Gestational diabetes happens when blood sugars become very high in pregnancy but return to normal after the baby is born. This happens as the body struggles to keep up with the baby’s increased requirement for insulin, which converts the sugars in food into energy. It is usually more common in the second or third trimester but can develop at any time.

New figures show that gestational diabetes has risen by 60% in 5 years. In 2018, 1 in 12 expectant Mothers would develop gestational diabetes but by 2022, this had risen to 1 in 8.

Gestational diabetes causes risk to both Mum and Baby and so it is very important that it is detected as early as possible and that it is well managed, in order to reduce this risk.

The risks to Mothers due to this include dangerously high blood pressure (pre-eclampsia), risk of stroke and heart attacks. You are more likely to develop gestational diabetes again in future pregnancies if you have had it and there is an increased risk of developing type 2 diabetes. Around half of women diagnosed with gestational diabetes will develop type 2 within 5 years.

In respect of the baby, gestational diabetes affects the functioning of the placenta, which delivers food and oxygen to the baby. This can then increase the risk of problems including:

• Larger than expected birth weight – this is can make labour and birth more difficult and increase the likelihood of needing an induced labour or caesarean section.
• Polyhydramnios, which is too much amniotic fluid – this can cause premature labour or problems during delivery
• Premature birth – early delivery i.e. before 37 weeks, significantly increases the risk of complications, such as:
  • Underdeveloped lungs
  • Bleeding to the brain
  • Digestive issues
  • Vision loss
  • Hearing impairment
  • Developmental delays
• Trouble breathing – babies born to people with diabetes may be more likely to have breathing difficulties after birth, particularly if they are born early, they may need observation or treatment in the neonatal unit
• Developing low blood sugar or jaundice after birth
• Stillbirth (in rare cases) – there is a slight increased risk of stillbirth when diabetes is not well controlled

It should be ascertained at your first antenatal appointment if you are increased risk of gestational diabetes. Obesity is the biggest risk factor, accounting for roughly half of all cases. Other risk factors are:

• If you are over 40
• you previously had a baby who weighed 4.5kg (10lb) or more at birth
• you had gestational diabetes in a previous pregnancy
• 1 of your parents or siblings has diabetes
• you are of south Asian, Black, African-Caribbean or Middle Eastern origin (even if you were born in the UK)
• you have had a gastric bypass or other weight-loss surgery

Pregnant women with specific risk factors are offered screening for gestational diabetes; this is usually an oral glucose tolerance test between 24-28 weeks of pregnancy.

You can develop gestational diabetes even if you do not have any risk factors. The symptoms to look out for include:

• Increased thirst
• Needing to urinate more
• A dry mouth
• Tiredness
• Blurred eyesight
• Thrush/genital itching

If you develop these symptoms, you should report them urgently to your midwife or doctor, so that it can be investigated whether you have gestational diabetes.

If you do develop it, you should receive extra monitoring during the pregnancy of your blood sugar levels and of the baby’s growth. You should have an ultrasound scan at around week 18 to 20 to check your baby and repeat ultrasounds at weeks 28, 32 and 36 to monitor growth and the amount of amniotic fluid, as well as regular checks from week 38 onwards.

It is also best for delivery to take place before 41 weeks if you have gestational diabetes; the ideal time to give birth is between weeks 38 and 40. However, earlier delivery may be recommended if there are concerns about yours or your baby’s health or if your blood sugar levels have not been well controlled.

Once your baby is born, their blood sugar levels will need careful monitoring; testing should start 2 to 4 hours after birth and if it is low, treatment will be needed which may require admission to the neonatal unit.

If either you or your baby have suffered harm which is related to gestational diabetes, which feel should have been avoided, please contact our Clinical Negligence Department on 01482 323697 to discuss how we can help.