Nhs Highland Gestational Diabetes

Download as pdf or txt
Download as pdf or txt
You are on page 1of 10

Gestational

Diabetes
Finding out that you have gestational
diabetes can be a worrying time for any
parent but there is information, help and
support for you and your baby.
What is Gestational Diabetes?
Gestational diabetes is a condition that can develop at any stage in your
pregnancy but usually the 2nd and 3rd trimester, when some of the
pregnancy hormones affect the way that insulin works in your body. Insulin
is the hormone which helps control your blood glucose. Gestational
diabetes causes glucose (blood sugars) to increase in your blood but this
usually returns to normal after you give birth.
The main thing is that gestational diabetes can be managed very well with
diet and sometimes medication such as tablets or taking insulin. You will
be supported by your midwife and receive more specialist advice from the
diabetes team. They can offer advice around food choices to manage your
blood glucose in a way that fits best for you.

Positive Glucose Tolerance Test


If you have had a positive confirmation of gestational diabetes, your midwife
will refer you to the diabetes team. Someone from the diabetes team will
phone you, but if you have any urgent queries you can call to speak to one of
them on 01463 255 950.
We want to make it as easy as possible for you to stay in touch
with the diabetes team throughout your pregnancy and we
would like to offer a remote system to help you manage your
diabetes.

It would be helpful if you were able to


1. Own a smartphone or tablet
2. Download the AgaMatrix Diabetes Manager App
3. Have access to email
4. Consent to email your blood glucose results before 5pm on
Mondays.
Don’t worry if you don’t have a smartphone as this is not
essential.

What do I do next?
You can develop gestational diabetes for different reasons. Some people
have predisposing risk factors before they were pregnant, which means that
they were always more at risk than other people at developing gestational
diabetes. For some, it can feel like it has come out of the blue. Be kind to
yourself like you would be to a friend if they received the same diagnosis.
What might you say or do? How might you be with them? We are all worthy
of the same care and compassion.
The Diabetic Team will be in contact shortly for further information and
advice.

Why do I have Gestational Diabetes?


Gestational diabetes can happen to anyone but some factors can put you at
a higher risk than others:
• A history of Polycystic Ovarian Syndrome
• Previous baby weighing over 4.5kg
• Body Mass Index (BMI) of 30 or more
• Family with South Asian, Black Caribbean or Middle Eastern origins
• Previous unexplained stillbirth
• Previous history of gestational diabetes
• A first degree relative (parent, sibling) with diabetes.

Is my baby at risk?
Now that we know you have gestational diabetes, you can be monitored
more closely to manage any potential risks and support you through
pregnancy. You will continue to see your community midwife for all your
routine appointments. You will be offered extra scans to measure the growth
of your baby.
If you’re required to start medication to manage your blood sugars, you will
be invited to a special diabetic clinic at Raigmore Hospital where you will see
a consultant and specialist nurse, who are part of the diabetes team. You will
also have contact from a dietitian, usually by telephone. These appointments
are important as they will be able to monitor you and your baby closely and
answer any questions you may have relating to gestational diabetes.
It is important to contact a midwife or the maternity unit if you have
concerns about yourself or your baby at any time during your pregnancy and
let them know that you have gestational diabetes.
What about food and eating in pregnancy?
A healthy balanced diet is important but nourishment for self-care is about
more than just what we eat. Most people know what foods are needed to
stay physically healthy, however what you eat and when you eat can also
make a big difference to how you feel.
Improving your diet may help you to cope, by:
• Improving your mood
• Giving you energy
• Thinking more clearly
Think about the changes that you can make, and sustain, and notice how it
makes you feel. Some of the options might be:
• Improving what you eat:
– Plenty of fruit and vegetables
– Including oily fish, nuts and seeds
– Trying more fibre foods – wholemeal bread, oats, peas, beans and
lentils, high fibre breakfast cereals
• Improving how you eat:
– Eating when you’re physically hungry
– Stopping when you’re full
– Recognising when you’re eating because of how you feel
– Having options to improve how you feel emotionally
• Doing regular physical activity:
– Becoming more active can seem a daunting task if you’ve not enjoyed
it in the past. Taking small steps to find enjoyable ways of moving,
stretching and relaxing your body will help build a sense of vitality. Too
often the missing ingredient in active living is fun! What activity do you
feel better in yourself for doing? Do you want time alone or as part of
a group? What makes activity fun for you? Look for something that will
work for you.
• Other things:
– Larger people are often stereotyped as not bothering about their health
and given other negative characteristics. Everybody deserves respect,
whatever their size, shape, fitness level, health status, eating patterns,
etc. Learning to look after yourself and protect yourself against these
stereotypes may be difficult, but is important.
Let’s look at this in a bit more detail...
A variety of nutritional food is essential for you and your growing baby.
Dieting in pregnancy is not recommended. Eating this way will also benefit
your mood and give you more energy.

You should continue to take vitamin D 10mg supplement that is


recommended to everyone throughout pregnancy. In Scotland, you can
receive free Best Start vitamins from your midwife. These vitamins have
vitamin D, vitamin C and folic acid.
Please ask your midwife for these vitamins if you have not already received
them. It important to remember, that only pregnancy vitamins are taken
when you are expecting a baby. Other multi-vitamins may have too much
vitamin A, which can be harmful to your baby.
Potatoes & cereals (starchy foods)
A large section of the main plate is made of potatoes, bread, rice, pasta
and other cereals or grain based foods. These are all high in starchy
carbohydrates. They give us energy. Some types also give us fibre.

Vegetables & Salad


Vegetables and salad give us fibre, water and lots of vitamins and minerals.
This is also a large part of the plate because we need plenty of these foods to
stay healthy.

Protein
Only a small amount of our plate needs to have high protein foods, e.g.
beans, nuts, cheese, fish and meat. This is shown as the smallest group.
Protein is needed for growth, repair and many other functions of the
body. When pregnant you should avoid raw or uncooked meats, liver/liver
products, pate and game meat.

Fruit & Nuts


Fruit and nuts are shown together as common snack foods. Fruit gives us
fibre, water and lots of vitamins and minerals. Nuts are a good snack as they
are high in fibre and minerals. They are also high in protein and can be used
instead of meat, fish or pulses, but in Scotland they are more likely to be
eaten as a snack.
Milk & Yoghurt
Milk and yoghurt are high in calcium. This is important for healthy bones.
They are also high in protein although be aware low fat yoghurt can be very
high in sugar
People who cannot tolerate dairy foods can choose a milk substitute that has
added calcium. Cheese is also high in calcium and protein but we’ve shown
it on the main plate as an alternative to meat, fish, beans and pulses. While
pregnant try and avoid soft cheeses as there is a chance that unpasteurised
or soft ripened dairy products may contain Listeria bacteria.

Oils & fats


We’ve not shown oils or fats on our plate as we tend not to eat them
separately. Many people like butter or spread on their bread, dressing on
their salad, stir fried vegetables, or oil for shallow frying. Use what you like in
the amounts that make sense to you. Your plate does not need to look like
this every meal. The point is that eating each of these four groups everyday
will help us feel good and stay well.
When you eat carbohydrates, they release glucose into the blood. Slow
release, low glycaemic index (low GI) carbohydrates are absorbed more
slowly, so blood glucose levels will rise more slowly, keeping them more
stable. They are often higher in fibre which is good for healthy gut bacteria.
Some examples of these include:
• multigrain and • brown rice • sweet potato
granary bread • porridge • couscous
Foods which are high in sugar should mainly be avoided as these will raise
your glucose levels, but a small amount can be eaten occasionally. Instead,
try sugar-free squash/drinks. Examples of high sugar foods include:
• chocolate • ice-creams • sweets
• biscuits • jams
• cakes • honey
Dairy and alternatives contain carbohydrates and are a good source of
calcium and protein. Seek advice from the diabetes team if using milk to
treat indigestion.
What if I want to be more active?
Being active, such as going for a walk, can not only benefit controlling your
blood sugars but is also very good for your mental health.

www.thinkhealththinknature.scot/downloadable-activities-2/
It can be difficult to be more active as you go through your pregnancy. It is
important to stay active and find an activity that is realistic for you. Some
activity is better than no activity.
During this time there can be a lot of added stress. This can have an impact
on blood glucose levels. It is important to find ways of reducing stress that
feel right for you. We feel better when we do things we enjoy.

How will I deliver my baby and will this affect my birth choices?
Everyone is different therefore this question would be best discussed with
your midwife or consultant who knows your medical background well. It is
important that you continue to share your birth choices with your midwife
and the diabetic specialist team so they can advise and support you in your
choices.
If you are diet controlled then your labour will progress as normal. If you
need insulin during pregnancy your care will be discussed individually with
the medical team.

What happens after I have my baby?


After your baby is born, your blood sugars
should return to normal. Midwives will
recommend that your baby’s blood sugars and
body temperature are monitored for a short
period of time after birth.
You will be supported in your feeding choice
following birth and supported to feed your
baby. We know that gestational diabetes increases the risk of requiring
formula supplementation for breastfed babies, so please ask your midwife
about colostrum harvesting for your baby if you would like to breastfeed.
Your midwife will discuss this with you and a colostrum harvesting pack will
be sent to you in the post. You can start collecting colostrum from 36 weeks
gestation and after labelling and freezing at home, you can take into hospital
with you either before birth or after to be stored in a special freezer until you
need it.
Your baby will remain with you on the hospital ward for monitoring. Most
babies are well but occasionally some babies do require extra help to control
blood sugar and may need to go for a short time to the neonatal unit.

What does this mean for me long term?


You will be advised to get your blood sugars checked again approximately
12 weeks following the birth of your baby by your GP. It is recommended
that you have your blood sugar level checked once a year.
Sometimes, people who have gestational diabetes are at higher risk of
developing diabetes type 2 or developing gestational diabetes again.
However, eating well, being active and discussing any concerns at an early
stage with your Midwife or GP can help manage these risks.
If you have any concerns please discuss with your midwife.
Please see links below for further information about gestational diabetes.

Diabetes UK
www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes

Diabetes UK – parent with gestational Diabetes


www.youtube.com/watch?v=8xz4VCgx-uE

NHS
www.nhs.uk/conditions/gestational-diabetes/
Content sources and references
Highland Food Guide (NHS Highland)
BDA Gestational Diabetes
Health Weight in Pregnancy (NHS Highland)
NHS Highland Gestational Diabetes Theraputic Guidelines

Produced by NHS Highland Public Health


Autumn 2022

You might also like