Gestational diabetes: screening, follow-up and everyday advice

During pregnancy, the mother’s body changes deeply, including in the way it handles sugar. In some women, blood sugar becomes too high: this is called gestational diabetes. It usually causes no symptoms, which is why screening matters.

With proper care, the vast majority of women go on to have a calm pregnancy and birth. This article explains what gestational diabetes is, who is affected, how screening works and how to keep it under control day to day.

What is gestational diabetes?

The placenta produces hormones that make insulin less effective. Insulin is the hormone that moves sugar into the cells. Normally, the pancreas compensates by producing more insulin. When it cannot do so enough, sugar builds up in the blood.

This diabetes usually appears in the second or third trimester and generally goes away after birth. It differs from diabetes that was already present before pregnancy, which is sometimes discovered at this time.

Who is affected?

Any pregnant woman can develop gestational diabetes. Some factors raise the risk, however:

• being overweight or obese before pregnancy;
• an older maternal age;
• diabetes in a parent, brother or sister;
• gestational diabetes in a previous pregnancy;
• a previous baby with a high birth weight;
• polycystic ovary syndrome.

Screening

In early pregnancy

For women with risk factors, a fasting blood sugar test is generally requested in the first trimester. It can also reveal undiagnosed diabetes that existed before pregnancy.

Between 24 and 28 weeks

The reference test is the oral glucose tolerance test. Blood sugar is measured while fasting, then you drink a sugary solution and have blood taken again one hour and two hours later. You need to stay at rest during the test. Your doctor will tell you whether you need it and will interpret the results.

Why treat it?

Poorly controlled gestational diabetes can have consequences for mother and child:

• a large baby, which can make birth more difficult;
• excess amniotic fluid;
• high blood pressure or pre-eclampsia in the mother;
• low blood sugar in the newborn in the first hours.

The good news is that these risks fall markedly when blood sugar is well controlled. Regular follow-up, including pregnancy ultrasounds, makes it possible to monitor the baby’s growth.

Managing diabetes day to day

Diet

This is the foundation of treatment. It is not about a strict diet, but about spreading food intake better:

• three meals and two or three snacks a day, without skipping meals;
• favour wholegrain starches, pulses and vegetables;
• limit fast sugars: sweet drinks, juices, pastries, honey in large amounts;
• combine protein and fibre at every meal;
• be careful with white bread and very sweet tea, which are common in our habits.

A session with a dietitian can help adapt meals to family habits.

Physical activity

A daily walk of about thirty minutes, if the pregnancy allows it, helps lower blood sugar. A walk after meals is especially useful.

Self-monitoring

The doctor may ask you to check your blood sugar with a finger-prick meter several times a day. The record of results helps adjust advice at each visit.

Sleep and stress

Getting enough sleep and managing stress also help keep blood sugar balanced. The diagnosis can feel worrying, so do not hesitate to share your concerns at each visit. Gestational diabetes is a common situation that care teams know well, and you will not face it alone. Your partner and family can also help by sharing healthier meals and walks with you.

Insulin treatment

If diet and activity are not enough, insulin is offered. It is safe for the baby and doses are adjusted regularly.

After birth

Gestational diabetes usually goes away after the baby is born. But it signals a higher risk of developing type 2 diabetes later. A blood sugar check is therefore recommended a few weeks after birth, and then regularly over the years.

Breastfeeding, a balanced diet, regular physical activity and returning to a healthy weight all help reduce this risk. In a future pregnancy, early screening will be offered.

Pregnancy care in Fes

Gestational diabetes is well managed when it is detected early and followed regularly, together with your gynecologist and, if needed, an endocrinologist or dietitian.

At Boudra Fertility Center, an IVF center in Fes, Dr Najib Boudra, an obstetrician gynecologist with more than 30 years of experience, provides pregnancy follow-up (page in French), screening for gestational diabetes and monitoring of the baby until birth. See also our gynecology page and book an appointment on 05 35 93 08 18.

Frequently asked questions

This article is for information only and does not replace a consultation. For any question about your situation, talk to your doctor.