worried about the shoulder dystocia than the diabetes, otherwise they probably would have let me hit 40 weeks. As it turned out I was induced 2 days before my due date.
The induction went as followed: I had a sweep at 38 and 39 weeks. Then on the day I was monitored, then given a pessary, to which I reacted very strongly. I was in established labour within 1 hour, though was stuck at 2-4 cm for 7 hours. Once the gel stopped having an effect they broke my waters. The baby shot out within 11 minutes (ouchies). Throughout labour I was on the FHB monitor (wireless so I could move) and my blood sugar was tested every hour (if it had gone high, I would have been put on an insulin drip). I was not allowed the birthing pool (which was a shame as I had laboured in it for the other two and found it helpful as I also have SPD/PGD). I was also not allowed in the MLU.
As soon as the baby was out they stopped checking my blood sugar and I could eat all I wanted (cue lots of white toast and sweet tea!). The baby was 8lbs6 (3.8kg). Post birth, he had to have 4 CONSECUTIVE normal blood sugar tests over 24 hours (before each feed) to check his sugars so neither could be released (not that I wanted to!). They checked his blood by doing a heal prick. He was fine and breastfeeding fine. We ended up staying 2 nights, but the second night was because he had a rash that needed to be checked out (it was caused by being born so quickly). I was encouraged to breastfeed to reduce BOTH our chances of developing diabetes. If I BF my odds are calculated at developing diabetes within 10 years. If no BF within 3-5 years.
I repeated the GTT after 6 weeks, it came back clear. I need to test every year now.
I quizzed the consultant lots. He said that the majority of women manage on diet alone, and very few that were diet control needed insulin during birth. The ones who struggle the most are the ones who have high readings first thing in the morning. They are also the ones who tend to develop "proper" diabetes sooner.
My baby is 3.5 months, breastfeeding fine and on the 75th percentile for weight. He is perfect. I worry that he is now at higher risk of diabetes because of me, but tbh it is in my family so his odds were high. I am overweight, he was my 3rd, having a previous baby over 4kg is also a risk factor and being over 35. I was pretty much ticking all the boxes! If we ever had a 4th I would be tested even sooner as developing GD again would pretty much be a given.
Don't worry though, there are worst things that could happen during pregnancy, and if your hospital is anything like mine you will be in safe hands.