By guest blogger – Louise Jackson

We’ve all heard the horror stories of mothers giving birth to 12-pound babies and we’ve been terrified at the thought of it happening to us! Well, chances are the pregnant mother had undiagnosed or ineffectively treated gestational diabetes, resulting in a larger than normal baby.

It’s National Diabetes Week this week so I’d like to shed some light on this condition that affects between 5%-10% of pregnant women. The content in this blog is for brief informational purposes based on my experience only and does not constitute medical advice, see your health care professional if you have any questions or concerns regarding this condition, I have provided a link below.

When I was six weeks pregnant my GP told me I was at risk of Gestational Diabetes as I have a family history of Type 2 diabetes. As this was my fourth pregnancy I was pretty certain it wouldn’t be an issue so I didn’t rush off to be tested. Diagnosis is through an Oral Glucose Tolerance Test (OGTT). This test requires fasting for 8 hours before having a blood test to check blood glucose levels, and then drinking 75 grams of glucose and having the blood test repeated in one hour and again an hour after that. Raised blood glucose levels indicate GDM. I have no problem with needles so the blood test wasn’t ever going to be an issue for me but I had terrible morning sickness and just the thought of drinking a glucose drink after fasting for eight hours was enough to make me sick. It wasn’t until I was 15 weeks pregnant (and heard another one of those big baby horror stories) that I finally decided I should probably be tested. So off I went, starving and with morning sickness in full swing, to sit in the pathology room for two hours trying not to vomit while someone pumped what I assumed was going to be copious amounts of blood out of me. To cut a very long story short I managed to keep down the sickly sweet sugary liquid, a copious amount of blood was not required and I was subsequently diagnosed with GDM and referred to the hospital for my first check-up… asap!

So what is Gestational Diabetes Mellitus (GDM) and how is it related to big babies? In short, GDM is a condition in which the pregnant mother is unable to produce enough insulin. In pregnancy, the placenta produces hormones to help the baby develop and some of these hormones block the typical action of the mother’s insulin, a process known as insulin resistance. Due to this insulin resistance, the mother has to produce up to three times the amount of insulin as she normally would when she is not pregnant and if her body is unable to do so she will develop GDM. Most women diagnosed with GDM go on to have a healthy pregnancy and deliver a healthy baby if adequate measures are taken to maintain normal blood glucose levels. Some women may require medication to keep levels in the normal range, however, for a lot of us this can be done through diet and exercise. If blood glucose levels are not maintained the extra glucose crosses the placenta to the baby and the baby counteracts this by producing more insulin, which makes the baby grow larger. Biology 101.

Two days after my diagnosis I was sitting in a hospital room with eight other women with GDM feeling fairly confident Dr. Google had already told me everything I need to know. (Side note: Google is not your best friend and is best avoided for a stress-free pregnancy; if you have any concerns at all please speak to your health care practitioner) The Diabetes Educator was a lovely lady who told us all to snack every few hours (Easy!) and to exercise regularly. I liked the idea of snacking more than the exercise but I figured I could fit a walk-in somewhere between all the snacking and decided this whole diabetes thing isn’t so bad after all. Then the lovely lady handed us all “gift bags” and the first thing I pulled out was a sharps container and then a box of needles. I did not like this gift bag at all. Keep in mind at this point I had no problem with needles, however, I had never actually given myself a needle had I? It’s incredibly hard to inflict harm upon your self and after a great deal of procrastinating, I made my partner do my first finger prick. Pregnancy hormonal mood swings aside I had every right to be upset at his lack of hesitation in stabbing me with this big sharp needle. Okay so that’s a slight exaggeration, it’s actually a tiny needle and although it’s no butterfly kiss it’s far from the pain of a paper cut and let’s be honest here, a finger prick is not even in the same ballpark as childbirth.

The rest of my pregnancy consisted of monitoring my blood glucose levels four times a day and recording them in a diary to show the GP, the midwife, the obstetrician, the endocrinologist, the diabetes educator and the dietician. I was so over the testing and the recording and having to discuss the results with so many people and on a few occasions after not filling out my diary as frequently as I should have I felt like a little schoolgirl sitting in the principals office getting in trouble for not doing my homework. I’ll even admit I fudged the numbers a few times, either to give me lower readings or to make up for the lack of testing I was actually doing. At this stage my exercise was limited to walking from the bus stop to the hospital, which is quite cruelly located at the top of a ridiculously steep hill. It wasn’t until the endocrinologist recommended medication that I actually began taking my GDM seriously. My dietician recommended late night toasted cheese sandwiches as a last ditch effort to avoid medication, the benefits being two-fold, this delicious cheesy goodness was high in carbohydrates and when eaten late at night it reduced my fasting time between dinner and breakfast, therefore reducing the risk of my blood glucose levels rising. I am in no way recommending midnight toasted cheese sandwiches as a substitute for medication, however diet and exercise have been proven to play a crucial role in the management of GDM and I was able to avoid medication.

Most importantly I now have a very healthy six-month-old baby girl and the GDM is long gone. Once again this is just a brief outline of my experience with Gestational Diabetes and I encourage anyone with concerns or questions to speak with a health care professional. Although I don’t recommend getting medical advice from the internet there are many helpful and reputable resources online including this informational brochure below.

Gestational Diabetes – Caring for yourself and your baby