Help! I’ve got gestational diabetes and my blood glucose readings are high.

What is gestational diabetes?

Gestational Diabetes Mellitus (GDM) or gestational diabetes (GD) is a type of diabetes that occurs during pregnancy. It is diagnosed following a 2-hour Oral Glucose Tolerance Test (OGTT) at around 24 to 28 weeks of pregnancy.

Some women whose health, pregnancy or family history put them at a higher risk will also have this test early in their pregnancy.

The OGTT is a blood test ordered by your GP, obstetrician, or antenatal clinic. This is considered a ‘universal test’, which means all pregnant women should have this test.

What happens if my blood glucose levels stay too high in pregnancy?

If high blood glucose levels (BGLs) are not treated you and your baby may experience a number of problems. Women with sub-optimal BGLs are at much higher risk of developing type 2 diabetes mellitus after pregnancy. This risk increases when women are not supported to follow a healthy lifestyle during and after pregnancy. This risk is exacerbated by postpartum weight retention in the longer term.

A woman with GDM can have a baby that has an unhealthy growth pattern before it is born. Glucose crosses the placenta into your baby’s bloodstream. If your BGLs are high, your baby will receive high amounts of glucose. A baby’s insulin still works well meaning, even in utero, it is able to store this extra glucose and will grow faster and fatter.

This means the growing baby can be at risk of:

being a very large baby
being born early
being distressed during birth, and/or
having low blood glucose levels at birth.

Babies born to mums who have had sub-optimal BGLs are also more likely to be overweight or obese into their adult lives, and have diabetes themselves.

What do I do if I have a high BGL reading?

If you have a high BGL it is important to work out why so you can minimise the chance of it happening again. Ask yourself the following questions to help work out why your level might be high.

Did you eat a larger meal than usual (e.g. eating out)?

Check your serve sizes against the portions list and sample meal plan provided by your dietitian.

Did you eat too much carbohydrate?

Take care with large serves of bread, pasta, noodles and rice – these can increase your BGLs.

Try to choose slow release (low GI) carbohydrate e.g. grain bread in place of white, high fibre cereal rather than low fibre and fresh fruit rather than juice. Make sure you choose ‘slow’ rather than ‘no’ carbs.

Did you wait long enough after eating before your BGL test?

Always wait for a full hour after starting to eat a meal before testing and delay snacks until after you test.

Were your hands clean?

Always wash your hands prior to testing, dirty hands can affect your BGL reading.

Have you been taking your diabetes medication as prescribed?

If you have been prescribed insulin or other medication to manage your gestational diabetes missing this medication will cause a high BGL reading.

Were you active after your meal?

Sitting down immediately after your meal can cause a higher BGL reading than if you do some activity such as a short walk or some housework. Exercise can help to lower your BGL after a meal.

Do you need more help?

Our specialist maternal health-GDM dietitians are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. If you need support, please make an appointment to help you achieve your goals.

IMAGE CREDIT: Unsplash Rima Kruciene

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