Gestational Diabetes is a form of diabetes that can only bediagnosed in pregnant women. Please refer tothe previous chapter ‘Gestational Diabetes’ that concentrates on risk factorsand the methods used to diagnose gestational diabetes.

Inthis article we are giving advice to women with gestationaldiabetes:

Ifyou are pregnant, you have had your Glucose ToleranceTest (GTT) and the result was abnormal, you were diagnosed withgestational diabetes. The next step is referral to a gestational diabetesspecialist (Consultant specialising in pregnancy diabetes) and Dietician forfurther care and regular visits.

Andwhat can you expect during your visits to the gestationaldiabetes specialist?

· At the first visit –the woman is usually shown how to test her blood sugar at home and is providedwith a blood glucose monitoring kit (normal blood glucose ranges are 3.5 to7mmol/L).

· Dietetic advice willbe given on how to control your diabetes through your diet.

· Additional bloodtests would be taken during visits to check that the long-term glucose is alsowithin limits.

· Extra ultrasound testmight be needed to make sure the baby is growing fine.

· The woman should beable to meet with a diabetic midwife and discuss her birth plan.

· The baby of the womanwith the gestational diabetes should be delivered before 41 weeks.

· 6 weeks after thebaby is born – a GTT should be carried out and reviewed by the GestationalDiabetes Consultant.

Itis important to mention, that the primary aim of gestational diabetes controlis always to maintain a normal blood sugar through diet control and life-stylechanges, and/or administering insulin if necessary.

Thechanges that you can make to your diet and life-styleinclude:

· Eat regularly, 3 meals per day.

· Cut down on sugar, sugary foods and sugary drinks.

· Choose foods low in saturated fat.

· Choose food with complex carbohydrates (pasta,rice, wholemeal bread).

· Eat more fruit and vegetables.

· Use less salt.

· Keep active during your pregnancy (alwayscheck with your midwife on safe exercise).

Insome cases, if the control of your gestational diabetes is not adequate throughdiet control and life-style changes, you mightneed to start administering insulin. Insulinshould be only started by the diabetes specialist and closely supervised by thediabetes midwife or the diabetes nurse specialist, who will explain all aboutinsulin and the injecting technique.

Ifat any stage of your pregnancy, you experience increased thirst, increasedfrequency to urinate, raised blood sugar levels, or fatigue, always contactyour Doctor.

Gestational diabetes is a type ofdiabetes that may occur only in pregnant woman. The risk of being diagnosedwith gestational diabetes is higher in women, who present with risk factors that include:

-       Obesity- especially if the woman’s pre-pregnancy BMI is30 and higher,

-       Familyhistory of type 2 diabetes,

-       Maternalage of 35 years and higher,

-       Ethnicity,and

-       Previoushistory of gestational diabetes.

If your midwife oryour GP recognises that you might be at a higher risk of developing gestationaldiabetes, you will be offered a Glucose ToleranceTest (GTT), which can diagnosegestational diabetes.

The Glucose Tolerance Test is usually carried out duringthe second trimester, typically between 24^th and 28^thweek of pregnancy, which is the time when gestational diabetes usually arises.Though, if you had gestational diabetes before, the GTT will usually beperformed earlier on in the second trimester.

What does GTT involve and what to expect?

The Glucose Tolerance Test can be describedin 6 stages:

1/ when booking yourGTT – you will be asked to eat a normal diet, as you would normally do, withoutany alterations.

2/ the evening beforethe test – you will be asked to stop eating before 10pm and have nothing to eator drink after that time, with the exception of water that you can drink freelyat any time as required. (If you take any regular medications, check with yourGP, who will advise you which are safe to take.)

3/ in the morning of thetest – you will arrive in the special clinic where the test will be carriedout. On arrival, the nurse will checked that you haven’t eaten since last nightand then will take a blood test.

4/ after the firstblood test – you will be asked to drink a measured amount of a sugary drink.

5/ you will then beasked to wait in the clinic for two hours (usually in a quiet sitting room).You should spend the two hours resting, sitting quietly, reading a magazine ora book, as any physical activity may have an impact on the test results.

6/ after the two hours– the nurse will take the second blood test, and you will be offered a drinkand a sandwich or a toast (depending on the clinic). Once you are ready you cango home and the clinic will phone you with the results in the afternoon.

Most midwives recommend that you relax and restfor the rest of your day, as the glucose tolerance test is starving your bodyand is quite demanding on your body and your growing baby.