Gestational diabetes is managed by a team, including your doctor, midwife, diabetes educator and dietitian. You may be referred to a specialist doctor (an endocrinologist).

While gestational diabetes is a cause for concern, you can work together with your health care team to lower your blood glucose levels. You can focus on achieving a healthy pregnancy for you and a healthy start for your baby.

Why Treat?

Glucose in the mother's blood crosses the placenta, but insulin doesn't. From an early stage the baby produces its own insulin. If maternal blood glucose levels are high, the amount of glucose being transferred to the baby is high. As a result, the baby will produce more insulin of its own which promotes excessive growth and fat.

Some potential risks include:

For the baby

• A larger than normal baby (called macrosomia). This can lead to problems with delivery for the baby and the mother (a large baby makes birth more difficult and increases the risk of intervention during labour and delivery).
• Low blood glucose levels (known as hypoglycaemia). This is easily treatable, however occasionally this may require the baby being admitted to the special care nursery. Starting to breastfeed your baby as soon as possible after delivery may help to prevent this.
• Respiratory distress syndrome. Occasionally the baby may need oxygen or some other assistance with breathing.
• Jaundice. This is a yellow colouration of the skin and the whites of the eyes. Visible jaundice occurs in one third to a half of normal newborn babies. It usually does not cause a problem and can be treated.
• Risk of 'programming' the baby to develop diabetes later in life is now considered a very important reason for treating women with gestational diabetes. Babies born to mothers with undiagnosed or poorly managed diabetes are more likely to be overweight in childhood and young adulthood. There is an increased likelihood for the child to develop type 2 diabetes later in life.

For the Mother

• Delivery – there is an increased incidence of assisted delivery or caesarean section, if the baby is large.
• Predisposition to diabetes. There is a higher risk of developing type 2 diabetes later in life. Gestational diabetes does not cause diabetes; rather it unmasks a tendency that was going to develop. Up to 50% of women with gestational diabetes may go on to develop type 2 diabetes.
• There is an increased risk of developing high blood pressure in pregnancy.

How is gestational diabetes managed?

Gestational diabetes is managed by:

• Diet
• Self monitoring of blood glucose
• Physical activity
• Possibly medication if the diabetes is not well controlled. This is usually in the form of insulin injections (in some circumstances oral medication may be prescribed).