You will have more regular appointments and will see more specialist healthcare professionals.
Extra appointments during your pregnancy
As soon as you are diagnosed with gestational diabetes through tests, you will be offered an appointment with a specialist team within one week. It will probably be at your local pregnancy diabetes clinic and should start to receive extra care straight away.
At this point you should have the HbA1c test to check whether you had type 2 diabetes before you became pregnant.
You will have contact with the diabetes and antenatal team every one to two weeks throughout your pregnancy. This may be clinic appointments, or by phone or email to check that everything is fine.
"At first it was quite overwhelming. I was a borderline case but all of a sudden you’ve got a dietician and an obstetrician… Before, it had been just the midwife."Michelle, mum of two
Monitoring your glucose levels
One of the most important things that you will have to do for the rest of your pregnancy is to measure your blood glucose levels at points during each day. Your healthcare team will teach you how to do this for yourself. They will also review you regularly, to check your results and make sure your diet, exercise and any medication are keeping your blood glucose levels under control.
As well as the routine scans offered to all pregnant women, you should be offered extra scans at various points through your pregnancy to check how your baby is growing and how much amniotic fluid you have. The timing of these scans may depend on your individual case.
These scans are important because one of the biggest risks in gestational diabetes is that the baby grows bigger than normal (macrosomia). This can cause complications when it comes to labour and giving birth. The team will need to check your baby’s size regularly and will talk to you about the best options for the birth of your baby. Towards the end of your pregnancy you will be checked very regularly to make sure that all is well.
"I was reassured that they were keeping an eye on me. At least I could see the baby was OK."Gemma, mum of one
Your team will give you plenty of information and advice about your care leading up to and after the birth. From around 38 weeks you will have appointments to check that your baby is doing well.
When to give birth
Your team will advise you to give birth no later than 40 weeks and 6 days if you are in England and Wales. Elective birth (by inducing labour or by caesarean section) will be offered if you have not given birth by this time.
In Scotland, you will be advised to have labour induced within 40 weeks.
- NICE (2015) Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period, National Institute of Health and Care Excellence https://www.nice.org.uk/guidance/ng3
- NHS Choices [accessed April 2015] Gestational diabetes - treatment http://www.nhs.uk/Conditions/gestational-diabetes/Pages/Treatment.aspx
- SIGN (2010) Management of diabetes, a clinical guideline, Scottish Intercollegiate Guidelines Network http://www.sign.ac.uk/pdf/sign116.pdf
Help and support managing gestational diabetes
For most women, glucose levels return to normal the moment the baby is born, when your hormones return to their natural levels, and you will stop any treatment immediately.
Today, for women with gestational diabetes, the emphasis is on trying to keep the birth as normal as possible unless there is a particular reason to do things differently.
Some women can control their glucose levels through diet and exercise alone but the majority will need to take tablets or injections to help control it.
If you have gestational diabetes, you will have been told that gestational diabetes holds risks to the mother and baby, but women tell us they are not always clear exactly what those risks are.
Women with gestational diabetes often do not have any symptoms at all, and this is why women are all monitored for it by routine checks in pregnancy.